The Genesis of Graphic Perseverations in Alzheimers Disease and Vascular Dementia

Natascia De Lucia, Dario Grossi, Luigi Trojano

Research output: Contribution to journalArticlepeer-review


Objective: Perseveration is the involuntary production of iterative responses. This study explored graphic perseverative errors in Alzheimers disease and vascular dementia, to comprehend the neuropsychological correlates of this behavior. Method: We performed a retrospective analysis of graphic productions in 114 individuals with clinical diagnosis of Alzheimers disease and in 63 individuals with clinical diagnosis of vascular dementia, who completed frontal-executive, visuo-spatial, visuo-constructional, and verbal memory tests. For assessing perseverative behavior, we considered recurrent perseverations (inappropriate re-drawing of a figure drawn in a previous trial) and continuous perseverations (inappropriate replication of the same figure or of its element within one trial) produced in a standard copying task. Results: Two or more graphic perseverative errors occurred in 66/114 individuals with Alzheimers disease (57.9%) and in 31/63 individuals with vascular dementia (49.2%). Participants with moderate-to-severe dementia produced a significantly higher number of perseverations than individuals with mild dementia. Logistic regression revealed a significant relationship of graphic perseverations with frontal and visuo-constructive impairments, in both Alzheimers disease and vascular dementia. Conclusions: Graphic perseverations are frequent in both Alzheimers disease and vascular dementia. Frontal-executive defects can hamper inhibition of iterative graphic productions. Identification of graphic perseverations can be useful for detection and monitoring of frontal-executive impairments throughout the disease course in individuals with dementia.

Original languageEnglish
Pages (from-to)924-937
Number of pages14
JournalClinical Neuropsychologist
Issue number7
Publication statusPublished - Oct 3 2015


  • Alzheimer's disease
  • Frontal defect
  • Perseveration
  • Vascular dementia
  • Visuo-construction

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Neuropsychology and Physiological Psychology
  • Clinical Psychology
  • Arts and Humanities (miscellaneous)
  • Developmental and Educational Psychology


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