Theearliest cognitive change ina personwith familial Alzheimer's disease: presymptomatic neuropsychological features inapedigree with familial Alzheimer's disease confirmed at necropsy

Comprehensive, longitudinal neuropsychological assessments arereported ina person"atrisk"fromautosomal dominant, necropsyconfirmedfamilial Alzheimer's disease. Thefirst assessment showeda moderately selective verbal memory deficit inthecontextofmild generalintellectual impairment. Subsequenttesting showedtheprogressive deterioration ofvisualmemory and a milddecline ofperceptual and spatial skills. Languageandliteracy skills, however, remainedcomparatively intact. The neuropsychological profiles obtainedat eachassessment arepresented inprofile maps.Thesepermitdirect longitudinal comparison ofcognitive function, and may serveinthecomparison ofdifferent potential casesoffamilial Alzheimer's disease. Thiscasesought medical attentionformemory difficulties 26months after thefirst neuropsychological assessment.Theseresults markthefirst cognitivemanifestations ina pedigree with familial Alzheimer's diseasewhich,in thiscase, wereseenpresymptomatically. Thefindings arediscussed inrelation to neuropsychological studies ofaffected cases, andintermsoftheirreflecting theheterogeneous natureoffamilial Alzheimer's disease.