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The Closing-In Phenomenon in an Ecological Walking Task

Published online by Cambridge University Press:  04 December 2017

Natascia De Lucia ,
Dario Grossi ,
Graziella Milan  and
Luigi Trojano
Natascia De Lucia*
Affiliation:
Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy Department of Psychology, University of Campania “Luigi Vanvitelli”, Caserta, Italy
Dario Grossi
Affiliation:
Department of Psychology, University of Campania “Luigi Vanvitelli”, Caserta, Italy
Graziella Milan
Affiliation:
Geriatric Centre Frullone, Naples, Italy
Luigi Trojano
Affiliation:
Department of Psychology, University of Campania “Luigi Vanvitelli”, Caserta, Italy ICS Maugeri, IRCCS Institute of Telese Terme, Benevento, Italy
*
Correspondence and reprint requests to: Natascia De Lucia, Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy. E-mail: natascia.delucia@unina.it
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Abstract

Objectives: Alzheimer’s disease (AD) patients may show the Closing-in (CI), a tendency to reproduce figures close to or superimposed on the model. AD patients with CI might manifest reduced functional independence compared to AD patients without CI, but no study directly assessed if CI can hamper common daily living activities. To address this issue here we investigated whether AD patients with CI veer their walking trajectory toward irrelevant objects more often than AD patients without CI. Methods: Fifty AD individuals, and 20 age- and education-matched healthy adults, underwent a graphic copying task to detect CI and a newly developed walking task to assess the tendency to veer toward irrelevant objects and to bump into them. All participants also completed a comprehensive neuropsychological battery to assess dementia severity; impairments in frontal/executive, visuo-spatial, visuo-constructional, and memory domains; and functional independence in daily living activities. Results: Graphic CI occurred in 34/50 (68%) AD patients (AD-CI group) who achieved significantly lower scores on frontal/executive abilities, and daily living functioning than AD individuals not showing CI. Most AD-CI patients (20/34; 58.8%) also showed at least one veering error in the walking task. Participants with CI and veering errors showed significantly poorer performance on Stroop test, and lower level of functional independence than AD individuals with CI in isolation. Conclusions: CI on graphic tasks can identify difficulties in walking and in complying with everyday activities in AD patients. These observations demonstrate the value of assessing CI in copying tasks. (JINS, 2018, 24, 437–444)

Keywords

Frontal defectAttentionAlzheimer’s diseaseDrawingWalkingClosing-in
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 24 , Issue 5 , May 2018 , pp. 437 - 444
Copyright
Copyright © The International Neuropsychological Society 2017 

