scholarly journals Neuropsychiatric symptoms and severity of dementia

2013 ◽  
Vol 7 (2) ◽  
pp. 171-175
Author(s):  
Gustavo Henrique de Oliveira Caldas ◽  
Sueli Luciano Pires ◽  
Milton Luiz Gorzoni
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Motor Behavior ◽  
Neuropsychiatric Symptoms ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Clinical Dementia Rating ◽  
Cross Sectional ◽  
Specific Stage ◽  
Severity Of Dementia

ABSTRACT Neuropsychiatric symptoms (NPS) cause distress, disabilitiy and reduced quality of life for both the patient and their families Objective: To evaluate the prevalence of NPS as a specific stage of dementia status. Methods: A cross-sectional study in patients attending an outpatient clinic for dementia was performed. We applied the Neuropsychiatric Inventory and Clinical Dementia Rating (CDR) scale. Statistical analysis was carried out with SPSS 17 software. Results: The 124 subjects (mean age of 80.4±7.0 years), 88 women (70.9%) had average duration of dementia of 7.1±3.2 years, most common dementias of Alzheimer's disease (35.5%) and mixed (31.5%) and most prevalent NPS of apathy (75%) and irritability (66.9%). Correlation between apathy and a CDR 1 had a PR (prevalence ratio) = 0.289 and p<0.001 while between apathy and CDR 4-5 (PR=8.333, p<0.005). A similar result was found between aberrant motor behavior (AMB) and CDR 1 (PR=0.352, p<0.003) and between AMB and CDR4-5 (PR=2.929, p<0.006). Conclusion: Alzheimer's disease and mixed dementia were predominant, while apathy and AMB were detected in association with the progressive stages of dementia.

Relationship of frontal lobe dysfunction and aberrant motor behaviors in patients with Alzheimer's disease

2009 ◽  
Vol 22 (3) ◽  
pp. 463-469 ◽  
Author(s):  
Tomoyuki Nagata ◽  
Shunichiro Shinagawa ◽  
Yusuke Ochiai ◽  
Hirohide Kada ◽  
Hiroo Kasahara ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Frontal Lobe ◽  
Motor Behavior ◽  
Cross Sectional Study ◽  
Stepwise Multiple Regression ◽  
Clinical Dementia Rating ◽  
Cross Sectional ◽  
Motor Behaviors ◽  
Relationship Of

ABSTRACTBackground: In order to address the neuropsychological pathogenesis of aberrant motor behaviors in Alzheimer's disease (AD), we used a cross-sectional study design to investigate the association between frontal lobe function, including executive function, and activity disturbances (wandering, purposeless activities and inappropriate activities).Methods: Among 75 consecutive outpatients with AD, 50 subjects with a Clinical Dementia Rating (CDR) score of 1 or 2 were selected and divided into two groups based on data obtained from interviews with their caregivers: an aberrant motor behaviors (AMB) group (n = 22), and a non-aberrant motor behaviors (NAMB) group (n = 28). Aberrant motor behavior was defined according to whether the “activity disturbance” score (ranging from 0 to 9) of the Behavioral Pathology in Alzheimer Disease (Behave-AD) scale was 0 or ≥1. The total and subtest scores of the Frontal Assessment Battery (FAB) were then compared between the two groups.Results: Significant differences were found between the FAB total (P < 0.05) and the subtest scores (lexical fluency, conflicting instructions; P < 0.05) in the two groups. The FAB score was significantly associated with the activity disturbance score (r = −0.49; P<0.001). A stepwise multiple regression analysis showed that only the FAB score significantly influenced the activity disturbance score (P < 0.001).Conclusions: This finding suggested that in addition to episodic memory disturbance, frontal lobe dysfunctions might lead patients with AD to develop aberrant motor behavior.

scholarly journals Perceived stress and depressive symptoms not neuropsychiatric symptoms predict caregiver burden in Alzheimer’s disease: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Manee Pinyopornpanish ◽  
Kanokporn Pinyopornpanish ◽  
Atiwat Soontornpun ◽  
Surat Tanprawate ◽  
Angkana Nadsasarn ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Depressive Symptoms ◽  
Caregiver Burden ◽  
Perceived Stress ◽  
Neuropsychiatric Symptoms ◽  
Cross Sectional Study ◽  
Assessment Tools ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background Caregiver burden affects the caregiver’s health and is related to the quality of care received by patients. This study aimed to determine the extent to which caregivers feel burdened when caring for patients with Alzheimer’s Disease (AD) and to investigate the predictors for caregiving burden. Methods A cross-sectional study was conducted. One hundred two caregivers of patients with AD at Maharaj Nakorn Chiang Mai Hospital, a tertiary care hospital, were recruited. Assessment tools included the perceived stress scale (stress), PHQ-9 (depressive symptoms), Zarit Burden Interview-12 (burden), Clinical Dementia Rating (disease severity), Neuropsychiatric Inventory Questionnaires (neuropsychiatric symptoms), and Barthel Activities Daily Living Index (dependency). The mediation analysis model was used to determine any associations. Results A higher level of severity of neuropsychiatric symptoms (r = 0.37, p < 0.01), higher level of perceived stress (r = 0.57, p < 0.01), and higher level of depressive symptoms (r = 0.54, p < 0.01) were related to a higher level of caregiver burden. The direct effect of neuropsychiatric symptoms on caregiver burden was fully mediated by perceived stress and depressive symptoms (r = 0.13, p = 0.177), rendering an increase of 46% of variance in caregiver burden by this parallel mediation model. The significant indirect effect of neuropsychiatric symptoms by these two mediators was (r = 0.21, p = 0.001). Conclusion Caregiver burden is associated with patients’ neuropsychiatric symptoms indirectly through the caregiver’s depressive symptoms and perception of stress. Early detection and provision of appropriate interventions and skills to manage stress and depression could be useful in reducing and preventing caregiver burden.

