Behavioral and Psychological Signs and Symptoms of Dementia (BPSD) in antipsychotic-naïve Alzheimer's Disease patients

2004 ◽  
Vol 16 (3) ◽  
pp. 337-350 ◽  
Author(s):  
Guk-Hee Suh ◽  
Seung Kyum Kim
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Psychological Symptoms ◽  
Severity Of Illness ◽  
Signs And Symptoms ◽  
Community Dwelling ◽  
Global Deterioration Scale ◽  
Dementia Patients ◽  
Elderly Koreans ◽  
At Home

Background/Objective: There were few studies identifying the natural unfolding of behavioural and psychological symptoms of dementia (BPSD) in the course of Alzheimer's disease (AD) progression in antipsychotic-naïve AD patients. This study aims to examine the specific nature of the association between BPSD in AD and the global severity of illness measured by Global Deterioration Scale(GDS) in antipsychotic-naïve AD patients in Korea.Methods: A total of 562 antipsychotics-naïve AD patients were recruited from four different groups [a geriatric mental hospital (n=145), a semi-hospitalized dementia institution (n=120), a dementia clinic (n=114) and community-dwelling dementia patients (n=183)]. BPSD exhibited by AD patients were measured using the 25-item Korean version of the BEHAVE-AD.Results: Ninety-two percent (n=517) of AD patients had at least one BPSD, while 56% (n=315) had 4 or more BPSD. Specific kinds of behavioral disturbance peak at the stages of moderate AD (GDS stage 5) or moderately severe AD (GDS stage 6). AD patients left at home without any treatment had higher frequency of BPSD than did other groups seeking treatment, although all of them were antipsychotic-naïve.Conclusion: BPSD potentially remediable to treatment were highly frequent in Korean AD patients. Health policies to meet the unmet needs of elderly Koreans are urgently needed, especially for AD patients at home without treatment.

scholarly journals Nationwide study of antipsychotic use among community-dwelling persons with Alzheimer's disease in Finland

2011 ◽  
Vol 23 (10) ◽  
pp. 1623-1631 ◽  
Author(s):  
Marja-Liisa Laitinen ◽  
J. Simon Bell ◽  
Piia Lavikainen ◽  
Eija Lönnroos ◽  
Raimo Sulkava ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
Primary Care Physicians ◽  
Social Insurance ◽  
Psychological Symptoms ◽  
Conditional Logistic Regression ◽  
Age Groups ◽  
Community Dwelling ◽  
Limited Effectiveness

ABSTRACTBackground: Antipsychotics continue to be widely used in the treatment of behavioral and psychological symptoms of dementia despite their limited effectiveness and well-known risks, including increased mortality. Our aim was to investigate the national pattern of antipsychotic use among community-dwelling persons with and without Alzheimer's disease (AD) in Finland.Methods: The Social Insurance Institution of Finland (SII) identified all persons with a verified diagnosis of AD in Finland on 31 December 2005. A control for each person with AD, matched in terms of age, sex and region of residence, was also identified. Data on reimbursed drug purchases in 2005 were extracted from the Finnish National Prescription Register. Conditional logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the use of antipsychotics.Results: The study population comprised 28,089 matched pairs of persons with and without AD (mean age 80.0 years, SD 6.8, 32.2% men). The annual prevalence of antipsychotic use was higher among persons with than without AD (22.1% vs. 4.4%, adjusted OR = 5.91; 95% CI 5.91–6.31). Among persons with AD, the prevalence of antipsychotic use was similar across all age groups. Of the antipsychotic users, 85.2% with AD and 51.3% without AD purchased second generation antipsychotics. Most antipsychotic prescriptions – 67.8% in the AD and 62.9% in the non-AD group – were generated in primary care situations.Conclusion: One-fifth of persons with AD used antipsychotic drugs. Antipsychotic use was six times more prevalent among persons with AD than without AD. Most antipsychotics were prescribed by primary care physicians.

scholarly journals A STUDY FOR COMPARISON OF CAREGIVER BURDEN AND BEHAVIORAL AND PSYCHOTIC SYMPTOMS IN FRONTOTEMPORAL DEMENTIA AND ALZHEIMER’S DEMENTIA

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Nirad Yadav ◽  
Sanjay Jain ◽  
Richa Jain
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Caregiver Burden ◽  
Significant Positive Correlation ◽  
Psychological Symptoms ◽  
Behavioral Problem ◽  
Psychotic Symptoms ◽  
Psychiatric Clinic ◽  
Positive Correlation ◽  
Dementia Patients

