Impairment in calculation is seen early on in AD. Although the pattern tends to be heterogeneous and inconsistent, there is greater impairment in relation to execution of calculation procedures rather than in answering arithmetic facts (rote-learned calculation outcomes). Within the latter, there is more impairment with multiplication rather than addition and subtraction facts. The deficit in execution has been related in part to the higher executive demand, particularly when the task emphasizes divided attention, such as writing and memorizing. Errors may also be due to problems in organizing and monitoring the sequence of cognitive operations.

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