Poster Presentations P2S348

cases were selected from the Alzheimer Disease Research Center (ADRC),

which performed comprehensive cognitive testing, and were divided into

three age groups (70-79 (Control n ¼ 7, AD n ¼ 137, DLB n ¼ 53), 80-

89 (Control n ¼ 7, AD n ¼ 197, DLB n ¼ 39), and �90 years (Control n

¼ 2, AD n ¼ 64, DLB n ¼ 6)). Neuropathological markers were assessed

for AD and DLB and were correlated with clinical measurements of cogni-

tive impairment and severity of dementia. Protein levels of tau and amy-

loid-beta were also assessed by immunohistochemistry. Results: The

results demonstrate that with increasing age, the proportion of DLB cases

as a percentage of total (DLB and AD) cases decreased. In the DLB cases,

LB pathology was lower in the older patients than younger ones and in

AD cases neuropathological burdens were inversely related to age. For

AD, cognitive impairment was also least severe in the oldest age group,

but cognitive impairment did not vary with age in DLB. Extent of AD neu-

ropathology correlated well with severity of AD dementia in the two younger

age groups, while synaptophysin immunoreactivity was more strongly asso-

ciated with severity of dementia in the older age groups in AD and DLB.

Conclusions: Neuropathology in both AD and DLB is less severe in older

subjects and synaptophysin is better associated with cognitive impairment

in the very elderly.

P2-118 THE RELEVANT OUTCOME SCALE FOR

ALZHEIMER’S DISEASE (ROSA): A NEW

INSTRUMENT FOR DAILY MEDICAL PRACTICE

Steven Ferris1, Serge Gauthier2, Ralf Ihl3, Philippe Robert4, Bengt Winblad5,

V. Holtoff6, K. Sternberg7, Frank Tennigkeit8, 1New York University,Langone Medical Center, New York, NY, USA; 2McGill Centre for Studies in

Aging, Verdun, QC, Canada; 3Maria-Hilf Hospital, Krefeld, Germany;4CHU-Universite de Nice Sophia Antipolis, Nice, France; 5Karolinska In-stitutet, Alzheimer Center, Stockholm, Sweden; 6Universitatsklinikum Carl

Gustav Carus, Dresden, Germany; 7Merz Pharmaceuticals GmbH, Frank-

furt, Germany; 8Merz Pharmaceuticals, Frankfurt, Germany.

Contact e-mail: frank.tennigkeit@merz.de

Background: To develop a new multi-domain scale for assessment of Alz-

heimer’s disease (AD) progression and response to therapy in daily medical

practice. Methods: The Relevant Outcome Scale for Alzheimer’s disease

(ROSA) was developed after a comprehensive literature review of existing

scales for clinical practice and extensive discussions with medical practi-

tioners, caregiver experts and opinion leaders. Practice-relevant endpoints

for AD treatment were compared with the AD relevant domains covered

by different scales used as standard measures of cognition, activities of daily

living and behaviour in patients with dementia. Other rating instruments such

as scales for assessment of communication skills, social competence and pa-

tients’ quality of life were considered for the comparison, too. Results: The

ROSA includes items grouped in 6 dimensions as follows: cognition, com-

munication, behavior, function/ADL, quality of life and caregiver burden.

The items contribute to assessing the actual disease status of a patient in terms

of patient impairment and behavior and also provide a global clinical evalu-

ation of patients’ quality of life and caregiver burden. Each ROSA-item is

rated from 0 to 10 on a numeric scale. Higher scores indicate higher patient

abilities/quality of life and smaller caregiver burden. The item assessment is

based on a given situation (‘‘scenario’’) specific for each AD severity stage

(early, mid, and late). Choosing the right scenario for a patient is based on

the global impression for AD severity stage set by the clinician prior to the

first use of ROSA. Conclusions: The ROSA is a new AD rating tool for clin-

ical practice, covering a wide spectrum of AD symptoms and applicable to all

stages of AD severity.

