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To the Editor:
I read with interest Thal et al.’s article on the use of acetyl-l-carnitine in early-onset dementia of the Alzheimer type.1 However, I am puzzled by their classification of errors on the Folstein Mini-Mental State Examination (MMSE).2
They state that attentional differences accounted for better performance in the treated completer sample. It is, of course, surprising that a bedside test of attention would distinguish individuals with early AD. Unlike “attentional” or “intentional” dementias3 that may be present with isolated frontal lobe abnormalities, dementia of the Alzheimer type rarely presents with distractibility, …
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