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6% Caucasian, 571% male) The group demonstrated the anticipated V > P profile of 105 points, but, once again, the index pattern provided more information about the skill areas of the group: VCI (930) > WMI (872) > POI (848) > PSI (796) Overall, studies with the WAIS, WAIS-R, and WAIS-III support a consistent V > P profile, but this cognitive pattern is not good at differentially diagnosing Alzheimer-type dementia from other types of dementia (Nixon, 1996) The Fuld Profile for Alzheimer s-Type Dementia The Fuld profile (Fuld, 1983, 1984) has generated a growing amount of interest with a WAIS/ WAIS-R profile that she believes to be characteristic of adults with Alzheimer s-type dementia Most of the research has been quite positive, particularly in discriminating Alzheimer s patients from patients with other types of dementia.

1 1u v2 2 ,

The next step is to determine the required security properties. The decision is based on the assets and business factors already identified. The summary of this process is shown in Table 14.5.

(10-26)

The Fuld Profile Fuld derived her WAIS profile from an earlier study (Drachman & Leavitt, 1974) and initially reported that an estimated 50% of Alzheimer s patients, compared to less than 1% of normal elderly adults, displayed the characteristic profile (Fuld,.

(10-27)

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1983). She and other investigators subsequently conducted careful research studies to systematically confirm or deny these clinical estimates. The profile makes use of only seven WAIS-R subtests (actually, Fuld and most other researchers have used the WAIS), eliminating the four tasks which are most likely to reflect cultural bias or difficulties in visual acuity (Fuld, 1984, p. 382): Arithmetic, Comprehension, Picture Completion, and Picture Arrangement. The seven tasks are grouped as follows: A = [Information + Vocabulary] divided by 2 B = [Similarities + Digit Span] divided by 2 C = [Digit Symbol + Block Design] divided by 2 D = Object Assembly The Fuld profile, which is computed using age-corrected scaled scores on the previous editions of Wechsler s adult scales, is shown below. A > B > C D and A > D or

and is said to follow the F distribution with u degrees of freedom in the numerator and v degrees of freedom in the denominator. It is usually abbreviated as Fu,v.

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( I + V ) ( S + DSp ) ( DSy + BD ) (I + V) ---------------- > ------------------------ > ----------------------------- (OA) and ---------------- > (OA) 2 2 2 2

Two F distributions are shown in Fig. 10-4. The F random variable is nonnegative, and the distribution is skewed to the right. The F distribution looks very similar to the chi-square distribution; however, the two parameters u and v provide extra exibility regarding shape. The percentage points of the F distribution are given in Table V of the Appendix. Let f ,u,v be the percentage point of the F distribution, with numerator degrees of freedom u and denominator degrees of freedom v such that the probability that the random variable F exceeds this value is P1F f

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The profile has a neuropharmacological basis rather than a neuroanatomic basis and is related to neurotransmitter changes noted in Alzheimer s disease; Fuld (1984) noted that a dramatic deficiency of the cholinergic system is the most severe neurochemical change known to occur in [Alzheimer s disease] (p. 381). Fuld s WAIS-R profile is believed to show the patterning of abilities that results from cholinergic dysfunction. In a systematic investigation of the profile, Fuld (1984) studied normal college students, about half of whom had a chemically induced cholinergic deficiency that mimicked the chemically related dysfunction of Alzheimer s patients. Of the 19 drug subjects, 53% displayed the characteristic Fuld profile; in contrast, only 18% of the 22 college students receiving an injection of a placebo drug evidenced the profile. The difference was statistically significant.

This is illustrated in Fig. 10-5. For example, if u Appendix that P1F f0.05,5,10 2

P1F5,10

Design with a strong Gv component (Space, a match-to-sample spatial orientation test) IMPLICATIONS OF RESULTS These data became the subject of controversy, with Horn and Donaldson (1976) and Botwinick (1977), for example, citing variables such as selective attrition to account for the apparent maintenance of both fluid and crystallized abilities through old age Regardless of the arguments and counterarguments (Baltes & Schaie, 1976; Horn & Donaldson, 1977), the early Schaie data show both consistency and inconsistency with Wechsler and Kaufman cross-sectional results In Schaie s findings, scores on the nonverbal, Gf/Gv tasks (Space, along with a measure of inductive reasoning) clearly began a decline much later in life than was found for Wechsler s Performance subtests Yet, like the Wechsler findings, scores on Space and Reasoning peaked far earlier than the more crystallized PMA subtests (Verbal Meaning and Number).

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