Intended for healthcare professionals


Great minds don’t always think alike

BMJ 2009; 338 doi: (Published 16 April 2009) Cite this as: BMJ 2009;338:b1106
  1. Shelley A Sternberg, director of geriatrics, Jerusalem-Shfela region, Maccabi Healthcare Services Israel, Jerusalem, Israel
  1. ssternbe{at}

    One of the well worn mnemonics used in assessing Alzheimer’s disease focuses on the four A’s—aphasia, amnesia, agnosia, and apraxia. I have always relied on this tool as a useful diagnostic guide. The dictionary definition of the fourth A, apraxia, is “inaction” from the Greek praktos (to do, to practice). This inaction is due to the loss of ability to recognise objects or their uses. “My mother can’t …

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