Dysgraphia in Alzheimer's disease with mild cognitive impairment

The objectives of this study were (a) to examine the prevalence and onset of dysgraphia (i.e. writing impairment) in comparison with other neuropsychological deficits commonly associated with mild Alzheimer's disease (AD); and (b) to determine the patterns of neuropsychological deficits, if any, that are associated with dysgraphia in the early stages of the disease. Fourteen people diagnosed with mild AD and fourteen age-, sex-, and education-matched healthy individuals were administered a battery of writing tests along with a comprehensive neuropsychological test battery traditionally administered in the diagnosis of AD. Seven of the fourteen AD subjects presented with dysgraphia in the early stage of the disease. Memory and reasoning were more often impaired than writing; however, dysgraphia was more common than deficits of attention, visuospatial functions, language, and visuoconstruction. Regression analysis indicated that the cumulative effects of deficits in language and attention predicted the occurrence of dysgraphia. Analysis of errors on the individual writing tasks showed more spelling errors in homophones written to dictation than in regular and irregular words written to dictation. A spontaneous writing sample elicited with the Boston Diagnostic Examination cookie theft picture did not yield as many errors as homophone spelling.