Motor perseveration in geriatric medical patients.

Perseveration has long been considered as a pathognomonic sign of neurological disease, yet, surprisingly, little research exists regarding the accuracy of this assumption. This study matched 56 geriatric medical inpatients with 56 inpatients with recent cerebrovascular accidents. Participants were given one of two measures of general cognition and four Lurian tasks of motor coordination. The results suggest that both motor incoordination and across-tasks perseveration were associated with decreased cognitive status. After controlling for cognitive status, individuals with a neurological history evidenced greater dyscoordination and increased perseveration when compared to age-equivalent general medical patients. Perseveration in participants with recent strokes appeared more related to the amount of neural system disruption as opposed to specific lesion sites. Overall, the results suggest that motor incoordination and "stuck-in-set" perseveration are more indicative of global than localizable brain dysfunction. Possible nonneurologic factors associated with this behavior are also proposed as benchmarks for future research.