[Apraxia of ideas and movements and visual-constructive skills]

To study alterations in copying behaviour in Alzheimer's disease (AD) and its relationship with other cognitive parameters. As secondary objectives, in this paper we describe the evolution of concepts, definitions and examination of ideas-movement and constructive apraxia, together with its involvement in AD and review the investigations of the Uruguayan school on the development of behaviour copying and how this is affected in patients with cerebral lesions.

We made a study of 82 consecutive patients with probable AD at stages 3 to 5 on the overall deterioration scale (GDS), registered in the Department of Neuropsychology, and a group of healthy persons, paired for age, sex and educational level. We used an extensive protocol for cognitive evaluation. We evaluated the idea-movement apraxia by means of imitation of increasingly complex gestures, and constructive apraxia using the protocol described by Mendilaharsu et al.

At stages 4 and 5 of the GDS scale, the idea-movement apraxia was significantly correlated with digital agnosia and the anomias. Constructive apraxia was found in GDS stage 3. We found 'homogeneous cognitive deterioration' in advanced patients (GDS 5) who showed closing-in when copying figures. The closing-in correlated significantly with the presence of anomias, idea apraxia and digital agnosia.

In the early stages, EA shows varied praxis profiles, but above stage 5 of the GDS scale there was a tendency to homogeneity.