Behavioral and Neuropsychiatric Outcomes in Alzheimer's Disease

CNS Spectrums ◽  
2005 ◽  
Vol 10 (S18) ◽  
pp. 22-25 ◽  
Author(s):  
Jeffrey L. Cummings
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cholinesterase Inhibitors ◽  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Caregiver Distress ◽  
Aspartate Receptor ◽  
Home Placement ◽  
Behavioral And Psychological Symptoms

AbstractBehavioral and psychological symptoms of dementia pose significant challenges in the management of patients with Alzheimer's disease. Neuropsychiatric symptoms are associated with cognitive decline, highly impaired activities of daily living, and frontal lobe pathology. Moreover, behavioral and psychological symptoms can diminish patient quality of life, increase caregiver distress, and accelerate nursing home placement. Although these symptoms are often associated with the later stages of Alzheimer's disease, a high percentage of individuals with mild cognitive impairment or mild Alzheimer's report symptoms as well. This article provides an overview of behavioral and neuropsychiatric symptoms associated with Alzheimer's disease and discusses nonpharmacologic and pharmacologic approaches to the management of such symptoms. For patients with severe behavioral and psychological symptoms of dementia, pychotropic agents may be warranted, whereas approved therapies for Alzheimer's, including cholinesterase inhibitors and the N-methyl-D-aspartate receptor antagonist memantine, may be appropriate in less severe cases.

scholarly journals Caregiver distress associated with behavioral and psychological symptoms in mild Alzheimer's disease

2010 ◽  
Vol 4 (3) ◽  
pp. 238-244 ◽  
Author(s):  
Ari Pedro Balieiro Jr. ◽  
Emmanuelle Silva Tavares Sobreira ◽  
Marina Ceres Silva Pena ◽  
José Humberto Silva-Filho ◽  
Francisco de Assis Carvalho do Vale
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Psychological Symptoms ◽  
Time Behavior ◽  
Caregiver Distress ◽  
Night Time ◽  
The Mean ◽  
The Individual ◽  
The Relationship ◽  
Behavioral And Psychological Symptoms

Abstract The aim of this study was to analyze the relationship between Caregiver Distress and Behavioral and Psychological Symptoms in Dementias (BPSD) in mild Alzheimer's disease. Methods: Fifty patients and caregivers were interviewed using the Neuropsychiatric Inventory (NPI). Results: 96.0% of the patients had at least one BPSD. The mean NPI total score was 19.6 (SD=18.05; range=0-78) whereas the mean Caregiver Distress Index (CDI) total score was 11.5 (SD=10.41; range=0-40). For the individual symptoms, the weighted mean CDI was 2.8 (SD=1.58). All symptom CDI means were higher than 2.0 except for euphoria/elation (m=1.8; SD=1.49). There were correlations between CDI and derived measures (Frequency, Severity, FxS, and Amplitude) for all symptoms, except Disinhibition and Night-time behavior. Correlations ranged between 0.443 and 0.894, with significance at p<0.05. Conclusions: All the derived measures, including amplitude, were useful in at least some cases. The data suggests that CDI cannot be inferred from symptom presence or profile. Symptoms should be systematically investigated.

Behavioral and psychological symptoms of dementia in an Indian population: comparison between Alzheimer's disease and vascular dementia

2006 ◽  
Vol 18 (1) ◽  
pp. 87-93 ◽  
Author(s):  
C. Pinto ◽  
R. Seethalakshmi
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Vascular Dementia ◽  
Rating Scale ◽  
Psychological Symptoms ◽  
Behavioral Symptoms ◽  
Caregiver Distress ◽  
Population Comparison ◽  
Behavioral And Psychological Symptoms ◽  
Behavioral Pathology

Background: Differential patterns of brain lesions in patients with Alzheimer's disease (AD) or vascular dementia (VaD) can result in differing clinical courses and presentations.Method: Thirty patients with AD were compared with 29 patients with VaD for differences in behavioral symptoms using the Behavioral Pathology in Alzheimer's Disease (BEHAV-AD) rating scale.Results: Patients with AD had significantly more delusions, hallucinations, anxieties and phobias and caregiver distress than patients with VaD.Conclusions: Behavioral symptoms in both AD and VaD exhibit specific longitudinal patterns. An understanding of the pattern can aid the treating physician in giving appropriate advice to caregivers regarding the course of the illness and also help them in planning appropriate interventions.