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References

Ambron, E., McIntosh, R.D., Allaria, F., & Della Sala, S. (2009). A large-scale retrospective study of closing-in behavior in Alzheimer’s disease. Journal of the International Neuropsychological Society, 15, 787–792. doi: 10.1017/S1355617709990245 Google Scholar
Ambron, E., McIntosh, R.D., & Della Sala, S. (2012). Closing-in behaviour and motor distractibility. Neuropsychologia, 50, 419–425. doi: 10.1016/j.neuropsychologia.2011.12.019 Google Scholar
Appollonio, I., Leone, M., Isella, V., Piamarta, F., Consoli, T., Villa, M.L., & Nichelli, P. (2005). The Frontal Assessment Battery (FAB): Normative values in an Italian population sample. Neurological Sciences, 26, 108–116. doi: 10.1007/s10072-005-0443-4 Google Scholar
Caffarra, P., Vezzadini, G., Dieci, F., Zonato, F., & Venneri, A. (2002a). Una versione abbreviata del test di Stroop. Dati normativi nella popolazione italiana. Nuova Rivista di Neurologia, 12, 111–115.Google Scholar
Caffarra, P., Vezzadini, G., Dieci, F., Zonato, F., & Venneri, A. (2002b). Rey-Osterrieth complex figure: Normative values in an Italian population sample. Neurological Sciences, 22, 443–447.Google Scholar
Carlesimo, G.A., Caltagirone, C., & Gainotti, G. (1996). The mental deterioration battery: Normative data, diagnostic reliability and qualitative analyses of cognitive impairment. European Neurology, 36, 378–384.Google Scholar
Carter, K., Monaghan, S., O’Brien, J., Teodorczuk, A., Mosimann, U., & Taylor, J.P. (2015). Driving and dementia: A clinical decision pathway. International Journal of Geriatric Psychiatry, 30, 210–216. doi: 10.1002/gps.4132 Google Scholar
Della Sala, S., Spinnler, H., & Venneri, A. (2004). Walking difficulties in patients with Alzheimer’s disease might originate from gait apraxia. Journal of Neurology, Neurosurgery, and Psychiatry, 75, 196–201.Google ScholarPubMed
De Lucia, N., Grossi, D., Fasanaro, M.A., Carpi, S., & Trojano, L. (2013). Frontal defects contribute to the genesis of closing-in in Alzheimer’s disease patients. Journal of the International Neuropsychological Society, 19, 802–808. doi: 10.1017/S1355617713000568 Google Scholar
De Lucia, N., Grossi, D., & Trojano, L. (2014). The genesis of closing-in in Alzheimer disease and vascular dementia: A comparative clinical and experimental study. Neuropsychology, 28, 312–318. doi: 10.1037/neu0000036 Google Scholar
De Lucia, N., Grossi, D., Mauro, A., & Trojano, L. (2015). Closing-in in Parkinson’s disease individuals with dementia: An experimental study. Journal of Clinical and Experimental Neuropsychology, 37, 946–955. doi: 10.1080/13803395.2015.1071339 Google Scholar
De Lucia, N., Trojano, L., Vitale, C., Grossi, D., Barone, P., & Santangelo, G. (2015). The closing-in phenomenon in Parkinson’s disease. Parkinsonism and Related Disorders, 21, 793–796. doi: 10.1016/j.parkreldis.2015.04.013 Google Scholar
De Lucia, N., Grossi, D., & Trojano, L. (2016). A clinical study on closing-in in focal brain-damaged individuals. Journal of Neurological Science, 15, 170–175. doi: 10.1016/j.jns.2016.02.059 Google Scholar
De Lucia, N., Grossi, D., & Trojano, L. (2017). Closing-in is related to daily living functioning in patients with mild-to-moderate Alzheimer Disease. Alzheimer Disease and Associated Disorders, 31, 177–179. doi: 10.1097/WAD.0000000000000165 Google Scholar
Gainotti, G. (1972). A qualitative study of the closing-in symptom in `normal children and in brain-damaged patients. Neuropsychologia, 10, 429–436.Google Scholar
Gasparini, M., Masciarelli, G., Vanacore, N., Ottaviani, D., Salati, E., Talarico, G., & Bruno, G. (2008). A descriptive study on constructional impairment in fronto-temporal dementia and Alzheimer’s disease. European Journal of Neurology, 15, 589–597. doi: 10.1111/j.1468-1331.2008.02128.x Google Scholar
Giovagnoli, A.R., Del Pesce, M., Mascheroni, S., Simoncelli, M., Laiacona, M., & Capitani, E. (1996). Trail making test: Normative values from 287 normal adult controls. Italian Journal of Neurological Sciences, 17, 305–309.Google Scholar
Grossi, D., Orsini, A., & De Michele, G. (1978). The copying of geometric drawings in dementia: An experimental study of 218 subjects. Acta Neurologica, 33, 355–360.Google Scholar
