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. 2007;24(6):424-8.
doi: 10.1159/000109827. Epub 2007 Oct 16.

Visuospatial planning and problem solving in Alzheimer's disease patients: a study with the Tower of London Test

Massimo Franceschi  1 , Paolo Caffarra, Luc De Vreese, Oriana Pelati, Samantha Pradelli, Rita Savarè, Renata Cerutti, Enzo Grossi; ToL Research Group
Affiliations

Visuospatial planning and problem solving in Alzheimer's disease patients: a study with the Tower of London Test

Massimo Franceschi et al. Dement Geriatr Cogn Disord. 2007.

Abstract

Background: Executive dysfunction in Alzheimer's disease (AD) has been recently recognized as an early and prominent clinical sign. The Tower of London (ToL), a task specifically devised to test executive functions of visuospatial planning and problem solving, has frequently been used in neuropsychological experiments, but rarely in the clinical ground.

Methods: One hundred and sixty-one AD patients and 212 nondemented healthy controls were administered a simplified ToL version.

Results: AD patients were significantly impaired (p < 0.0001) in all ToL scores and in the total execution time. The 'accuracy' score of ToL at a cut off of <or=29/36 yielded a sensitivity of 71.2% and a specificity of 76.4% (AUC 0.79) for the diagnosis of AD versus controls.

Conclusions: Visuospatial planning and problem solving are significantly impaired in early dementia of the Alzheimer's type. A successful sensitivity/specificity ratio, the independence of education and the simplicity of this version of ToL make it a useful executive functioning screening test for early AD.

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