Trajectories of cognitive decline differ in hippocampal sclerosis and Alzheimer's disease

Denis S Smirnov; Douglas Galasko; Lawrence A Hansen; Steven D Edland; James B Brewer; David P Salmon

doi:10.1016/j.neurobiolaging.2018.11.015

Trajectories of cognitive decline differ in hippocampal sclerosis and Alzheimer's disease

Neurobiol Aging. 2019 Mar:75:169-177. doi: 10.1016/j.neurobiolaging.2018.11.015. Epub 2018 Nov 22.

Authors

Denis S Smirnov¹, Douglas Galasko², Lawrence A Hansen³, Steven D Edland⁴, James B Brewer⁵, David P Salmon⁶

Affiliations

¹ Neurosciences Graduate Program, Medical Scientist Training Program, University of California, San Diego, La Jolla, CA, USA.
² Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA.
³ Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA; Department of Pathology, University of California, San Diego, La Jolla, CA, USA.
⁴ Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA; Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA.
⁵ Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA; Department of Radiology, University of California, San Diego, La Jolla, CA, USA.
⁶ Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA. Electronic address: dsalmon@ucsd.edu.

PMID: 30579145
PMCID: PMC6492933
DOI: 10.1016/j.neurobiolaging.2018.11.015

Abstract

Hippocampal sclerosis (HS) is a prevalent cause of dementia in the oldest old but is generally misdiagnosed as Alzheimer's disease (AD) due to similarities in clinical presentation. To determine if clinical and cognitive features diverge over time, we compared results from longitudinal evaluations of participants in the University of California, San Diego, Alzheimer's Disease Research Center with autopsy-confirmed AD (n = 195), HS (n = 21), or both HS + AD (n = 18). Each group exhibited decline in all cognitive measures, with HS declining at a slower rate than AD on the Mini-Mental State Examination, immediate recall condition of a word-list learning test, and Dementia Rating Scale total and subtest scores (except memory). Five years before the final evaluation, more prominent semantic and visuospatial deficits were apparent in AD participants than in HS participants despite comparable global cognitive impairment. Groups did not differ on any measure of executive function. HS + AD differed from AD only on the Boston Naming Test. Overall, results suggest that HS dementia is associated with cognitive deficits that progress more slowly than, but generally mimic, those observed in AD.

Keywords: Alzheimer's disease; Cognitive decline; Hippocampal Sclerosis; Longitudinal; Neuropsychology.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Alzheimer Disease / pathology*
Alzheimer Disease / psychology*
Autopsy
Cognitive Dysfunction / pathology*
Cognitive Dysfunction / physiopathology
Female
Hippocampus / pathology*
Humans
Male
Memory, Short-Term / physiology
Nervous System Diseases / pathology
Nervous System Diseases / psychology

Abstract

Publication types

MeSH terms

Grants and funding