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Apraxia and Alzheimer’s Disease: Review and Perspectives

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Abstract

Apraxia is one of the cognitive deficits that characterizes Alzheimer’s disease. Despite its prevalence and relevance to diagnosing Alzheimer’s disease, this topic has received little attention and is without comprehensive review. The review herein is aimed to fill this gap by first presenting an overview of the impairment caused in different clinical situations: pantomime of tool use, single tool use, real tool use, mechanical problem solving, function and manipulation knowledge tasks, and symbolic/meaningless gestures. On the basis of these results, we then propose alternative interpretations regarding the nature of the underlying mechanisms impaired by the disease. Also presented are principal methodological issues precluding firm conclusions from being drawn.

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Notes

  1. In the references, the studies preceded by (*), are those for which the data could have been transformed in percentage of accuracy for patients and controls. The results of these studies can be seen in the tables and the figures of this review. The studies preceded by (•) do not display data for controls (e.g., study of 1 case) and consequently the results can solely be seen in the tables of this review. The methods and type of data analyzed in the studies preceded by (♦) did not allow us to convert the performances of patients and controls in accuracy percentages (Benke et al. 1993; Parakh et al. 2004). The results of those studies do not appear in any figure or table but are discussed in the text. Finally, studies preceded by (°) are mentioned but cannot be discussed in the present review either because they are beyond the scope of this review (i.e., Jacobs et al. 1999) or because of methodological problems (Della Sala et al. 1987; Lucchelli et al., 1987; both symbolic and meaningless gestures were used for the imitation task; Giovannetti et al. 2006b: two of the 16 patients included in the study did not meet criteria for AD and were ultimately diagnosed with mixed dementia).

  2. As suggested elsewhere (e.g., Osiurak et al. 2010, 2011), we use the term “tool” for the implement performing an action (e.g., a hammer or a screwdriver) and “object” for the recipient of the action (e.g., a nail or a screw).

  3. We also used other procedures such as the ratio patients’/controls’ performance, but the results did not differ whatever the procedure used.

  4. Ceiling effects are very frequent in the field of apraxia even in patients with other neurological disorders such as vascular brain damage (e.g., De Renzi and Lucchelli 1988; Goldenberg and Hagmann 1998).

  5. This difference was significant for the study of Parakh et al. (2004) while this information was not available in the study of Rousseaux et al. (2012). Note also that the results of Parakh et al. (2004) are not shown in Table 2 and Fig. 3 because they were expressed in z-scores and we could not obtain the raw data.

  6. However, it is important to remind that we did not include in the present review the results of studies on everyday actions such as the naturalistic action test (e.g., Giovannetti et al. 2006a). More particularly, as mentioned above, executive functions are highly involved in this kind of tasks and, consequently, the interpretation of the results observed in these tasks are beyond the scope of the present review. Note also that we did not report the results of Benke (1993) because the data could not be transformed into percentages.

  7. The four sub-groups of Ochipa et al. (1992) were formed on the basis of the difficulties in terms of ideomotor praxis and semantic language impairment. Nevertheless, it is very likely that the different sub-groups also correspond to patients at different stages of the disease. So given that we could not obtain this information, we considered that the different sub-groups corresponded with patients at different stages of the disease.

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Acknowledgments

This work was supported by grants from ANR (Agence Nationale pour la Recherche; Project Démences et Utilisation d’Outils/Dementia and Tool Use, N°ANR 2011 MALZ 006 03) to François Osiurak and Didier Le Gall, Région Pays de la Loire (Project Outils et Vie Quotidienne/Tool Use and Daily Life Activities, 2012-09689 OVQ) to Didier Le Gall, and was performed within the framework of the LABEX CORTEX (ANR-11-LABX-0042) of Université de Lyon (François Osiurak), within the program “Investissements d’Avenir” (ANR-11-IDEX-0007) operated by the French National Research Agency (ANR).

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  1. Laboratoire d’Étude des Mécanismes Cognitifs (EA 3082), Institut de Psychologie, Université Lyon 2, 5, avenue Pierre Mendès-France, 69676, Bron Cedex, France

    Mathieu Lesourd & François Osiurak

  2. Service de Neuropsychologie, Hôpital Neurologique Pierre Wertheimer, Bron, France

    Mathieu Lesourd & Bernard Croisile

  3. Laboratoire de Psychologie des Pays de la Loire (EA 4638), Université d’Angers, Angers, France

    Didier Le Gall, Josselin Baumard & Christophe Jarry

  4. Unité de Neuropsychologie, Département de Neurologie, Centre Hospitalier Universitaire d’Angers, Angers, France

    Didier Le Gall, Josselin Baumard & Christophe Jarry

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Lesourd, M., Le Gall, D., Baumard, J. et al. Apraxia and Alzheimer’s Disease: Review and Perspectives. Neuropsychol Rev 23, 234–256 (2013). https://doi.org/10.1007/s11065-013-9235-4

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