Objective: The aim of this study is to compare behavioral problems andMRI findings in patients with mild dementia based on 3 types of etiology.

Material and method: 14 patients with AD (mean age, 72 years), 10patients with vascular dementia (mean age, 61.5 years), and 5 patients withsemantic dementia (mean age, 58 years) were enrolled in the study. Allpresented mild dementia. The diagnosis of dementia was confirmed byclinical criteria NINCDS-ADRDA, the imaging findings (MRI) and Hamiltonscale of depression were used for the appreciation of depressive feelings.

Results: Bilateral hippocampus atrophy was found in 70% of the patientswith AD, patients with SD presented asymmetric hippocampus atrophy,more extensive than AD. The following domains were evaluated: globalcognitive ability, episodic memory, executive functioning, verbal ability,visuo-spatial skill, attention, perceptual speed, and primary memory. Ofinterest was whether there would be systematic differences among differentcognitive domains and mood manifestation.

Discussions: Clinical differentiation of VD from AD has remained difficult.SD patients had lower scores than AD, while VD patients on fluency andconfrontational naming (both tasks depend on semantic knowledge). In ADpatients low scores on confrontational naming were generally associatedwith low performance on the Mini Mental State Examination (MMSE), butamong semantic dementia patients the typical pattern was one of lowconfrontational naming with relatively higher MMSE scores. We believe thathippocampus atrophy predicted decline only in those without lacunes.Neither lacunes nor white matter hyperintensity independently predicteddecline.

Conclusions: Patients with semantic dementia show a progressivedeterioration in their semantic knowledge about people, objects, facts andthe meanings of words. They seem to possess relatively preserved day-to-day(episodic) memory. Patients with VD have more severe behavioral retarda-tion, depression, and anxiety than those with AD when the groups havesimilar levels of cognitive impairment.

doi:10.1016/j.jns.2009.02.297

Cognitive impairment as functional outcome predictor in patients withischemic stroke

N.I. Usolteva, M.A. Dudarova, O.S. LevinDepartment of Neurology, Russian Medical Academy of Postgraduate Education,Moscow, Russia

Objective. Cognitive impairment is found in a majority of the patientswith ischemic stroke; however, its relation to functional outcome in patientswith of ischemic stroke remains unclear. The aim of the study was toestimate the relation of cognitive impairment revealed in the acute period ofischemic stroke with functional outcome in 6 month after stroke.

Methods. Sixty patients (32 men and 28 women) with an ischemic strokeare evaluated. Age of patients varied from 44 to 80 years (on the average –

63.4±10.0 years). Cognitive functions were evaluated with Short Test ofMental Status (STMS) and comprehensive battery of quantitative neuropsy-chological tests. Evaluation of cognitive functions was spent in 3 weeks, 3and 6 months after stroke. The severity of neurological deficit was assessedwith NIH Stroke Scale (NIHSS). The functional outcome was estimated with amodified Rankin scale at 6 months after stroke.

Results. Cognitive impairment of variable severity was revealed in 43patients (72%) at 3 weeks and in 34 patients (57%) at 6 months after stroke.The STMS score was correlated with the NIHSS score (r=−0.57, р=0.008).Rankin scale score at 6 months after stroke was correlated with age, NIHSSscore, presence of heart failure, but did not depend on arterial hypertensionseverity or other vascular risk factors. Rankin scale score in 6 months wasassociated with STMS score (r=−0.41, p=0.03), delayed recall in verbalmemory test score (r=−0.58, p=0.004), logic memory score (r=−0.47,р=0.03), block design test score (r=−0.58, р=0.006). According logisticregression older age, higher NIHSS score and lower STMS score indepen-dently diminished likelihood of a good outcome.

Conclusion. Presence of cognitive impairment can be considered aspredictor of poor functional outcome of ischemic stroke.

doi:10.1016/j.jns.2009.02.298

Prospective memory function in stroke patients

H.J. Kima, L. Luob, H. Limc, J.E. Weenc,d, F.I.M. Craikb,eaDepartment of Rehabilitation Medicine, Eulji University School of Medicine,Eulji Hospital, Seoul, South KoreabDepartment of Psychology, University of Toronto, Toronto, CanadacKunin-Lunenfeld Applied Research Unit, Baycrest, Toronto, CanadadDivision of Neurology, Department of Medicine, University of Toronto,Toronto, CanadaeRotman Research Institute, Baycrest, Toronto, Canada

Background and Aims: Prospective memory (PM) is the ability toremember to perform intended activities in the future. Impairment of PMcan be a limiting factor for daily life, including social integration. PM deficitsamong stroke survivors are a poorly understood contributor to disability. Thisstudy assesses PM function in stroke survivors.

