THE MILD ALZHEIMER PROJECT

It’s a prospective study on the natural history of early cognitive impairment and Alzheimer's disease (The Mild Alzheimer Project) started on January 1st, 1996 in the Alzheimer Unit of our Institute. Patients enrolled in The Mild Alzheimer Project had cognitive impairment due to primary cause and the Mini Mental State Examination [28] (MMSE) was of 18 or higher. Enrolled patients underwent a standardized clinical, neuropsychological, and instrumental evaluation. Follow-up evaluation was made every year for two years.
A multidimentional protocol evaluated the following aspects:
- General information and history collection
- Cognition:
Mini Mental State Examination (Folstein 1975)
Clinical Dementia Rating (Morris 1993)
Ideomotor apraxia (Spinnler, Tognoni 1987)
Orofacial apraxia (Spinnler, Tognoni 1987)
Token Test (Spinnler, Tognoni 1987)
Boston naming test (William 1989)
Verbal fluency (name and categories) (Novelli 1986)
Wisconsin Card Sorting Test (categories, errors and perseverations) (Heaton 1981)
Rey’s figure copy and recall (Rey 1968)
Digit Span FW and BW (Wechsler 1981, Orsini 1987)
Raven PM color (Raven 1965, basso 1987)
Corsi test (Spinnler, Tognoni 1987)
Attentional matrix (Spinnler, Tognoni 1987)
Recognition of unfamiliar test (Benton 1975)
- Function:
Barthel Index (Mahoney 1965)
Activities of daily living scale (Lawton 1969)
Direct Assessment of Functional status (Loewenstein 1989)
Bedford Alzheimer Nursing Severity Scale (Volicer 1994)
- Behavior:
Neuropsychiatric Inventory (Cummings 1994)
Caregiver’s stress (Cummings 1994)
- Mood
Geriatric Depression Scale (Yesavage 1983)
Hamilton Depression Scale (Hamilton 1967)
Cornell Depression Scale (Cornell 1988)
- Physical health:
Use of drugs
Nutritional state and Mini Nutritional Assessment (Vellas 1994)
Number of diseases (Geenfield 1987)
Somatic symptoms
- Neurological features and motor status
Neurological objective examination
Arms and legs strength
ROT of arms and legs (Hallet 1993)
Primitive reflexes (Jacobs 1980)
Extrapyramidal signs (EPS) (Richards)
Tinetti scale (Tinetti 1986)
Hachinski Ischemia Score (Hachinski 1975)
Physical Performance Test (Reuben 1990)
- Insight
Anosognosia Questionnaire Dementia (Migliorelli 1995)
Guidelines for the Rating of Awareness Deficits (Verhey 1993,Vallotti 1997)
Clinical Insight Rating scale (Ott 1992,Vallotti 1997)
- Instrumental assessment
Blood count and chemistry profile, ECG, EEG, Ecodoppler TSA
CT and SPET