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Dissertation
Factor analytic models of the Mattis dementia rating scale in dementia of the Alzheimer's type and vascular dementia patients
Doctor of Philosophy (Ph.D.), Drexel University
1999
DOI:
https://doi.org/10.17918/00009768
Abstract
The current investigation examined the construct validity of the Mattis Dementia Rating Scale's (DRS) factor structure across groups of differing dementia etiologies, dementia of the Alzheimer's type (DAT) and vascular dementia (VaD). It was expected that the factor structure of the Mattis DRS would deviate from that originally proposed by Mattis (1988), as prior investigations have demonstrated in single, heterogeneous groups of dementia patients. Furthermore, the factor structure that was anticipated to emerge for each dementia group (matched on age, education, and dementia severity) would differ and be in accordance with the hallmark neuropsychological deficits seen in each respective dementia etiology. Specifically, it was expected that the performance of the DAT group on the Mattis DRS would produce a more parsimoneous factor structure most influenced by the group's anticipated deficits in semantic and episodic memory. In turn, the VaD group's performance would produce a factor structure most representative of their notable frontal systems deficits. As expected, each of the emerging factor structures for each dementia group differed significantly from the one proposed by Mattis (1988) in the DRS, as well as from each other. Consistent with the wide spectrum of dementia severity included in the current investigation and the neuro pathological progression of the Alzheimer's disease course from posterior association and medial temporal regions to anterior regions and progressive dissolution of basal forebrain, the Mattis DRS factor model of the DAT group, as a whole, represents the neuropsychologically-based progression of the ravages of the disease. In contrast, the factor structure that emerged for the VaD group's performance on the Mattis DRS reflected an influence of the group's prominent frontal systems dysfunction, as well as exhibiting the various behavioral manifestations of such frontal systems dysfunction including problems with initiation and self-monitoring behavior, and deficient constructional skills. In contrast to the DAT model, the VaD factor structure primarily represented various manifestations of higher level, executive functioning. Based on the respective factor structures of each respective etiological group several implications can be derived including ones related to the clinical utility of the Mattis DRS, clinical conceptualization of the respective disease process, patient care recommendations, and the importance of neuropsychological assessment in early diagnosis and potential delay of disease onset.
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Details
- Title
- Factor analytic models of the Mattis dementia rating scale in dementia of the Alzheimer's type and vascular dementia patients
- Creators
- George E. Ledakis
- Contributors
- Thomas Taysum Hewett (Advisor) - Drexel University, Drexel University (1970-)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- x, 201 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- College of Arts and Sciences; Drexel University
- Other Identifier
- 991021889061704721