scholarly journals AFFECTIVE THEORY OF MIND IN PEOPLE WITH ALZHEIMER’S DISEASE

2021 ◽  
Author(s):  
Aline De Lucena ◽  
Paulo Fernando Santos ◽  
Marcia Cristina Dourado
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Emotional State ◽  
Neuropsychiatric Symptoms ◽  
Cross Sectional Study ◽  
Social Situations ◽  
Cross Sectional ◽  
Emotional Reasoning ◽  
Significant Difference ◽  
Emotional Aspects

Background: In recent years, interest has been growing in cognitive and affective ToM functioning in individuals suffering from neurodegenerative disorders, such as Alzheimer’s disease (AD). However, the affective ToM has been less investigated. Objective: This study aims to compare affective ToM performance in persons with mild to moderate AD and healthy older controls (HOC), and its relationship with cognition. Methods: A cross-sectional study of 97 mild to moderate AD individuals and 40 HOC. To assess affective ToM, participants were administered a task that examines ability to comprehend the emotional situation nature along with the appropriate emotional state that one would experience in that situation. Assessments of cognition, dementia severity, functionality, awareness of disease and neuropsychiatric symptoms were completed for AD group. Results: Analyses of emotional reasoning indicated a group effect on performance. There was a significant difference between the AD and HOC groups in terms of their ability to understand situations of sadness, surprise, anger, and happiness, with the moderate AD showing the worst performance for all emotional situations. Ability to appropriately name the emotional state was significantly different for surprise, anger, and happiness, but not for sadness, with both AD groups showing lower performance for surprise and anger, and with the mild AD showing better performance for happiness. In both AD groups, ability to understand the emotional situation and to name the emotion was significantly correlated with cognitive impairment and awareness of disease. Neuropsychiatric symptoms were significantly correlated in moderate AD group. Conclusions: Impairment in understanding the emotional aspects of situations can lead moderate AD people to experience conflicts in family and social situations. Mild AD people can experience same conflicts when their preserved ability in understanding the emotional situation is underestimated.

Patterns of neuropsychiatric sub-syndromes in Brazilian and Norwegian patients with dementia

2012 ◽  
Vol 25 (2) ◽  
pp. 228-235 ◽  
Author(s):  
Annibal Truzzi ◽  
Ingun Ulstein ◽  
Letice Valente ◽  
Eliasz Engelhardt ◽  
Evandro Silva Freire Coutinho ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Factor Analysis ◽  
Motor Behavior ◽  
Neuropsychiatric Symptoms ◽  
Principal Component ◽  
Mixed Dementia ◽  
Cross Sectional ◽  
Brazilian Sample ◽  
Two Samples

ABSTRACTBackground: Neuropsychiatric symptoms (NPS) affect the majority of patients who have dementia. Neuropsychiatric sub-syndromes with symptoms that occur together and have common neurobiological correlates have been identified. There are scarce data regarding the comparison of the pattern of the neuropsychiatric sub-syndromes in distinct ethnical and cultural populations. We aim at comparing the pattern of the NPS, and the factor analysis of the Neuropsychiatric Inventory (NPI-10) in two samples of outpatients with dementia living in Brazil and Norway.Methods: This is a cross-sectional study. The sample consists of 168 Brazilian and 155 Norwegian demented patients from psychogeriatric facilities and community-based educational programs. Brazilian patients were diagnosed with Alzheimer's disease (63.7%), vascular dementia (15.5%), or mixed dementia (20.8%), whereas the diagnoses of Norwegian patients were Alzheimer's disease (97.4%) and mixed dementia (2.6%). Principal component analysis with the Varimax rotation was used for factor analysis of the NPI-10.Results: Apathy (80.4 %), agitation/aggression (45.8%), and aberrant motor behavior (45.8%) were the most common symptoms in the Brazilian sample. Apathy (72.3%), dysphoria (61.9%), and anxiety (52.3%) were the most frequent symptoms in the Norwegian sample. Factor analysis of the NPI-10 revealed three syndromes for the Brazilian (Psychosis, Mood, Psychomotor) and Norwegian (Psychosis, Mood, Frontal) groups.Conclusions: The frequency of individual NPS may differ among distinct populations. However, Psychosis and Depression are common sub-syndromes in diverse ethnical and cultural patients with dementia. Our findings support the syndromic approach for the clinical assessment of the patients with dementia.