Methods: Twelve stroke patients and twelve controls, matched for ageand education, were included. Background neuropsychological measuresincluded MMSE, Trails A and B, Verbal Fluency phonemic (FAS) and semanticcategories, Sustained Attention to Response Task (SART), Revised StrategyApplication Test (R-SAT), Verbal Paired Associates I, II (Verbal PA), andCalifornia Verbal Learning Test (CVLT). PM was assessed by: Memory forIntentions task (MIT), the Virtual Week (VW), Remembering a Belongingsubtest from the Rivermead Behavioral Memory Test, Prospective andRetrospective Memory Questionnaire.

Results: Patients performed worse than controls in FAS, SART commissionerror, Verbal PA I and CVLT T-score(p<0.05). MIT provided three measures:PM and RM components for the intentions and an associative recallperformance. There was a significant interaction effect between the groupsand the component (p=0.016), such that patients showed deficits in the PMcomponent but not in the RM component. Associative recall performanceshowed patients performing worse than controls but an ANCOVA withassociative recall as a covariate did not change the result. For VW, patientsperformed worse on the time-check task; proportions of correct responsesand misses (p<0.01).

Conclusions: These results suggest that stroke patients show deficits inPM performance, especially in more demanding tasks. Findings in PM andmemory function measures suggest that PM deficits may be attributed toproblems of self-initiation.

doi:10.1016/j.jns.2009.02.299

Cognitive status is impaired in apparently recovered stroke survivors

G. Ortega, M. Quintana, M. Ribo, O. Maisterra, E. Santamarina, M. Rubiera,R. Delgado-Mederos, C.A. Molina, J. Alvarez SabinNeurovascular Unit, Hospital De La Vall D'Hebron, Barcelona, Spain

Aim: The cognitive status of stroke patients with total functional recoveryremains unknown. We aim to determine different cognitive functions in“recovered” stroke patients at 6 months.

Methods: We prospectively studied consecutive stroke patients with amodified Rankin Scale score (mRS) <=1 at 6 months. All patientsunderwent a complete neuropsychological evaluation including: attentional,information processing speed, visuospatial, learning and memory, languageand executive functions. All scores were adjusted by age, education and werestandardized (0–100). Global cognitive status was defined as the mean scoreof all individual functions. Scores<40 determined impaired functions.Clinical and demographic data were also collected.

Results: 47 patients were studied, mean age was 65 and 28% were female.Mean years of education was 9. 38 (81%) patients had an ischemic stroke, ofthem 4 had a TIA. On admission median NIHSS scorewas 3; at discharge 1 and23% had a mRS of 1 at 6 months. Most subjects (59.6%) had a global cognitiveimpairment (GCI). Languagewas affected only in 4% of patients. The remainingcognitive functions were impaired in more than 50% of subjects beingexecutive ability themost affected (72 %). GCI was higher among patients withintracerebral hemorrhage (100% Vs 50%, p=0.006). Other variables asso-ciated with GCI were: previous stroke (p=0.027) and no-smoking(p=0.032). Initial stroke severity was not associated with GCI (p=0.57).

Abstracts / Journal of the Neurological Sciences 283 (2009) 240–320 319

Conclusions: In most self-sufficient stroke survivors with apparently nolimitations in daily activities a neuropsychological evaluation proves animportant cognitive impairment. Commonly used outcome measures may beinsufficient to evaluate full recovery.

doi:10.1016/j.jns.2009.02.300

Quality of life in patients with vascular mild cognitive impairment

M.M. Sagova, N.I. Usolteva, O.S. LevinDepartment of Neurology, Russian Medical Academy of Postgraduate Education,Moscow, Russia

Objective. Vascular cognitive impairment (VCI) is an entity associatedwith vascular damage of the brain resulting in cognitive dysfunction of awide spectrum from mild cognitive impairment to vascular dementia. Thequality of life (QL) of patients with VCI is poorly understood especially inpatients with mild VCI. The aim of the study was to estimate medical factorsinfluencing QL of patients with mild VCI.

Methods. We investigated 90 patients with mild VCI (52 men and 38women, mean age 67.5±10.6 years) that had score 3 on Riesberg GlobalDeterioration Scale, a MMSE score of more than 24 and focal or diffusevascular changes on MRI (0.5 T scan). We used the EQ-5D scale for QLassessment and comprehensive neuropsychological battery for evaluation ofseveral domains of cognitive functions: verbal and visual memory, attention,language, abstraction, visuospatial and executive functions, praxis. Forassessment of motor dysfunction we used Tinetti balance and mobility scale(TBMS) and scale of pseudobulbar syndrome and for measure of affectivedisorders—Beck depression inventory (BDI).

