In this Japanese study, researchers gave a short cognitive test to patients with several types of dementia — 125 with Alzheimer’s Disease (AD), 4 with AD plus vascular dementia, 8 with amnestic MCI (mild cognitive impairment), 34 with dementia with Lewy bodies (DLB), 8 with progressive supranuclear palsy (PSP), and 6 with vascular dementia.
While they were giving the test, they noted the “incidence and severity” of the “head-turning sign” (HTS) — whether the patient turned his/her head to look at the caregiver for help. They were trying to determine if this “sign” is unique to (specific to) Alzheimer’s Disease.
“HTS [head-turning sign] can be a clinical marker of AD and aMCI, and may represent a type of excuse behavior as well as a sign of dependency on and trust in the caregivers.”
These sorts of studies seem so hokey to me, particularly given the diagnostic accuracy of all of these dementing disorders. (Actually, the dementing form of PSP, which is the disease my father had — autopsy-confirmed — has the highest accuracy of these dementias listed.)
You can read the full article online at no charge, if you are interested. I’ve copied the abstract below.
www.ncbi.nlm.nih.gov/pmc/articles/PMC3246279/ –> the full article is available at no charge here
Dementia and Geriatric Cognitive Disorders Extra. 2011 Jan;1(1):310-7. Epub 2011 Oct 11.
Can the ‘head-turning sign’ be a clinical marker of Alzheimer’s disease?
Fukui T, Yamazaki T, Kinno R.
Division of Neurology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan.
To investigate the incidence and severity of the ‘head-turning sign’ (HTS), i.e. turning the head back to the caregiver(s) for help, in patients with various dementias and discuss its clinical specificity in Alzheimer’s disease (AD).
WE INVESTIGATED THE INCIDENCE AND SEVERITY OF HTS WHILE ADMINISTERING A SHORT COGNITIVE TEST (THE REVISED HASEGAWA DEMENTIA RATING SCALE: HDSR) in outpatients with AD [125 patients, including 4 with AD + vascular dementia (VaD)], 8 with amnestic mild cognitive impairment (aMCI), 34 with dementia with Lewy bodies (DLB), 8 with progressive supranuclear palsy (PSP) and 6 with VaD.
Significant differences were found among the 5 disease groups in the incidence and severity of HTS, and HDSR scores. Given the significant differences between AD and DLB in post hoc analyses, patients were dichotomized into AD-related (AD and aMCI) and AD-nonrelated (PSP, DLB and VaD) groups. Both incidence (41 vs. 17%, p = 0.002) and severity of HTS (0.80 ± 1.13 vs. 0.21 ± 0.60, p = 0.001) were significantly higher in the AD-related group, while average age and HDSR scores were comparable between both groups. AD-related disease, female gender and low HDSR score contributed significantly to the occurrence and severity of HTS.
HTS can be a clinical marker of AD and aMCI, and may represent a type of excuse behavior as well as a sign of dependency on and trust in the caregivers.
PMID: 22203823 (see pubmed.gov for this abstract only)