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DOI: 10.1055/s-2002-24990
The Effect of Attentional Dysfunction in Alzheimer's Disease: Theoretical and Practical Implications
Publication History
Publication Date:
11 April 2002 (online)
ABSTRACT
Attention may be one of the earliest cognitive abilities to change in Alzheimer's disease (AD), although its role has received belated recognition. This article discusses different aspects of attention and how these are differentially affected in AD. Of the various attention functions, divided and selective attention are particularly vulnerable. The etiology of attentional deficits in AD arises from damage to areas of frontal and parietal association cortex, disconnection between the anterior and posterior attentional networks, and decreased cholinergic function. Severity of illness is associated with attentional deterioration. Complexity or increased load of a task may further disrupt attentional function. Knowledge of attentional changes in AD is important to the understanding of disease-related changes in other cognitive domains such as memory, visuospatial functions, and language.
KEYWORD
Alzheimer's disease - attention
REFERENCES
- 1 McKhann G, Drachman D, Folstein M F. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA work group, Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology . 1984; 34 939-944
- 2 Perry R J, Hodges J R. Attention and executive deficits in Alzheimer's disease: a critical review. Brain . 1999; 122 383-404
- 3 Haxby J V, Horowitz B, Ungerleider L G. The functional organization of human extrastriate cortex: a PET-rCBF study of selective attention to faces and locations. J Neurosci . 1994; 14 6336-6353
- 4 Johannsen P, Jakobsen J, Bruhn P, Gjedde A. Cortical responses to sustained and divided attention in Alzheimer's disease. Neuroimage . 1999; 10 269-281
- 5 Almkvist O. Functional brain imaging as a looking-glass into the degraded brain: reviewing evidence from Alzheimer disease in relation to normal aging. Acta Psychologica . 2000; 105 255-277
- 6 Haxby J V, Grady C L, Duara R. Neocortical metabolic abnormalities precede nonmemory cognitive defects in early Alzheimer's-type dementia. Arch Neurol . 1986; 43 882-885
- 7 Parasuraman R, Greenwood P M. Selective attention in aging and dementia. In: Parasuraman R, ed. The Attentive Brain Cambridge, MA: The MIT Press 1998: 461-487
- 8 Parasuraman R, Haxby J V. Attention and brain function in Alzheimer's disease: a review. Neuropsychology . 1993; 7 242-272
- 9 Perry R J, Watson P, Hodges J R. The nature and staging of attention dysfunction in early (minimal and mild) Alzheimer's disease: relationship to episodic and semantic memory impairment. Neuropsychologia . 2000; 38 252-271
- 10 Kastner S, Ungerleider L G. Mechanisms of visual attention in the human cortex. Annu Rev Neurosci . 2000; 23 315-341
- 11 Wolfe J M. Guided search 2.0: a revised model of visual search. Psychonomic Bulletin and Review . 1994; 1 202-238
- 12 Cherry E C. Some experiments on the recognition of speech, with one and with two ears. J Acoust Soc Am . 1953; 26 975-979
- 13 Posner M I, Petersen S E. The attention system of the human brain. Annu Rev Neurosci . 1990; 13 25-42
- 14 Mesulam M-M. Principles of Behavioral and Cognitive Neurology, 2nd ed. New York: Oxford University Press; 2000 .
- 15 Nebes R D, Brady C B. Phasic and tonic alertness in Alzheimer's disease. Cortex . 1993; 29 77-90
- 16 Parasuraman R, Nestor P G. Preserved cognitive operations in early Alzheimer's disease. In: Cerella J, Rybash J, Hoyer W, Commons ML, eds. Adult Information Processing: Limits on Loss San Diego: Academic Press 1993: 77-111
- 17 Connors C K. Multi-Health Systems Staff. Connors' Continuous Performance Test. Toronto: Multi-Health Systems 1995
- 18 Lines C R, Dawson C, Preston G C. Memory and attention in patients with senile dementia of the Alzheimer type and in normal elderly subjects. J Clin Exp Neuropsychol . 1991; 13 691-702
- 19 Sano M, Rosen W, Stern Y, Rosen J, Mayeux R. Simple reaction time as a measure of global attention in Alzheimer's disease. J Int Neuropsychol Soc . 2001; 1 56-61
- 20 Brazzelli M, Cocchini G, Della Salla S, Spinnler H. Alzheimer patients show a sensitivity decrement over time on a tonic alertness task. J Clin Exp Neuropsychol . 1994; 16 851-860