Grossi, D., De Lucia, N., & Trojano, L. (2015). Closing-in is related to apathy in Alzheimer’s disease patients. Journal of Alzheimers Disease, 43, 849–855. doi: 10.3233/JAD-141257 Google Scholar
Grossi, D., De Lucia, N., Milan, G., & Trojano, L. (2015). Relationships between environmental dependency and closing-in in patients with fronto-temporal dementia. Journal of the International Neuropsychological Society, 21, 1–7. doi: 10.1017/S135561771400099X Google Scholar
Hughes, C.P., Berg, L., Danziger, W.L., Coben, L.A., & Martin, R.L. (1982). A new clinical scale for the staging of dementia. The British Journal of Psychiatry, 140, 566–572. doi: 10.1192/bjp.140.6.566 610 Google Scholar
Katz, S., Downs, T.D., Cash, H.R., & Grotz, R.C. (1970). Progress in development of the index of ADL. Gerontologist, 10, 20–30.Google Scholar
Kwak, Y.T. (2004). Closing-in phenomenon in Alzheimer’s disease and subcortical vascular dementia. BMC Neurology, 4, 1–7.Google Scholar
Lawton, M.P., & Brody, E.M. (1969). Assessment of older people: Self maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.Google Scholar
Lee, B.H., Chin, J., Kang, S.J., Kim, E.J., Park, K.C., & Na, D.L. (2004). Mechanism of the closing-in phenomenon in a figure coping task in Alzheimer’s disease patients. Neurocase, 10, 393–397. doi: 10.1080/13554790490892194 Google Scholar
Martyr, A., & Clare, L. (2012). Executive function and activities of daily living in Alzheimer’s disease: A correlational meta-analysis. Dementia and Geriatric Cognitive Disorders, 33, 189–203. doi: 10.1159/000338233 Google Scholar
Mayer Gross, W. (1935). Some observations on apraxia. Proceedings of the Royal Society of Medicine, 28, 63–72.Google Scholar
McIntosh, R.D., Ambron, E., & Della Sala, S. (2008). Evidence for an attraction account of closing-in behaviour. Cognitive Neuropsychology, 25, 376–394. doi: 10.1080/02643290802028981 Google Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E.M. (1984). Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology, 34, 939–944. doi: 10.1212/WNL.34.7.939 630 Google Scholar
Measso, G., Cavarzeran, F., Zappala, G., Lebowitz, B.D., Crook, T.H., Pirozzolo, F.J., && Grigoletto, F. (1993). The Mini-Mental State Examination: Normative study of an Italian random sample. Developmental Neuropsychology, 9, 77–85. doi: 10.1080/87565649109540545 Google Scholar
Mondini, S., Mapelli, D., Vestri, A., & Bisiacchi, P.S. (2003). Esame Neuropsicologico Breve. Milan: Cortina Editor.Google Scholar
Poletti, M., Lucetti, C., Del Dotto, P., Borelli, P., Baldacci, F., Logi, C., && Bonuccelli, U. (2012). The “closing-in” phenomenon in Parkinson’s disease dementia and Lewy-body dementia. The Journal of Neuropsychiatry and Clinical Neuroscience, 24, 38–39. doi: 10.1176/appi.neuropsych.11110327 Google Scholar
Ruffieux, J., Keller, M., Lauber, B., & Taube, W. (2015). Changes in standing and walking performance under dual-task conditions across the lifespan. Sports Medicine, 45, 1739–1758. doi: 10.1007/s40279-015-0369-9 Google Scholar
Spinnler, H., & Tognoni, G. (1987). Standardizzazione e taratura italiana di tests neuropsicologici. Italian Journal of Neurological Sciences, 6, 8–96.Google Scholar
Trojano, L., & Gainotti, G. (2016). Drawing disorders in Alzheimer’s disease and other forms of dementia. Journal of Alzheimers Disease, 53, 31–52. doi: 10.3233/JAD-160009 Google Scholar
Uc, E.Y., Rizzo, M., Anderson, S.W., Shi, Q., & Dawson, J.D. (2005). Driver landmark and traffic sign identification in early Alzheimer’s disease. Journal of Neurology, Neurosurgery, and Psychiatry, 76, 764–768. doi: 10.1136/jnnp.2004.049338 Google Scholar
Vermeulen, J., Neyens, J.C., van Rossum, E., Spreeuwenberg, M.D., & de Witte, L.P. (2011). Predicting ADL disability in community-dwelling elderly people using physical frailty indicators: A systematic review. BMC Geriatrics, 1, 11–33. doi: 10.1186/1471-2318-11-33 Google Scholar
Wollesen, B., Voelcker-Rehage, C., Regenbrecht, T., & Mattes, K. (2016). Influence of a visual-verbal Stroop test on standing and walking performance of older adults. Neuroscience, 318, 166–177. doi: 10.1016/j.neuroscience.2016.01.031 CrossRefGoogle ScholarPubMed
Yogev-Seligmann, G., Hausdorff, J.M., & Giladi, N. (2008). The role of executive function and attention in gait. Movement Disorders, 23, 329–342.Google Scholar