Natural history of behavioural changes and psychiatric symptoms in Alzheimer's disease

BackgroundAlzheimer's disease and other types of dementia are characterised by numerous psychiatric and behavioural changes. Little is known of their natural history.AimsTo investigate the sequence and pattern of these changes throughout the course of dementia.MethodOne hundred people, initially living at home with carers, entered a prospective, longitudinal study. At four-monthly intervals, behavioural and psychiatric symptoms were assessed using the Present Behavioural Examination and Mini-Mental State Examination. Follow-up continued for up to nine years (mean 3.3 years; s.d. 2.4). Patterns of onset and disappearance of these symptoms, their sequence and association with time of death and cognitive decline were analysed. Autopsy confirmed a diagnosis of pure Alzheimer's disease in 48 subjects. Data for this subgroup are presented.ResultsSome changes tend to occur earlier than others but changes can occur at almost any time in the course of dementia.ConclusionsThe natural history of behaviour changes in Alzheimer's disease shows great individual variation although some changes tend to follow a recognisable sequence.

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Multimodal Spatio-Temporal Model of the Natural History of Alzheimer's Disease from Joint Serial Assessment of Amyloidosis, Tauopathy, Hypometabolism, and Atrophy

SSRN Electronic Journal ◽

10.2139/ssrn.3444425 ◽

2019 ◽

Author(s):

Marco Lorenzi ◽

Federica Ribaldi ◽

Valentina Garibotto ◽

Frederik Barkhof ◽

Giovanni B. Frisoni ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Natural History ◽

History Of ◽

Temporal Model ◽

Spatio Temporal

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Prospective longitudinal study of depression and anosognosia in Alzheimer's disease

The British Journal of Psychiatry ◽

10.1192/bjp.171.1.47 ◽

1997 ◽

Vol 171 (1) ◽

pp. 47-52 ◽

Cited By ~ 92

Author(s):

Sergio E. Starkstein ◽

Erán Chemerinski ◽

Liliana Sabe ◽

Gabriela Kuzis ◽

Gustavo Petracca ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Major Depression ◽

Cognitive Status ◽

Initial Evaluation ◽

Consecutive Series ◽

Psychiatric Interview ◽

Prospective Longitudinal Study ◽

Prospective Longitudinal

BackgroundThe aim was to examine the longitudinal evolution of depression and anosognosia in patients with probable Alzheimer's disease (AD).MethodSixty-two of a consecutive series of 116 AD patients that were examined with a structured psychiatric interview had a follow-up evaluation between one and two years after the initial evaluation.ResultsAt the initial evaluation 19% of the 62 patients had major depression, 34% had dysthymia, and 47% were not depressed. After a mean follow-up of 16 months, 58% of patients with major depression at the initial evaluation were still depressed, whereas only 28% of patients with initial dysthymia and 21% of the non-depressed patients were depressed at follow-up. During the follow-up period, all three groups showed similar declines in cognitive status and activities of daily living. At the initial evaluation, 39% of the patients had anosognosia, and there was a significant increment of anosognosia during the follow-up period.ConclusionsWhile dysthymia in AD is a brief emotional disorder, major depression is a longer-lasting mood change. Anosognosia is another prevalent disorder among AD patients, and increases with the progression of the illness.

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THE NATURAL HISTORY OF ALZHEIMER'S DISEASE

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.1996.tb01846.x ◽

1996 ◽

Vol 44 (6) ◽

pp. 734-734 ◽

Cited By ~ 1

Author(s):

Froukje Boersma ◽

Jan A. Eefsting

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Natural History ◽

History Of

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Relation between neuritic plaques and depressive state in Alzheimer's disease

Acta Neuropsychiatrica ◽

10.1111/j.1601-5215.2009.00423.x ◽

2010 ◽

Vol 22 (1) ◽

pp. 14-20 ◽

Cited By ~ 5

Author(s):

Gerben Meynen ◽

Heleen Van Stralen ◽

Jan H. Smit ◽

Wouter Kamphorst ◽

Dick F. Swaab ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Depressive Symptoms ◽

Temporal Cortex ◽

Clinical Severity ◽

Depressive State ◽

Neuritic Plaques ◽

Prospective Longitudinal Study ◽

Severity Of Dementia ◽

Prospective Longitudinal

Meynen G, Van Stralen H, Smit JH, Kamphorst W, Swaab DF, Hoogendijk WJG. Relation between neuritic plaques and depressive state in Alzheimer's disease.Background:To investigate for the first time in a prospective study the relationship between depressive state and the neuropathological hallmarks of Alzheimer's disease, using a scale for depressive symptoms in dementia, while controlling for clinical severity of dementia.Method:Within the framework of a prospective longitudinal study of depression in Alzheimer's disease, patients with dementia underwent a clinical evaluation every six months during the last years of their lives, using the Cornell scale for depression in dementia to assess depressive symptoms and using the Functional Assessment Staging scale to control for clinical severity of dementia. The brains of 43 Alzheimer patients were obtained. The last clinical evaluations prior to death together with post-mortem neuropathology measures were analysed.Results:We found a correlation between the Cornell scores and the sum score for the density of neuritic plaques in the entire cortex (p = 0.027), and even stronger in the temporal cortex (p = 0.012). The observed correlations were independent of sex, age of death, clinical dementia severity and duration of Alzheimer's disease.Conclusions:This study shows a positive relationship between depressive state at time of death and the presence of neuritic plaques in Alzheimer's disease, which is independent of the clinical severity of dementia.

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