- 21 Davies D R, Jones D M, Taylor A. Selective and sustained-attention tasks: individual and group differences. In: Parasuraman R, Davies DR, eds. Varieties of Attention San Diego: Academic Press 1984: 395-447
- 22 Robertson I H, Ward T, Ridgeway V, Nimmo-Smith I. Tests of Everyday Attention. Bury St. Edmunds, UK: Thames Valley Test Company 1994
- 23 Wechsler D. Wechsler Adult Intelligence Scale-Revised. New York: The Psychological Corporation . 1981
- 24 Bäckman L, Small B J, Fratiglioni L. Stability of the preclinical episodic memory deficit in Alzheimer's disease. Brain . 2001; 124 96-102
- 25 Rizzo M, Anderson S W, Dawson J, Myers R, Ball K. Visual attention impairments in Alzheimer's disease. Neurology . 2000; 54 1954-1959
- 26 Perry R J, Hodges J R. Fate of patients with questionable (very mild) Alzheimer's disease: longitudinal profiles of individual subjects' decline. Dementia and Geriatric Cognitive Disorders . 2000; 11 342-349
- 27 Gainotti G, Marra C, Villa G. A double dissociation between accuracy and time of execution on attentional tasks in Alzheimer's disease and multi-infarct dementia. Brain . 2001; 124 731-738
- 28 Posner M I. Orienting of attention. Q J Exp Psychol . 1980; 32 3-25
- 29 Parasuraman R, Greenwood P M, Haxby J V, Grady C L. Visuospatial attention in dementia of the Alzheimer type. Brain . 1992; 115 711-733
- 30 Greenwood P M, Parasuraman R, Haxby J V. Visuospatial attention across the adult life span. Neuropsychologia . 1993; 31 471-485
- 31 Oken B S, Kishiyama S S, Kaye J A, Howieson D B. Attention deficit in Alzheimer's disease is not simulated by an anticholinergic/antihistaminergic drug and is distinct from deficits in healthy aging. Neurology . 1994; 44 657-662
- 32 Corbetta M, Miezin F M, Shulman G L, Petersen S E. A PET study of visuospatial attention. J Neurosci . 1993; 13 1202-1226
- 33 Greenwood P, Parasuraman R, Alexander G E. Controlling the focus of spatial attention during visual search: effects of advanced aging and Alzheimer disease. Neuropsychology . 1997; 11 3-12
- 34 Daffner K R, Mesulam M-M, Scinto L FM. The central role of the prefrontal cortex in directing attention to novel events. Brain . 2000; 123 927-939
- 35 Knight R T, Scabini D. Anatomic bases of event-related potential and their relationship to novelty detection in humans. J Clin Neurophysiol . 1998; 15 3-13
- 36 Cummings J L. The neuropsychiatric inventory: assessing psychopathology in dementia patients. Neurology . 1997; 48(Suppl 6) S10-S16
- 37 Miranda M I, Ramirez-Lugo L, Bermudez-Rattoni F. Cortical cholinergic activity is related to the novelty of the stimulus. Brain Res . 2000; 882 230-235
- 38 Daffner K R, Rentz D M, Scinto L FM. Pathophysiology underlying diminished attention to novel events in patients with early AD. Neurology . 2001; 56 1377-1383
- 39 LaBar K S, Mesulam M-M, Gitelman D R, Weintraub S. Emotional curiosity: modulation of visuospatial attention by arousal is preserved in aging and early-stage Alzheimer's disease. Neuropsychologia . 2000; 38 1734-1740
- 40 Heilman K M, Valenstein E, Watson R T. Neglect and related disorders. Semin Neurol . 1984; 2000 20:463-470
- 41 Ishiai S, Koyama Y, Seki K. Unilateral spatial neglect in AD: significance of line bisection performance. Neurology . 2000; 55 364-370
- 42 Nestor P G, Parasuraman R, Haxby J V, Grady C L. Divided attention and metabolic brain dysfunction in mild dementia of the Alzheimer's type. Neuropsychologia . 2001; 29 379-387
- 43 Baddeley A D, Baddeley H D, Bucks R S, Wilcock G K. Attentional control in Alzheimer's disease. Brain . 2001; 124 1492-1508
- 44 Foldi N S, Jutagir R, Davidoff D, Gould T. Selective attention skills in Alzheimer's disease: performance on graded cancellation tests varying in density and complexity. Journal of Gerontology - Psychological Sciences . 1992; 47 P146-P153
- 45 Parasuraman R, Greenwood P M, Alexander G E. Selective impairment of spatial attention during visual search in Alzheimer's disease. Neuroreport . 1995; 6 1861-1864
- 46 Caputo G, Guerra S. Attentional selection by distractor suppression. Vision Res . 1998; 38 669-689
- 47 Foster J K. Selective attention in Alzheimer's disease. Frontiers in Bioscience . 2001; 6 D135-D153
- 48 Treisman A, Gelade G A. A feature integration theory of attention. Cogn Psychol . 1980; 12 97-136
