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February 1989

A Comparison of Dementia in Alzheimer's Disease and Multiple Sclerosis

Author Affiliations

From the Departments of Psychiatry (Drs Filley and Heaton), Neurology (Drs Filley, Burks, and Franklin), and Preventive Medicine and Biometrics (Dr Franklin), the Rocky Mountain Multiple Sclerosis Center (Ms Nelson and Drs Burks and Franklin), and the Neuropsychology Laboratory (Dr Heaton), University of Colorado School of Medicine, Denver. Dr Heaton is now with the Department of Psychiatry, University of California, San Diego.

Arch Neurol. 1989;46(2):157-161. doi:10.1001/archneur.1989.00520380061013

• We compared results of comprehensive neuropsychological testing in 42 patients with clinically diagnosed Alzheimer's disease (AD) and in an equal number of patients with clinically definite chronic-progressive multiple sclerosis. Age, sex, and education were controlled using demographically corrected T scores based on a large normal sample. Both groups showed significant impairment on the test battery, but the degree of dementia was more severe in the patients with AD. A deviation score analysis, controlling for overall level of cognitive impairment, revealed significant differences between the groups. Alzheimer's disease was associated with relatively greater impairment of learning, memory, and verbal skills, whereas the MS group showed greater relative impairment of attention, incidental memory, and psychomotor functions. These data suggest that both the degree and pattern of mental impairment differ in patients with AD and patients with multiple sclerosis. Our results support a distinction between "gray matter" and "white matter" dementia, and may help clarify the issue of "cortical' vs "subcortical" dementia by demonstrating neuropsychological differences based on secure neuropathologic distinctions.

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