Progression of Alzheimer’s disease: variability and consistency: ontogenic models, their applicability and relevance

  • B. Reisberg
  • E. H. Franssen
  • L. E. M. Souren
  • S. Auer
  • S. Kenowsky
Part of the Journal of Neural Transmission. Supplementa book series (NEURAL SUPPL, volume 54)


Much has been learned about the clinical symptomatology of Alzheimer’s disease (AD) and ontogenic reciprocal relationships in the past few decades. It is now possible to describe and verify inexorable symptomatic sequences and corresponding temporal relationships. It is also possible to identify more variable symptoms in AD. Ontogenic models can be useful in providing a clearer understanding of the nature of AD symptomatology in terms of both consistency and variability. These models can also be informative in explicating the management needs of AD patients and the treatment possibilities of AD symptoms as well as the etiology of variability in AD symptoms.


Physical Threat Global Deterioration Scale Fast Stage Primary Degenerative Dementia Executive Functional Task 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Auer SR, Sclan SG, Yaffee RA, Reisberg B (1994) The neglected half of Alzheimer disease: cognitive and functional concomitants of severe dementia. JAGS 42: 1266–1272Google Scholar
  2. Braak H, Braak E (1991) Neuropathological stageing of Alzheimer-related changes. Acta Neuropathol 82: 239–259PubMedCrossRefGoogle Scholar
  3. Braak H, Braak E (1996) Development of Alzheimer-related neurofibrillary changes in the neocortex inversely recapitulates cortical myelogenesis. Acta Neuropathol 92: 197–201PubMedCrossRefGoogle Scholar
  4. Brun A, Englund E (1981) Regional pattern of degeneration in Alzheimer’s disease: neuronal loss and histopathological grading. Histopathology 5: 549–564PubMedCrossRefGoogle Scholar
  5. Cioni G, Biagioni E, Cipolloni C (1992) Brain before cognition: EEG maturation in pre-term infants. In: Kostovic I, Knezevic S, Wisniewski HM, Spillich GJ (eds) Neurodevelopment, aging and cognition. Birkhäuser, Boston, pp 75–98CrossRefGoogle Scholar
  6. Flechsig P (1920) Anatomie des menschlichen Gehirns und Rückenmarks auf myelogenetischer Grundlage. Thieme, LeipzigGoogle Scholar
  7. Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiat Res 12: 189–198PubMedCrossRefGoogle Scholar
  8. Franssen EH, Reisberg B (1997) Neurologic markers of the progression of Alzheimer disease. Int Psychogeriat 9 [Suppl 1]: 297–306CrossRefGoogle Scholar
  9. Franssen EH, Reisberg B, Kluger A, Sinaiko E, Boja C (1991) Cognition-independent neurologic symptoms in normal aging and probable Alzheimer’s disease. Arch Neurol 48: 148–154PubMedCrossRefGoogle Scholar
  10. Franssen EH, Kluger A, Torossian CL, Reisberg B (1993) The neurologic syndrome of severe Alzheimer’s disease: relationship to functional decline. Arch Neurol 50:1029–1039PubMedCrossRefGoogle Scholar
  11. Franssen EH, Souren LEM, Torossian CL, Reisberg B (1997) Utility of developmental reflexes in the differential diagnosis and prognosis of incontinence in Alzheimer disease. J Geriat Psychiat Neurol 10: 22–28Google Scholar
  12. Guttman L (1950) The basis for scalogram analysis. In: Stouffer SA, Guttman L, Suchman EA, Lazersfeld PF, Starr SA, Clausen JA (eds) Measurement and prediction. Princeton University Press, PrincetonGoogle Scholar
  13. Huff FJ, Boller F, Luchelli F, Querriera R, Beyer J, Belle S (1987) The neurologic examination in patient’s with probable Alzheimer’s disease. Arch Neurol 44: 929–932PubMedCrossRefGoogle Scholar
  14. Jacobs L, Gossman MD (1980) Three primitive reflexes in normal adults. Neurology 30: 184–188PubMedCrossRefGoogle Scholar
  15. McGeer PL, McGeer EG, Akiyama H, Itagaki S, Harrop R, Peppard R (1990) Neuronal degeneration and memory loss in Alzheimer’s disease and aging. Exp Brain Res [Suppl] 21: 411–426Google Scholar
  16. Paulson G, Gottlieb G (1968) Developmental reflexes: the reappearance of foetal and neonatal reflexes in aged patients. Brain 91: 37–52CrossRefGoogle Scholar
  17. Prichep LS, John ER, Ferris SH, Reisberg B, Alper K, Almas M, Cancro R (1994) Quantitative EEG correlates of cognitive deterioration in the elderly. Neurobiol Aging 15: 85–90PubMedCrossRefGoogle Scholar
  18. Reisberg B (1986) Dementia: a systematic approach to identifying reversible causes. Geriatrics 41: 30–46PubMedGoogle Scholar
  19. Reisberg B (1988) Functional assessment staging (FAST). Psychopharmacol Bull 24:653–659PubMedGoogle Scholar
  20. Reisberg B, Ferris SH, de Leon MJ, Crook T (1982) The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiat 139: 1136–1139PubMedGoogle Scholar
  21. Reisberg B, Ferris SH, Anand R, de Leon MJ, Schneck MK, Buttinger C, Borenstein J (1984) Functional staging of dementia of the Alzheimer’s type. Ann NY Acad Sci 435: 481–483CrossRefGoogle Scholar
