I disturbi motori nella demenza: uno strumento per la diagnosi e l'intervento precoci

Introduction Although dementia is essentially characterized by a progressive decline of cognitive functions, some data suggest that since the earlier stages this involves motor aspects as well. The aim of this study is the analysis of the presence and severity of motor disorders in the diff erent stages of the disease. Materials and methods The “Exam Geronto-Psychomoteur” (EGP) was administered to patients suff ering from Alzheimer dementia, with age between 60 and 100 years, education ≥ 5 years, absence of behavioral disorders. Results were compared with those of age-matched healthy controls. Results 67 patients were grouped into four severity classes (Mini-Mental State Examination score 24,51-30: n. 14; MMSE = 19,51-24,5: n. 19; MMSE = 15-19,5: n. 20; MMSE = < 15: n.14) and compared to two groups of healthy, age-matched subjects (age 81-85: n. 32, for MMSE = 19,51-24,5, 15-19,5 and < 15 and 76-80: n. 46 for MMSE = 24,51-30). Disorders in the motor system were found since the very early stages of the disease, in particular in dynamic coordination and muscular hypertonia. The most precocious cognitive defi cits involve praxis, memory, orientation, perceptual functions and communication. Finally, in the later stages of illness, cognitive and motor areas become gradually worse. Conclusions The Exam Geronto-Psychomoteur is useful to identify both motor and cognitive defi cits since the early stages of Dementia and may be considered as a good screening instrument, preliminary to an in-depth and specifi c assessment. It may also be useful for devising specifi c interventions aimed at maintaining autonomy in elderly people.