Neuropsychiatric symptoms (behavioral and psychological symptoms of dementia) and the development of dementia treatments

2007 ◽  
Vol 19 (3) ◽  
pp. 409-420 ◽  
Author(s):  
Constantine G. Lyketsos
Keyword(s):  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Caregiver Distress ◽  
Meaningful Change ◽  
Treatment Target ◽  
Clinical Measures ◽  
Behavioral And Psychological Symptoms

Neuropsychiatric symptoms (NPS) are central features of dementia and an important treatment target. They should be assessed in future studies of emerging dementia therapies, using appropriate measures matched to the purpose of each study. Several significant issues remain regarding (1) the classification of these symptoms into syndromes, and (2) the development of better clinical measures for their quantification. In particular, effort should be directed at assessing their evolution over shorter time periods, and at using more objective methods in their measurement, such as actigraphy. These issues can be solved with nosologic study and other advances that could be brought about quickly, if appropriate time and effort are allocated. Empirical characterization of clinically meaningful change in NPS – by examining their relationship with dementia care burden, disability, quality of life, caregiver distress, and resource utilization – would be an important advance.

scholarly journals 105 - Behavioral and Psychological Symptoms of Dementia: Novel modes of Treatment and Care Delivery

2020 ◽  
Vol 32 (S1) ◽  
pp. 11-11
Author(s):  
Melanie T. Gentry ◽  
Janette Leal ◽  
Joshua Baruth ◽  
Jaclyn Lindsey
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Psychological Symptoms ◽  
Care Delivery ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Neuropsychiatric Symptoms ◽  
World Population ◽  
Negative Consequences ◽  
Number Of Individuals ◽  
Behavioral And Psychological Symptoms

As the World Population continues to expand, the number of individuals affected by Alzheimer’s Disease and other Dementias is also rapidly increasing. The number of individuals living with dementia is expected to increase to 131.5 million by 2050. (Prince et al., 2015) Behavioral and Psychological Symptoms of Dementia (BPSD) are highly prevalent, affecting up to 80% of individuals with dementia. (Garre-Olmo, Lopez-Pousa et al. 2010) BPSD has significant negative consequences for morbidity, mortality, and quality of life in those with dementia. Unfortunately, available treatments for BPSD are often limited or inconsistent in their efficacy and prone to severe adverse drug effects such as increased mortality.(Schneider, Dagerman et al. 2006) It is increasingly clear that current approaches are inadequate and novel treatments for BPSD need to be explored and researched. This symposium will draw on the available research literature as well as clinical experiences and case examples to provide up to date information on some of the newest treatment options available for BPSD. Dr. Melanie Gentry will discuss the use of telemedicine and other forms of technology to improve diagnosis and treatment of individuals with BPSD. Dr. Baruth will discuss the rapidly growing interest in the use of medical marijuana and cannabinoids in the management of BPSD. Dr. Lindsey will review the evidence for neuromodulation techniques including electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). Dr. Leal will review environmental and behaviorally based interventions. Garre-Olmo, J., S. Lopez-Pousa, J. Vilalta-Franch, M. de Gracia Blanco and A. B. Vilarrasa (2010). “Grouping and trajectories of the neuropsychiatric symptoms in patients with Alzheimer's disease, part I: symptom clusters.” J Alzheimers Dis 22(4): 1157-1167.

scholarly journals A Comparison of Behavioral and Psychological Symptoms of Dementia (BPSD) and BPSD Sub-Syndromes in Early-Onset and Late-Onset Alzheimer’s Disease

2021 ◽  
pp. 1-9
Author(s):  
Natalia Altomari ◽  
Francesco Bruno ◽  
Valentina Laganà ◽  
Nicoletta Smirne ◽  
Rosanna Colao ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Early Onset ◽  
Psychological Symptoms ◽  
Late Onset ◽  
Point Of View ◽  
Behavioral And Psychological Symptoms ◽  
Over Time

