Behavioral and psychological symptoms in dementia with Lewy-bodies (DLB): Frequency and relationship with disease severity and motor impairment

Background/Aims: Behavioral and psychological symptoms of dementia (BPSD) are common in the clinical manifestation of dementia. Although most patients with dementia exhibit some BPSD during the course of the illness, the association of BPSD with the stage of dementia remains unclear. It was the aim of this study to evaluate the impact of severity of dementia on the expression of BPSD in patients with dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). Methods: Ninety-seven patients with DLB and 393 patients with AD were recruited from 8 dementia clinics across Japan. BPSD were assessed by the Neuropsychiatric Inventory (NPI). A relationship between BPSD and dementia stage classified by the Clinical Dementia Rating (CDR) in each type of dementia was assessed. Results: No significant difference was seen in NPI total score across CDR staging in the DLB group. On the other hand, the NPI total score significantly increased with dementia stage in the AD group. Conclusion: The relationship of dementia stage with the expression of BPSD was different according to the type of dementia. BPSD and dementia stage were correlated in AD subjects, in whom psychiatric symptoms increase as the disease progresses, but not in DLB subjects.

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Behavioral and psychological symptoms of dementia in different dementia disorders: A large-scale study of 12 000 individuals.

10.1101/2021.06.24.21259454 ◽

2021 ◽

Author(s):

Emilia Schwertner ◽

Joana Braga Pereira ◽

Hong Xu ◽

Juraj Secnik ◽

Bengt Winblad ◽

...

Keyword(s):

Large Scale ◽

Motor Behavior ◽

Psychological Symptoms ◽

Lewy Bodies ◽

Time Behavior ◽

Dementia Diagnosis ◽

Night Time ◽

Logistic Regression Models ◽

National Quality ◽

Behavioral And Psychological Symptoms

Objective: To characterize behavioral and psychological symptoms of dementia (BPSD) in different dementia diagnoses: Alzheimer's disease (AD), dementia with Lewy bodies (DLB), Parkinson's disease dementia (PDD), vascular dementia (VaD), frontotemporal dementia (FTD), mixed (Mixed) and unspecified dementia. Design: Registry-based cohort study. Setting and participants: 12,137 individuals with dementia registered in two national quality registries, the Swedish registry for cognitive/dementia disorders (SveDem) and the Swedish BPSD registry, during 2010 - 2016. Methods: BPSD was assessed with the Neuropsychiatric Inventory - Nursing Home Version (NPI-NH). Multivariate logistic regression models were used to evaluate the associations between dementia diagnoses and different BPSDs in reference to a) the AD group and b) each of the other diagnostic groups. All models were adjusted for age, gender, the severity of cognitive impairment at the time of dementia diagnosis, and time between dementia diagnosis and BPSD assessment. Results: In all individuals, the three most common symptoms were aberrant motor behaviour (35,1%), agitation (32,3%), and irritability (28,7%), while euphoria (5,9%) was the least frequent. Compared to AD, we found a lower risk of delusions (in VaD, FTD, unspecified dementia), hallucinations (in VaD and FTD), agitation (in PDD, unspecified dementia), elation/euphoria (in DLB), anxiety (in PDD, unspecified dementia), disinhibition (in PDD); irritability (in DLB, PDD, unspecified dementia), aberrant motor behavior (in Mixed, VaD, unspecified dementia) and sleep and night-time behavior changes (in unspecified dementia). Higher risks of delusions (in DLB), hallucinations (in DLB, PDD), apathy (VaD, FTD), disinhibition (in FTD) and appetite and eating abnormalities (in FTD) were found compared to AD. Conclusions and Implications: In this large contemporary cohort, BPSD was common in all types of dementia, with the most common symptoms being aberrant motor behavior, agitation, and irritability. Additionally, BPSD differed depending on the dementia type.

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[P1-462]: [11 C]PK11195 PET IMAGING REVEALS NEUROINFLAMMATION IN DEMENTIA WITH LEWY BODIES IS NEGATIVELY ASSOCIATED WITH DISEASE SEVERITY: NIMROD STUDY

Alzheimer s & Dementia ◽

10.1016/j.jalz.2017.06.478 ◽

2017 ◽

Vol 13 (7S_Part_9) ◽

pp. P463-P464

Author(s):

Ajenthan Surendranathan ◽

Li Su ◽

Luca Passamonti ◽

Young T. Hong ◽

William Richard Bevan-Jones ◽

...

Keyword(s):

Disease Severity ◽

Pet Imaging ◽

Dementia With Lewy Bodies ◽

Lewy Bodies ◽

Negatively Associated

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Increased Transforming Growth Factor β2 in the Neocortex of Alzheimer’s Disease and Dementia with Lewy Bodies is Correlated with Disease Severity and Soluble Aβ42 Load

Journal of Alzheimer s Disease ◽

10.3233/jad-160781 ◽

2017 ◽

Vol 56 (1) ◽

pp. 157-166 ◽

Cited By ~ 12

Author(s):

Joyce R. Chong ◽

Yuek Ling Chai ◽

Jasinda H. Lee ◽

David Howlett ◽

Johannes Attems ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Growth Factor ◽

Disease Severity ◽

Dementia With Lewy Bodies ◽

Transforming Growth Factor ◽

Lewy Bodies ◽

Transforming Growth Factor Β2

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Comparison of QOL between patients with different degenerative dementias, focusing especially on positive and negative affect

International Psychogeriatrics ◽

10.1017/s1041610216000491 ◽

2016 ◽

Vol 28 (8) ◽

pp. 1355-1361 ◽

Cited By ~ 6

Author(s):

Kairi Kurisu ◽

Seishi Terada ◽

Etsuko Oshima ◽

Makiko Horiuchi ◽

Nao Imai ◽

...

Keyword(s):

Negative Affect ◽

Positive Affect ◽

Outcome Measure ◽

Psychological Symptoms ◽

Lewy Bodies ◽

Positive And Negative Affect ◽

Dementia Patients ◽

The Difference ◽

Behavioral And Psychological Symptoms

ABSTRACTBackground:Quality of life (QOL) has become an important outcome measure in the care of dementia patients. However, there have been few studies focusing on the difference in QOL between different dementias.Methods:Two-hundred seventy-nine consecutive outpatients with Alzheimer's disease (AD), dementia with Lewy bodies (DLB) or frontotemporal dementia (FTD) were recruited. The QOL was evaluated objectively using the QOL Questionnaire for Dementia (QOL-D).The QOL-D comprises six domains: positive affect, negative affect and actions, communication, restlessness, attachment to others, and spontaneity. General cognition, daily activities, and behavioral and psychological symptoms of dementia were also evaluated.Results:The scores of positive affect of QOL-D of AD patients were significantly higher than those of patients with DLB or FTD (AD 3.1 ± 0.8, DLB 2.6 ± 0.9, FTD 2.6 ± 0.7). The scores of negative affect and action of QOL-D of FTD patients were significantly higher than those of patients with AD or DLB (FTD 2.0 ± 0.8, AD 1.4 ± 0.5, DLB 1.5 ± 0.6). The apathy scores of FTD and DLB patients were significantly higher than those of patients with AD. The disinhibition scores of FTD patients were significantly higher than those of patients with AD or DLB.Conclusions:The apathy of FTD and DLB patients and depression of DLB patients might affect the lower positive affect of FTD and DLB patients compared to AD patients. The disinhibition of FTD patients might affect the abundance of negative affect & actions in FTD patients compared to AD and DLB patients.

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