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Charting the decline in spontaneous writing in Alzheimer's disease: a longitudinal study.

Forbes-McKay, Katrina; Shanks, Mike; Venneri, Annalena


Mike Shanks

Annalena Venneri


Objective: This study aims to document the nature and progression of the spontaneous writing impairment observed in patients with Alzheimer's disease (AD) over a 12-month period using both a cross-sectional and prospective longitudinal design. Methods: Thirty-one minimal-moderate AD patients and 30 controls matched for age and socio-cultural background completed a simple and complex written description task at baseline. The AD patients then had follow-up assessments at 6 and 12 months. Results: Cross-sectional comparisons indicated that minimal-moderate AD patients produced more semantic paraphasias, phonological paraphasias, and empty and indefinite phrases, whilst producing fewer pictorial themes, repairing fewer errors, and producing shorter and less complex sentences than controls. The two groups could not be distinguished on visual paraphasias. Longitudinal follow-up, however, suggested that visual processing deteriorates over time, where the prevalence of visual errors increased over 12 months. Discussion: The findings suggest that the deterioration of writing skills observed in the spontaneous writings of AD patients shows a pattern of impairment dominated by semantic errors with a secondary impairment in phonological processing, which is later joined by a disruption of visuospatial and graphomotor processing.


FORBES-MCKAY, K., SHANKS, M. and VENNERI, A. 2014. Charting the decline in spontaneous writing in Alzheimer's disease: a longitudinal study. Acta neuropsychiatrica [online], 26(4), pages 246-252. Available from:

Journal Article Type Article
Acceptance Date Jan 9, 2014
Online Publication Date Feb 11, 2014
Publication Date Aug 31, 2014
Deposit Date Dec 21, 2021
Publicly Available Date Aug 23, 2022
Journal Acta Neuropsychiatrica
Print ISSN 0924-2708
Electronic ISSN 1601-5215
Publisher Cambridge University Press (CUP)
Peer Reviewed Peer Reviewed
Volume 26
Issue 4
Pages 246-252
Keywords Alzheimer's disease; Dementia; Disease progression; Longitudinal; Semantic; Writing
Public URL


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