- 49 Plude D J, Doussard-Roosevelt J A. Aging, selective attention, and feature integration. Psychol Aging . 1989; 4 98-105
- 50 Duncan J, Humphreys G W. Visual search and stimulus similarity. Psychol Rev . 1989; 96 433-458
- 51 Nebes R D, Brady C B. Focused and divided attention in Alzheimer's disease. Cortex . 1989; 25 305-315
- 52 Foster J K, Behrmann M, Stuss D T. Visual attention deficits in Alzheimer's disease: simple versus conjoined feature search. Neuropsychology . 1999; 13 223-245
- 53 Lavie N, Tsal Y. Perceptual load as a major determinant of locus of selection in visual attention. Perception and Psychophysics . 1994; 56 183-197
- 54 Cossa F M, Della Salla S, Spinnler H. Selective visual attention in Alzheimer's and Parkinson's patients: memory- and data-driven control. Neuropsychologia . 1989; 27 887-892
- 55 Albert M S, Moss M B, Tanzi R, Jones K. Preclinical prediction of AD using neuropsychological tests. J Int Neuropsychol Soc . 2001; 7 631-639
- 56 Killiany R J, Gomez-Isla T, Moss M. Use of structural magnetic resonance imaging to predict who will get Alzheimer's disease. Ann Neurol . 2000; 47 430-439
- 57 McKeith I G, Galasko D, Kosaka K. Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium of DLB international workshop. Neurology . 1996; 47 1113-1124
- 58 Hansen L, Salmon D, Galasko D. The Lewy body variant of Alzheimer's disease: a clinical and pathologic entity. Neurology . 1990; 40 1-8
- 59 Calderon J, Perry R J, Erzinclioglu S W. Perception, attention, and working memory are disproportionately impaired in dementia with Lewy bodies compared with Alzheimer's disease. J Neurol Neurosurg Psychiatry . 2001; 70 157-164
- 60 Ballard C, O'Brien J, Gray A. Attention and fluctuating attention in patients with dementia with Lewy bodies and Alzheimer disease. Arch Neurol . 2001; 58 977-982
- 61 Desimone R, Duncan J. Neural mechanisms of selective visual attention. Annu Rev Neurosci . 1995; 18 193-222
- 62 Reynolds J H, Pasternak T, Desimone R. Attention increases sensitivity of V4 neurons. Neuron . 2000; 26 703-714
- 63 Stuss D T, Shallice T, Alexander M P, Picton T W. A multidisciplinary approach to anterior attentional functions. Ann N Y Acad Sci . 1995; 769 191-211
- 64 Kastner S, Pinsk M A, De Weerd P, Desimone R, Ungerleider L G. Increased activity in human visual cortex during directed attention in the absence of visual stimulation. Neuron . 1999; 22 751-761
- 65 Stuss D T, Toth J P, Franchi D P. Dissociation of attentional processes in patients with focal frontal and posterior lesions. Neuropsychologia . 1999; 37 1005-1027
- 66 Davies P, Maloney A JF. Selective loss of central cholinergic neurons in Alzheimer's disease. Lancet . 1976; 2 1403
- 67 Davidson M C, Marrocco R T. Local infusion of scopolamine into intraparietal cortex slows covert orienting in rhesus monkeys. J Neurophysiol . 2000; 83 1536-1549
- 68 Levy J A, Parasuraman R, Greenwood P M, Dukoff R, Sunderland T. Acetylcholine affects the spatial scale of attention: evidence from Alzheimer's disease. Neuropsychology . 2000; 14 288-298
- 69 Rogers S L, Friedhoff L T. The efficacy and safety of donepezil in patients with Alzheimer's disease. Dementia . 1996; 7 293-303
- 70 Rösler M, Anand R, Cincin-Sain A. Efficacy and safety of rivastigmine in patients with Alzheimer's disease: international randomised controlled trial. BMJ . 2000; 318 633-638
- 71 Bentham P, Gray R, Sellwood E, Raftery J. Effectiveness of rivastigmine in Alzheimer's disease. Improvements in functional ability remain unestablished. BMJ . 1999; 319 640-641
- 72 Mirza R N, Stolerman P I. The role of nicotinic and muscarinic acetylcholine receptors in attention. Psychopharmacology . 2000; 148 243-250
- 73 Stryker M P. Drums keep pounding a rhythm in the brain. Science . 2001; 291 1506-1507
- 74 Wolfe J M, Friedman-Hill S R, Steward M I, O'Connel K M. The role of categorization in visual search for orientation. J Exp Psychol Hum Percept Perform . 1992; 18 34-39
- 75 Monsch A, Bondi M, Butters N. Comparisons of verbal fluency tasks in the detection of dementia of the Alzheimer type. Arch Neurol . 1992; 49 1253-1258
- 76 Rizzo M, Reinach S, McGehee D V, Dawson J. Simulated car crashes and crash predictors in drivers with Alzheimer disease. Arch Neurol . 1997; 54 545-553