Recent studies have reported cognitive asymmetries in patients with
Alzheimer's disease (AD) and in individuals with apolipoprotein E
ε4 (APOE ε4) genotype who are in the preclinical phase of AD.
This increased frequency of cognitive asymmetry, typically defined as a
significant discrepancy (in either direction) between verbal and spatial
abilities, often occurs despite an absence of differences on traditional
measures of central tendency (i.e., mean test scores). We prospectively
studied the relationship between APOE genotype and two modality-specific
executive-function tasks: The Verbal Fluency and Design Fluency tests of
the Delis-Kaplan Executive Function System (D-KEFS) in 52 normal
functioning older adult participants who were grouped according to the
presence (n = 24) or absence (n = 28) of the APOE
ε4 allele. Nondemented older adults with the APOE ε4 allele
demonstrated a greater frequency of cognitive asymmetric profile on the
new switching conditions of the Verbal and Design Fluency measures than
the APOE non-ε4 individuals. This study further supports the utility
of assessing cognitive asymmetry for the detection of subtle cognitive
differences in individuals at-risk for AD, and suggests that dual-task
executive function tests (i.e., fluency plus switching) may serve as a
useful preclinical marker of AD. (JINS, 2005, 11,
863–870.)