the expression. It is possible that, even in patients with a diagnosis of moderate severe AD, the analysis of the graphic expression provides the degree of the remaining capacity of understanding and through handwriting intentions of the patients can be expressed correctly. Assessment of fluctuations should be consid ered as an intrinsic and useful method in the evalu- ation of patients for cognitive disorders The evalu- ation of the dementia patient may be confounded if a fluctuation occurs during the course of assess- ment of functional abilities and test perfor-mance http://www.ncbi nlm nih govipme/arti cles/PMC2809035/ r3.7299sr3-7299. In the perspective of the present interpreta- tion, a more detailed evaluation of graphia can make an important contribution to the diagnostic assessment and to screen for cognitive impair- ment