Author :
Abstract
Aim: Neuropsychiatric symptoms (NPS) dramatically impacts the progression, caregiver burden, and healthcare cost of Alzheimer’s disease (AD). The assessment of NPS in each patient may help to understand disease progress and clinical condition. This study aimed to assess the frequency and severity of NPS and its possible correlation with cognitive impairment among AD patients. Material and Methods: A retrospective screening of AD patients with applied Neu-ropsychiatric Inventory (NPI), Mini-Mental State Examination (MMSE), and Clinical Dementia Rating (CDR) resulted in 51 AD patients in 2015-2020. Results: The gender of 51 patients was 29 male (%56.9) and 22 female (%43.1) in sample size. MMSE (mean SD: 19.75±4.408) was not correlated with NPI total score (mean SD: 22.06±19.781) (p=0.610, rho:-0.073). The most prevalent NPS were depression (62.7%), irritability (62.7%), anxiety (60.8%), while less reported NPS were delusion (5.9%), hallucination (13.7%), and euphoria (15.7%). The scores of delusions, hallucinations, euphoria, abnormal motor behaviour, night-time behavioural disturbances, and appetite were significantly more increased in CDR 1 (mild dementia) group than CDR 0.5 (very mild dementia) (Mann-Whitney U test, p<0.05). Conclusion: According to our results, NPS was associated with the stage of dementia, not with the mini mental test score. Considering the effect of NPS burden on the disease, these symptoms should be evaluated at each stage, as well as cognitive examination by healthcare professionals.
Keywords
Abstract
Keywords
- 1. Lyketsos, C.G., et al., prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. Jama, 2002. 288(12): p. 1475-1483.
- 2. Zhao, Q.-F., et al., The prevalence of neuropsychiatric symptoms in Alzheimer’s disease: systematic review and meta-analysis. Journal of affective disorders, 2016. 190: p. 264-271.
- 3. Musa, G., et al., Utility of the neuropsychiatric inventory questionnaire (NPI-Q) in the assessment of a sample of patients with Alzheimer’s disease in Chile. Dementia & neuropsychologia, 2017. 11(2): p. 129-136.
- 4. Srikanth, S., A. Nagaraja, and E. Ratnavalli, Neuropsychiatric symptoms in dementia-frequency, relationship to dementia severity and comparison in Alzheimer’s disease, vascular dementia and frontotemporal dementia. Journal of the neurological sciences, 2005. 236(1-2): p. 43-48.
- 5. Chow, T., et al., Neuropsychiatric symptoms of Alzheimer’s disease differ in Chinese and American patients. International Journal of Geriatric Psychiatry, 2002. 17(1): p. 22-28.
- 6. Steffens, D.C., et al., prevalence and clinical correlates of neuropsychiatric symptoms in dementia. American Journal of Alzheimer’s Disease & Other Dementias®, 2005. 20(6): p. 367-373.
- 7. Geda, Y.E., et al., prevalence of neuropsychiatric symptoms in mild cognitive impairment and normal cognitive aging: population-based study. Archives of general psychiatry, 2008. 65(10): p. 1193-1198.
- 8. Lyketsos, C.G., et al., Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. American Journal of Psychiatry, 2000. 157(5): p. 708-714.
- 9. Okura, T., et al., Prevalence of neuropsychiatric symptoms and their association with functional limitations in older adults in the United States: the aging, demographics, and memory study. Journal of the American Geriatrics Society, 2010. 58(2): p. 330-337.
- 10. González‐Salvador, M.T., et al., The stress and psychological morbidity of the Alzheimer patient caregiver. International journal of geriatric psychiatry, 1999. 14(9): p. 701-710.
- 11. Logsdon, R.G., et al., Wandering: a significant problem among community residing individuals with Alzheimer’s disease. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 1998. 53(5): p. P294-P299.
- 12. Okura, T., et al., Neuropsychiatric symptoms and the risk of institutionalization and death: the aging, demographics, and memory study. Journal of the American Geriatrics Society, 2011. 59(3): p. 473-481.
- 13. Wang, J., et al., Pharmacological treatment of neuropsychiatric symptoms in Alzheimer’s disease: a systematic review and meta-analysis. Journal of Neurology, Neurosurgery & Psychiatry, 2015. 86(1): p. 101-109.
- 14. Folstein, M.F., S.E. Folstein, and P.R. McHugh, “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research, 1975. 12(3): p. 189-198.
- 15. Morris, J.C., Clinical dementia rating: a reliable and valid diagnostic and staging measure for dementia of the Alzheimer type. International psychogeriatrics, 1997. 9(S1): p. 173-176.
- 16. Morris, J.C., The clinical dementia rating (cdr): Current version and. Young, 1991. 41: p. 1588-1592.
- 17. Culyer, A., et al., Searching for a threshold, not setting one: the role of the National Institute for Health and Clinical Excellence. Journal of health services research & policy, 2007. 12(1): p. 56-58.
- 18. Burns, A., R. Jacoby, and R. Levy, Psychiatric phenomena in Alzheimer’s disease. I: Disorders of thought content. The British Journal of Psychiatry, 1990. 157(1): p. 72-76.
- 19. Lyketsos, C., et al., Mental and neuropsychiatric symptoms in dementia: findings from the Cache County Study on Memory in Aging. Am J Psychiatry, 2000. 157(5): p. 708-714.
- 20. Lyketsos, C.G., et al., Major and minor depression in Alzheimer’s disease: prevalence and impact. Journal of Neuropsychiatry and Clinical Neurosciences, 1997. 9(4): p. 556-561.
- 21. Mega, M.S., et al., The spectrum of behavioral changes in Alzheimer’s disease. Neurology, 1996. 46(1): p. 130-135.
- 22. Allegri, F.E.T.R.F. and H.K.D.R.S. Cecilia, Mild behavioral impairment and risk of dementia: a prospective cohort study of 358 patients. The Journal of clinical psychiatry, 2009. 70(4): p. 584-592.
- 23. Geda, Y.E., et al., Baseline neuropsychiatric symptoms and the risk of incident mild cognitive impairment: a population-based study. American Journal of Psychiatry, 2014. 171(5): p. 572-581.
- 24. Chen, J.C., S. Borson, and J.M. Scanlan, Stage-specific prevalence of behavioral symptoms in Alzheimer’s disease in a multi-ethnic community sample. The American Journal of Geriatric Psychiatry, 2000. 8(2): p.
- 25. Mirea, A., Neuropsychiatric aspects of dementia. Dementia, 2000: p. 61-79.
- 26. Lapchak, Paul A., and John H. Zhang, eds. Neuroprotective therapy for stroke and ischemic disease. Switzerland: Springer International Publishing, 2017. doi:10.1007/978-3-319-45345-3