Background: Behavioral and psychological symptoms of dementia (BPSD) have a large impact on the quality of life of patients with Alzheimer’s disease (AD). Few studies have compared BPSD between early-onset (EOAD) and late-onset (LOAD) patients, finding conflicting results. Objective: The aims of this study were to: 1) characterize the presence, overall prevalence, and time of occurrence of BPSD in EOAD versus LOAD; 2) estimate the prevalence over time and severity of each BPSD in EOAD versus LOAD in three stages: pre-T0 (before the onset of the disease), T0 (from onset to 5 years), and T1 (from 5 years onwards); 3) track the manifestation of BPSD sub-syndromes (i.e., hyperactivity, psychosis, affective, and apathy) in EOAD versus LOAD at T0 and T1. Methods: The sample includes 1,538 LOAD and 387 EOAD diagnosed from 1996 to 2018. Comprehensive assessment batteries, including the Neuropsychiatric Inventory (NPI), were administered at the first medical assessment and at different follow-up period. Results: The overall prevalence for the most of BPSD was significantly higher in EOAD compared to LOAD whereas most BPSD appeared significantly later in EOAD patients. Between the two groups, from pre-T0 to T1 we recorded a different pattern of BPSD prevalence over time as well as for BPSD sub-syndromes at T0 and T1. Results on severity of BPSD did not show significant differences. Conclusion: EOAD and LOAD represent two different forms of a single entity not only from a neuropathological, cognitive, and functional level but also from a psychiatric point of view.

scholarly journals TOP CITED PAPERS IN INTERNATIONAL PSYCHOGERIATRICS: 6b. BEHAVIORAL DISORDERS AND CAREGIVERS' REACTION IN TAIWANESE PATIENTS WITH ALZHEIMER'S DISEASE

2009 ◽  
Vol 21 (6) ◽  
pp. 1031-1036 ◽  
Author(s):  
Jong-Ling Fuh ◽  
Jeffrey L. Cummings
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Behavioral Disorders ◽  
Medical Management ◽  
Psychological Symptoms ◽  
Cognitively Impaired ◽  
Clinical Issues ◽  
Behavioral And Psychological Symptoms

The behavioral and psychological symptoms of dementia (BPSD) are common and serious problems that affect the quality of life of the patients who experience such symptoms as well as their caregivers (Matsui et al., 2006). BPSD present a major challenge in the medical management of cognitively impaired patients. Our paper entitled “Behavioral disorders and caregivers’ reaction in Taiwanese patients with Alzheimer's disease” (hereafter referred to as the “paper”) (Fuh et al., 2001) has been cited widely, reflecting the importance of these clinical issues and the growing international interest in studies of BPSD.

scholarly journals The influence of caregivers and behavioral and psychological symptoms on nursing home placement of persons with Alzheimer’s disease: A matched case–control study

2016 ◽  
Vol 4 ◽  
pp. 205031211666187 ◽  
Author(s):  
Candace N Porter ◽  
Margaret C Miller ◽  
Marcia Lane ◽  
Carol Cornman ◽  
Khaled Sarsour ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Psychological Symptoms ◽  
Nursing Home Placement ◽  
Nursing Home Admission ◽  
Neuropsychiatric Inventory ◽  
Matched Case ◽  
Home Placement ◽  
Behavioral And Psychological Symptoms

Objectives: Behavioral and psychological symptoms of dementia in individuals with Alzheimer’s disease and caregiver characteristics may influence the decision to provide care at home or in a nursing home, though few studies examine this association near the actual time of nursing home placement. Using a matched case–control design, this study investigates the association between (1) total Neuropsychiatric Inventory score, (2) the Neuropsychiatric Inventory-4 (an agitation/aggression subscale), and (3) individual domains of the Neuropsychiatric Inventory and nursing home placement. Methods: Data from the South Carolina Alzheimer’s disease Registry provides an opportunity to expand the literature by looking at cases at the time of nursing home care eligibility/placement and allowing for propensity-score-matched controls. Cases (n = 352) entered a nursing home within 6 months of study initiation; controls (n = 289) remained in the community. Registry data were combined with caregiver survey data, including the Neuropsychiatric Inventory. Conditional logistic regression was applied. Results: A 10% increase in the Neuropsychiatric Inventory score implied a 30% increase in odds of nursing home admission (odds ratio: 1.30; 95% confidence interval: 1.14–1.50), having married or male caregivers predicted nursing home placement. Cases versus controls were significantly more likely to have behavioral and psychological symptoms of dementia related to agitation/aggression 1 month prior to nursing home admission. Conclusion: Interventions targeting behavioral and psychological symptoms of dementia without available effective interventions in individuals with Alzheimer’s disease and caregiver support services are necessary to prevent or delay nursing home admission.

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