Neurological Soft Signs in Nursing Home Residents with Alzheimer's Disease

Neurological soft signs (NSS), i.e., minor motor and sensory changes, are a common feature in psychiatric disorders related to brain changes. Nevertheless, they have rarely been investigated in patients with Alzheimer's disease (AD). NSS were examined in 104 nursing home residents with AD with respect to dementia severity, neuropsychiatric symptoms, and Parkinsonian signs as well as potential medication effects. 16 cognitively unimpaired residents served as a control group. NSS scores were significantly higher in residents with AD and were associated with both severity of cognitive deficits and non-cognitive symptoms, in particular apathy, but neither with Parkinsonian signs nor with antipsychotic medication. Our results demonstrate that NSS increase with progression of AD and one may hypothesize that they are linked to degenerative cerebellar changes. NSS in AD are clinically significant and thus, besides other neurological symptoms, are to be considered in diagnostics and therapy.