Background:  Dementia is a syndrome that results in the progressive deterioration of cortical functioning including comprehension, memory and thinking. Alzheimer’s disease (AD) is the most common cause of dementia accounting for 50-75% and Front temporal dementia (FTD) around 5-10% of dementia cases. Behavioral and psychological symptoms (BPSD) form a major part of the presentation of the dementia patients at psychiatric clinic and play a crucial role in caregiver distress which in turn is a major determinant of welfare of dementia patients in society. Objective:  Present study is to compare care giver burden and BPSD in patients with FTD and AD. Method:  We compared 41 patients’, of which 15 of FTD and 26 of AD with respect to the Neuropsychiatric Inventory (NPI), Hindi Mental State Examination (HMSE) and Zarit Burden Inventory (ZBI) at SMS Medical College, Jaipur. Results: FTD patients obtained a significantly higher NPI behavioral score And ZBI than AD patients and mean value of HMSE is higher in FTD than AD. Significant positive correlation between NPI and ZBI is observed in both groups. Significant positive correlation between HMSE and ZBI is found in FTD obtained, Conclusion: More behavioral problem in FTD makes it difficult for patient’s caregiver to manage patients at home this leads to rapid institutionalization, although severity of dementia is less. Keywords: Alzheimer’s disease, Front temporal dementia, BPSD, Caregiver Burden

Alzheimer’s Disease

2008 ◽  
Author(s):  
Martin Steinberg
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Depressive Disorders ◽  
Short Term Memory ◽  
Signs And Symptoms ◽  
The Elderly ◽  
Dementia Patients ◽  
Physical Burden ◽  
Degenerative Dementia ◽  
Proper Diagnosis

Alzheimer’s disease (AD), a progressive degenerative dementia, causes suffering for millions of patients as well as their caregivers. Among the elderly, the prevalence of AD increases dramatically with age: it is about 5% to 7% in people 65 years of age and older and rises to 40% to 50% in those older than 90 years of age (Rabins, Lyketsos, and Steele, 1999). AD typically affects short-term memory first; over time, impairment in language, praxis, recognition, and executive function occur. In the late stages, patients become completely dependent on others. In addition to this cognitive and physical burden, psychiatric signs and symptoms are nearly universal. These psychiatric phenomena, which include depression, delusions, hallucinations, apathy, and aggression, affect as many as 90% of patients with dementia over the course of their illness (Steinberg et al., 2003). Psychiatric phenomena often present differently in patients with AD than in the population without dementia. Uncertainty remains regarding how to best classify many of these phenomena. For example, delusions can be described as occurring in isolation, or as part of a psychotic syndrome, with associated features such as irritability and agitation. Delusions can also occur as part of a depressive syndrome or delirium. Little research is currently available to guide treatment. Nevertheless, many syndromes can be accurately diagnosed and can respond to a variety of pharmacologic and nonpharmacologic treatments. Depressive phenomena are common in AD. Estimates for the prevalence of major depression in patients with AD are 20% to 25%, (Lyketsos et al., 2003). Due to their dementia, patients with AD are often poor historians. They may not be aware of Depressive phenomena or able to recall them, and their aphasia may make describing symptoms difficult. Therefore, information from a reliable caregiver is crucial for making a proper diagnosis. Depressive disorders in AD are often somewhat different from those occurring in the absence of dementia. In particular, patients with AD may not endorse hopelessness, suicidal thoughts, or worthlessness (Zubenko et al., 2003). Patients with AD, however, express symptoms such as anxiety, anhedonia, irritability, lack of motivation, and agitation (Rosenberg et al., 2005).

scholarly journals Incidence of antipsychotic use in relation to diagnosis of Alzheimer's disease among community-dwelling persons

2015 ◽  
Vol 207 (5) ◽  
pp. 444-449 ◽  
Author(s):  
Marjaana Koponen ◽  
Anna-Maija Tolppanen ◽  
Heidi Taipale ◽  
Antti Tanskanen ◽  
Jari Tiihonen ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Time Window ◽  
Psychological Symptoms ◽  
Disease Diagnosis ◽  
Community Dwelling ◽  
Prescription Register ◽  
Behavioural And Psychological Symptoms ◽  
Distinct Increase ◽  
Community Dwellers

BackgroundBehavioural and psychological symptoms of dementia are frequently treated with antipsychotics.AimsTo determine the incidence of antipsychotic use in relation to diagnosis of Alzheimer's disease.MethodCohort of all community-dwellers in Finland diagnosed with Alzheimer's disease in 2005 and matched controls. All antipsychotics dispensed between 1995 and 2009 were extracted from the Finnish National Prescription Register.ResultsAltogether 1996/6087 (32.8%) persons with Alzheimer's disease initiated antipsychotic use. The incidence of antipsychotic use was fivefold among persons with Alzheimer's disease compared with controls, started to increase 2–3 years before diagnosis and was highest during the first 6 months after diagnosis.ConclusionsA distinct increase in antipsychotic initiations occurs in the same time window as Alzheimer's disease diagnosis.

