Differential diagnosis of cortical and subcortical demantial syndromes by praxis tests

Introduction and Objective: Dementia is a progressive clinical situation that is accompanied by at least one of cognitive functions such as language, orientation, praxis, abstract thinking and problem solving. Alzheimer's disease (AD) accounts for more than 50% of all dementia cases. Parkinson's disease Dementia (PD) occurs in a rate of 30-40% in the course of Parkinson's disease. AD is classified as cortical and PD is classified as subcortical dementia syndrome. It is known that cortical dementia frequently has high cerebral dysfunction such as apraxia. In this study, it was aimed to determine whether practical bedside praxia tests can be useful in differential diagnosis of cortical and subcortical dementia syndromes. Metod: 34 Alzheimer 's disease, 31 Parkinson' s disease dementia, 29 mild cognitive impairment and 28 healthy subjects followed at Outpatient Clinic at Department of Neurology Cukurova University Faculty, were included in the study. Complete blood count, liver / kidney / thyroid function tests, vitamin b12, folic acid levels and cerebral imaging were evaluated. In addition, minimental sititation test (MMSE), clock drawing test (CDT) , and DEKODa and AST tests which are the tests of experimental status and apraxia screening tests were performed. All data were compared among the groups. SPSS version 21.0 was used for statistical analysis of the data, p <0.05 was considered statistically significant. Results: There was a significant difference between all groups in terms of MMSE, CDT, DEKODa and AST scores (p <0.001). DEKODa and AST test scores were significantly lower in Alzheimer's disease compared to the other groups. The cut-off value was 12 for DEKODa and 10.5 for AST. Sensitivity and specificity for DEKODa were 76.5% and 100%, respectively; For AST, the sensitivity was 79.4% and the specificity was 100%. Conclusion: This work has shown that DEKODa and AST tests can be used in practice to differentiate Alzheimer's disease from subcortical dementia. The easy application of the tests has shown that it is suitable for both research and clinical application. Key Words: Alzheimer, Apraxia, Dementia, Parkinson