  22. Reisberg B, Ferris SH, Anand R, de Leon MJ, Schnek MK, Crook T (1985a) Clinical assessment of cognitive decline in normal aging and primary degenerative dementia: concordant ordinal measures. In: Pichot P, Berner P, Wolf R, Thau K (eds) Psychiatry, vol 5. Plenum Press, New York, pp 333–338Google Scholar
  23. Reisberg B, Ferris SH, de Leon MJ (1985b) Senile dementia of the Alzheimer type: diagnostic and differential diagnostic features with special reference to functional assessment staging. In: Traber J, Gispen WH (eds) Senile dementia of the Alzheimer type, vol 2. Springer, Berlin Heidelberg New York Tokyo, pp 18–37CrossRefGoogle Scholar
  24. Reisberg B, Ferris SH, Franssen EH (1986) Functional degenerative stages in dementia of the Alzheimer’s type appear to reverse normal human development. In: Shagass C, et al (eds) Biological psychiatry 1985, vol 7. Elsevier Science, New York, pp 1319–1321Google Scholar
  25. Reisberg B, Ferris SH, de Leon MJ, Sinaiko E, Franssen EH, Kluger A, Mir P, Borenstein J, George AE, Shulman E, Steinberg G, Cohen J (1988) Stage-specific behavioral, cognitive, and in vivo changes in community residing subjects with age-associated memory impairment (AAMI) and primary degenerative dementia of the Alzheimer type. Drug Dev Res 15: 101–114CrossRefGoogle Scholar
  26. Reisberg B, Franssen EH, Sclan SG, Kluger A, Ferris SH (1989a) Stage specific incidence of potentially remediable behavioral symptoms in aging and Alzheimer’s disease: a study of 120 patients using the BEHAVE-AD. Bull Clin Neurosci 54: 95–112Google Scholar
  27. Reisberg B, Ferris SH, de Leon MJ, Kluger A, Franssen EH, Borenstein J, Alba R (1989b) The stage specific temporal course of Alzheimer’s disease: Functional and behavioral concomitants based upon cross-sectional and longitudinal observation. In: Iqbal K, Wisniewski HM, Winblad B (eds) Alzheimer’s disease and related disorders: progress in clinical and biological research, vol 317. Alan R Liss, New York, pp 23–41Google Scholar
  28. Reisberg B, Pattschull-Furlan A, Franssen EH, Sclan S, Kluger A, Dingcong L, Ferris SH (1990) Cognition-related functional, praxis and feeding changes in CNS aging and Alzheimer’s disease and their developmental analogies. In: Beyreuther K, Schettler G (eds) Molecular mechanisms of aging. Springer, Berlin Heidelberg New York Tokyo, pp 18–40CrossRefGoogle Scholar
  29. Reisberg B, Ferris SH, Torossian CL, Kluger A, Monteiro I (1992) Pharmacologic treatment of Alzheimer’s disease: a methodologic critique based upon current knowledge of symptomatology and relevance for drug trials. Int Psychogeriat 4 [Suppl 1]: 9–42CrossRefGoogle Scholar
  30. Reisberg B, Sclan SG, Franssen EH, de Leon MJ, Kluger A, Torossian CL, Shulman E, Steinberg G, Monteiro I, McRae T, Boksay I, Mackell JA, Ferris SH (1993) Clinical stages of normal aging and Alzheimer’s disease: the GDS staging system. Neurosci Res Commun 13 [Suppl 1]: 551–554Google Scholar
  31. Reisberg B, Ferris SH, Franssen EH, Shulman E, Monteiro I, Sclan SG, Steinberg G, Kluger A, Torossian CL, de Leon MJ, Laska E (1996a) Mortality and temporal course of probable Alzheimer’s disease: a five-year prospective study. Int Psychogeriat 8: 291–311CrossRefGoogle Scholar
  32. Reisberg B, Kenowsky S, Franssen EH, Souren L, Shulman E, Steinberg G, Aronstein Z, Auer SR (1996b) Slowing the progression of Alzheimer’s disease: towards a science of Alzheimer’s disease care. The Fifth National Alzheimer’s Disease Education Conference Proceedings. Alzheimer’s Association, ChicagoGoogle Scholar
  33. Reisberg B, Auer SR, Monteiro I, Franssen E, Kenowsky S (1998) A rational psychological approach to the treatment of behavioral disturbances and symptomatology in Alzheimer’s disease based upon recognition of the developmental age. Int Acad Biomed Drug Res 13: 102–109CrossRefGoogle Scholar
  34. Sclan SG, Reisberg B (1992) Functional assessment staging (FAST) in Alzheimer’s disease: reliability, validity and ordinality. Int Psychogeriat 4 [Suppl 1]: 55–69CrossRefGoogle Scholar
  35. Sclan SG, Foster JR, Reisberg B, Franssen EH, Welkowitz J (1990) Application of Piagetian measures of cognition in severe Alzheimer’s disease. Psychiatr J Univ Ottawa 15: 221–226Google Scholar
  36. Souren LEM, Franssen EM, Reisberg B (1995) Contractures and loss of function in patients with Alzheimer’s disease. JAGS 43: 650–655Google Scholar
  37. Authors’ address: Dr. B. Reisberg, Alzheimer’s Disease Education and Resources Program, New York University Medical Center, New York, NY 10016, U.S.A.Google Scholar

Copyright information

© Springer-Verlag/Wien 1998

Authors and Affiliations

  • B. Reisberg
    • 1
    • 2
  • E. H. Franssen
    • 1
    • 2
  • L. E. M. Souren
    • 1
    • 2
  • S. Auer
    • 1
    • 2
  • S. Kenowsky
    • 1
    • 2
  1. 1.Alzheimer’s Disease Education and Resources ProgramNew York University Medical CenterNew YorkUSA
  2. 2.Zachary and Elizabeth M. Fisher Alzheimer’s Disease Education and Resources ProgramNew York University Medical CenterNew YorkUSA

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