P2-119 JAPANESE VERSIONS EQUIVALENT TO ORIGINAL

ENGLISH NEUROPSYCHOLOGICAL TESTS IN

ADNI

Morihiro Sugishita1, Isao Hemmi2, Takashi Iwatsubo3, Japanese ADNI,

ADNI, 1University of Niigata Rehabilitation, Murakami, Japan; 2The Jap-

anese Red Cross College of Nursing, Tokyo, Japan; 3University of Tokyo,

Tokyo, Japan. Contact e-mail: morihiro_sugi@ybb.ne.jp

Background: The number of international research project and that of global

clinical trials are increasing in the field of Alzheimer Disease. This situation

urges researchers to develop the non-English versions equivalent to original

English neuropsychological tests such as MMSE, CDR, Logical Memory,

ADAS-COG and so on. In non-English speaking countries, such equivalent

versions are prerequisite to collect the Alzheimer Disease, the MCI, and the

normal groups equivalent to the groups in the English speaking countries,

since neuropsychological tests are employed as the inclusion or the exclusion

criteria to classify the population into the AD, the MCI and the normal group.

We, Japanese, joined an international research project in US, namely, the

Alzheimer Disease Neuroimaging Initiative (ADNI) since 2007 and devel-

oped new versions of 6 neuropsychological tests(MMSE,CDR, GDS-S,

ADAS-COG, NPI-Q and FAQ). Methods: To create the equivalent version,

erroneous translation and unnecessary adaptation were avoided. Psycholin-

guistic data are employed to adapt cultural differences between US and Ja-

pan. Some comparisons between the Japanese ADNI data and the US-

ANDI data are in progress to clarify whether or not the new Japanese ver-

sions are equivalent to the 6 original English tests.In order to clarify whether

the original MMSE and MMSE-J are equivalent or not, the data of original

English MMSE in the US-ADNI and those of MMSE-J in the Japanese

ADNI were analyzed with regression analysis. Results: Excluding subjects

with depression, race origin other than white and Japanese, less than 8 years

of education and so on, 699 subjects in the US-ADNI and 224 subjects in the

Japanese ADNI were available. The dependent variable of the regression

model was the score of original English MMSE and that of MMSE-J. To con-

trol their effects on the test score, age, years of education and APOE geno-

type were used as independent variables besides nation. The results

showed the insignificant effect of nation and the significant effects of, age,

years of education and APOE genotype on the MMSE score. Conclusions:

These findings implied that both versions of MMSE were equivalent.

P2-120 MOTOR INTENTIONAL DISORDERS IN VASCULAR

MILD COGNITIVE IMPAIRMENT AND VASCULAR

DEMENTIA OF SUBCORTICAL TYPE

Chi Hun Kim1, Doo Sang Yoon1, Kihyo Jung2, Geon Ha Kim1,

Sook Hui Kim3, Byung Hwa Lee1, Sang Won Seo1, Heecheon You2,

Duk L. Na1, 1Department of Neurology, Sungkyunkwan University School ofMedicine, Samsung Medical Center, Seoul, Republic of Korea; 2Division of

Mechanical and Industrial Engineering, Pohang University of Science and

Technology, Pohang, Republic of Korea; 3Department of Neurology,

Konkuk University Hospital Konkuk University School of Medicine, Seoul,Republic of Korea. Contact e-mail: chkim0707@hotmail.com

Background: Damage to premotor and prefrontal regions results in motor

intentional disorders (MIDs) that disrupt initiation, maintenance, and termi-

nation of volitional movements. Mild cognitive impairment associated with

small-vessel disease (subcortical vascular MCI, svMCI) has been reported to

be a prodromal stage of subcortical vascular dementia (SVaD). svMCI pa-

tients are characterized by frontal executive dysfunction and cortical thinning

predominantly in the frontal regions. We aimed to investigate the severity of

MID in patients with svMCI using force dynamometer that is considered to

be one of the most sensitive methods to detect MID. Methods: Participants

consisted of 27 svMCI, 10 normal controls, 20 amnestic MCI and 14 SVaD

patients. The force control capabilities of the index finger were evaluated in

four phases (initiation, development, maintenance, and termination). The

force control test was repeated six times in the patient groups and four times

in the control group. Results: svMCI showed lower performances than nor-

mal control in force development and maintenance tasks. svMCI also showed

lower performances compared to aMCI in force maintenance task. SVaD

showed lower performances MID than svMCI in force initiation, develop-

ment and termination tasks while there were no differences between svMCI

and SVaD in terms of force maintenance task. Conclusions: Our results sug-

gest that svMCI showed MID, especially in motor impersistence, which was

not caused by general cognitive impairment. Also, the severity of MID was

greater in patients with SVaD than svMCI in motor akinesia and persevera-

tion.