Results. EQ-5D values correlated to a degree of cognitive dysfunctionmeasured with digit symbol constitution test (r=0.34, p<0.05), Rey–Osterrieth complex figure test (r=0.68, p<0.01), block design test (r=0.33,p<0,05), grammatical and phonetic associations number in verbal fluencytests (p<0.05) categories achieved and number of perseverative responseson Wisconsin Card Sorting Test (r=0.30, p<0.05, r=−0.39, p<0.01). Therewere no correlations between EQ-5D values and total severity of cognitivedysfunction. We also found that EQ-5D values correlated to TBMS score(r=0.51, p<0.05), pseudobulbar scale score (r=−0.4, p<0.05) andseverity of mood disturbances, assessed with BDI (r=−0.42, p<0,001).

Conclusion. These results suggest that QL of patients with mild VCIcorrelates with the severity of executive and visuo-spatial cognitivedysfunction, postural instability and gait disorder, pseudobulbar syndromeand mood disturbances.

doi:10.1016/j.jns.2009.02.301

Olfactory discrimination testing does not differentiate between vasculardementia and Alzheimer's disease

M. Vyhnaleka,b, H. Magerovaa,b, J. Laczoa,b, J. Horta,baDepartment of Neurology, 2nd Medical School of The Charles University, Prague,Czech RepublicbMotol University Hospital, Prague, Czech Republic

Background and aims: The early impairment of olfactory identificationin Alzheimer disease (AD) iswell knownand is considered to be causedmainlyby degeneration in anterior olfactory nucleus, entorhinal cortex and amygdala.

The smell identification impairment has been demonstrated also invascular dementia (VD). The anatomopathological substrate of this impair-ment has not yet been determined. The previous data on the degree ofolfactory impairment in VD have been contradictory.

The aim of this study was to evaluate the degree of olfactory dysfunctionin VD patients and to compare it to AD.

Methods: 19 patients with mild AD according to NINCDS-ADRDA criteria(mean MMSE=21), 12 patients with vascular dementia according to NINDS-AIREN criteria (mean MMSE=22) and 18 healthy aged matched controlsunderwent a multiple choice olfactory identification test with 18 differentodors developed in our memory clinic.

Results: Both AD and VD patients showed considerable impairment inolfactory identification test compared to controls (p<0,001). The differencein olfactory test score between AD and VD was not significant (p>0.5). Themean score (and interquartile range) for VD, AD and controls were 9.1 (5.1);8.7 (2.0); and 15.7 (2.5), respectively. The results of the smell testsignificantly correlated with MMSE in AD but not in VD patients.

Conclusions: The severity of olfactory identification impairment is similarin VD and AD patients. We found a lack of correlation with disease severity inVD contrasting to AD and greater interindividual data variability in VD, asexpressed by the interquartile range. This demonstrates greater hetero-geneity of smell impairment in VD and reflects possible different anatomo-pathological substrates involved in olfactory impairment among VD patients.

Supported by GAUK grant 7910/2007, internal grant of the MotolUniversity Hospital and GAŒR grant 309/05/0693.

doi:10.1016/j.jns.2009.02.302

Effects of multisensory stimulation on cognition, depression and anxietylevels of mildly-affected Alzheimer’s patients

Leyla Ozdemir, Nuran AkdemirHacettepe University, School of Nursing, Medical Nursing, Turkey

Aims: The purpose of this study was to investigate and assess the effectsof musical therapy, painting inanimate–animate object pictures, andorientation to time–place–person interventions on the cognitive state,depression, and anxiety levels of mildly-affected Alzheimer’s patients.

Methods: The study using a quasi-experimental design was conductedwith 27 mildly-affected Alzheimer’s patients. The effects of the multisensorystimulation were evaluated with the “Mini Mental State Examination,” the“Geriatric Depression Scale,” and the “Beck Anxiety Scale.” All of these wereadministered 1 day prior to beginning the study, immediately after itscompletion, and 3 weeks thereafter.

Results: A significant negative correlation was determined to existbetween the MMSE-depression scores and MMSE-anxiety scores; thecorrelation between the depression–anxiety scores, on the other hand, hada positive significance. The shifts over time in the MMSE, depression andanxiety scores were significant.

Conclusion: The primary conclusion of the study is that the multisensorystimulation method applied to mildly-affected Alzheimer’s patients had apositive effect on their cognitive state, depression, and anxiety, and that thiseffect continued for three weeks following completion of the studyintervention, with a tendency to decline progressively.

doi:10.1016/j.jns.2009.02.303

Abstracts / Journal of the Neurological Sciences 283 (2009) 240–320320