Enumeration in Alzheimer's disease and other late life psychiatric syndromes

Previous studies suggest that visual enumeration is spared in normal aging but impaired in abnormal aging (late stage Alzheimer's disease, AD), raising the task's potential as a marker of dementia. Experiment 1 compared speeded enumeration of 1–9 random dots in early stage AD, vascular dementia (VAD), depression, and age-matched controls. Previous deficits were replicated but they were not specific to AD, with the rate of counting larger numerosities similarly slowed relative to controls by both AD and VAD. Determination of subitizing span was complicated by the surprisingly slower enumeration of one than of two items, especially in AD patients. Experiment 2 showed that AD patients’ relative difficulty with one item persisted with further practice and extended to the enumeration of targets among distractors. However, it was abolished when pattern recognition was possible (enumerating dots on a die). Although an enumeration test is unlikely to help differentiate early AD from other common dementias, the unexpected pattern of patients’ performance challenges current models of enumeration and requires further investigation.