scholarly journals Yokukansankachimpihange Is Useful to Treat Behavioral/Psychological Symptoms of Dementia

2021 ◽  
Vol 7 ◽  
Author(s):  
Eiichi Katsumoto ◽  
Toru Ishida ◽  
Kenji Kinoshita ◽  
Miho Shimizu ◽  
Toshihito Tsutsumi ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Daily Living ◽  
Rating Scale ◽  
Psychological Symptoms ◽  
Gastrointestinal Symptoms ◽  
Multicenter Studies ◽  
Dementia Patients ◽  
Loss Of Appetite ◽  
Behavioral And Psychological Symptoms

Yokukansankachimpihange is a Japanese herbal medicine reported to benefit anxiety and sleep disorders, and it has recently been introduced to treat behavioral and psychological symptoms of dementia. There are no multicenter studies of its effectiveness regarding dementia in Japan, and this study's main objective was to clarify the effects of Yokukansankachimpihange on behavioral and psychological symptoms of dementia in a sample of patients from multiple healthcare centers. Nine facilities affiliated with Osaka Association of Psychiatric Clinics participated in November 2013 through April 2015 and provided 32 Alzheimer's disease patients to whom Yokukansankachimpihange was orally administered for 8 weeks. During the study, the patients continued their regular medication regimens. Behavioral and psychological symptoms of dementia (Behavioral Pathology in Alzheimer's Disease Rating Scale [Behave-AD]), core symptoms [Mini-Mental State Examination (MMSE)], activities of daily living [Nishimura Activity of Daily Living Scale (N-ADL)], and gastrointestinal symptoms (nausea/vomiting, loss of appetite, gastric discomfort, constipation, and diarrhea) were measured at baseline, after 4 weeks of treatment and after 8 weeks of treatment. Yokukansankachimpihange was orally administered at a dosage of 7.5 g twice daily before or between meals for 8 weeks. The Behave-AD mean score significantly improved after 8 weeks of treatment. There were no significant changes in MMSE, N-ADL, or gastrointestinal symptoms; however, decreased gastrointestinal scores were observed after 8 weeks. There were no side effects related to Yokukansankachinpihange. Pharmaceutical treatments are important for treating behavioral and psychological symptoms of dementia, and this study confirmed Yokukansankachimpihange's efficacy for treating Alzheimer's disease. Because the aggressiveness and sleep disorder components of the Behave-AD construct were the symptoms most improved and those symptoms are known to significantly burden dementia patients' caregivers, Yokukansankachimpihange's efficacy might indirectly relieve these caregivers' burden of care.

scholarly journals Classifying Non-Dementia and Alzheimer’s Disease/Vascular Dementia Patients Using Kinematic, Time-Based, and Visuospatial Parameters: The Digital Clock Drawing Test

2021 ◽  
Vol 82 (1) ◽  
pp. 47-57 ◽  
Author(s):  
Anis Davoudi ◽  
Catherine Dion ◽  
Shawna Amini ◽  
Patrick J. Tighe ◽  
Catherine C. Price ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Vascular Dementia ◽  
Area Under The Curve ◽  
Clock Drawing Test ◽  
Digital Clock ◽  
Clock Drawing ◽  
Drawing Test ◽  
Dementia Patients ◽  
Optimal Area

Background: Advantages of digital clock drawing metrics for dementia subtype classification needs examination. Objective: To assess how well kinematic, time-based, and visuospatial features extracted from the digital Clock Drawing Test (dCDT) can classify a combined group of Alzheimer’s disease/Vascular Dementia patients versus healthy controls (HC), and classify dementia patients with Alzheimer’s disease (AD) versus vascular dementia (VaD). Methods: Healthy, community-dwelling control participants (n = 175), patients diagnosed clinically with Alzheimer’s disease (n = 29), and vascular dementia (n = 27) completed the dCDT to command and copy clock drawing conditions. Thirty-seven dCDT command and 37 copy dCDT features were extracted and used with Random Forest classification models. Results: When HC participants were compared to participants with dementia, optimal area under the curve was achieved using models that combined both command and copy dCDT features (AUC = 91.52%). Similarly, when AD versus VaD participants were compared, optimal area under the curve was, achieved with models that combined both command and copy features (AUC = 76.94%). Subsequent follow-up analyses of a corpus of 10 variables of interest determined using a Gini Index found that groups could be dissociated based on kinematic, time-based, and visuospatial features. Conclusion: The dCDT is able to operationally define graphomotor output that cannot be measured using traditional paper and pencil test administration in older health controls and participants with dementia. These data suggest that kinematic, time-based, and visuospatial behavior obtained using the dCDT may provide additional neurocognitive biomarkers that may be able to identify and tract dementia syndromes.

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