scholarly journals Prescription of Benzodiazepines and Related Drugs in Patients with Mild Cognitive Deficits and Alzheimer’s Disease

2018 ◽  
Vol 52 (02) ◽  
pp. 84-91 ◽  
Author(s):  
Philipp Hessmann ◽  
Richard Dodel ◽  
Erika Baum ◽  
Matthias Müller ◽  
Greta Paschke ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Neuropsychiatric Symptoms ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Inappropriate Use ◽  
Related Quality ◽  
Health Related ◽  
Lower Hrqol

Abstract Introduction Benzodiazepines and related drugs (BZDR) should be avoided in patients with cognitive impairment. We evaluated the relationship between a BZDR treatment and the health status of patients with Alzheimer’s disease (AD). Methods Cross-sectional study in 395 AD patients using bivariate and multiple logistic analyses to assess correlations between the prescription of BZDR and patients’ characteristics (cognitive and functional capacity, health-related quality of life (HrQoL), neuropsychiatric symptoms). Results BZDR were used in 12.4% (n=49) of all participants. In bivariate analyses, the prescription was associated with a lower HrQoL, a higher need of care, and the presence of anxiety. Multivariate models revealed a higher risk of BZDR treatment in patients with depression (OR 3.85, 95% CI: 1.45 – 10.27). Community-dwelling participants and those treated by neurologists/psychiatrists had a lower risk of receiving BZDR (OR 0.33, 95% CI: 0.12 – 0.89 and OR 0.16, 95% CI: 0.07 – 0.36). Discussion The inappropriate use of BZDR conflicts with national and international guidelines. We suggest evaluating indications and treatment duration and improving the knowledge of alternative therapies in healthcare institutions.

A Cross-Sectional Study of Neuropsychiatric Symptoms in 435 Patients With Alzheimer's Disease

2005 ◽  
Vol 13 (6) ◽  
pp. 460-468 ◽  
Author(s):  
David Craig ◽  
Ajay Mirakhur ◽  
Dominic J. Hart ◽  
Stephen P. McIlroy ◽  
A. Peter Passmore
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Neuropsychiatric Symptoms ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Factors associated with caregiver burden: comparative study between Brazilian and Spanish caregivers of patients with Alzheimer's disease (AD)

2016 ◽  
Vol 28 (8) ◽  
pp. 1363-1374 ◽  
Author(s):  
Maria Fernanda B. Sousa ◽  
Raquel L. Santos ◽  
Oriol Turró-Garriga ◽  
Rachel Dias ◽  
Marcia C. N. Dourado ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Day Care ◽  
Neuropsychiatric Symptoms ◽  
Care Center ◽  
Clinical Dementia Rating ◽  
Cross Sectional ◽  
Day Care Center ◽  
High Burden ◽  
Factors Associated

ABSTRACTBackground:Transcultural studies regarding the comparison of levels of burden in caregivers of patients with Alzheimer's disease (AD) from Europe and Latin America are rare. We designed this study to investigate the differentiating factors associated with burden in Brazilian and Spanish caregivers of patients with AD.Methods:This is a cross-sectional study composed by samples of outpatients with AD and their caregivers from Brazil (n = 128) and Spain (n = 146). Caregivers answered the Zarit Burden Interview (ZBI) and a Sociodemographic Questionnaire. Patients were assessed with the Mini-Mental State Examination (MMSE), Functional Activities Questionnaire (FAQ), Disability Assessment for Dementia (DAD), Neuropsychiatric Inventory (NPI), and Clinical Dementia Rating (CDR) Scale.Results:In the multivariate regression analysis, high burden levels were reported in Brazil, when caregivers were female (p = 0.025) and when patients did not attend Day Care Center (p = 0.025). In Spain, high burden levels were associated with living with the patient (p = 0.014), younger caregivers (p = 0.003), and participation of patients at Day Care Center (p = 0.046). Also, different neuropsychiatric symptoms explained high burden levels: in Brazil, depression (p < 0.001) and anxiety (p = 0.024) and, in Spain, apathy/indifference (p < 0.001), agitation/aggression (p = 0.019) and irritability/lability (p = 0.027).Conclusions:Caregivers’ gender, patients who attended Day Care Center and neuropsychiatric symptoms were differentiating factors in the burden of Brazilian and Spanish caregivers.

scholarly journals Depression, quality of life and cortisol: a cross-sectional study of caregivers of patients with Alzheimer’s disease

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 672
Author(s):  
Emanuela Bernardi ◽  
Katiuscia de Oliveira Francisco Gabriel ◽  
Luana Bernardi ◽  
Gláucia Renée Hilgemberg ◽  
Elizama de Gregório ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Elderly Patients ◽  
Salivary Cortisol ◽  
Short Form ◽  
Cross Sectional Study ◽  
Clinical Dementia Rating ◽  
Extrinsic Factors ◽  
Cross Sectional

Background: Stress can impact human health in multiple ways. Among the related mechanisms are the hormonal systems of the hypothalamic–pituitary–adrenal axis, which produces cortisol. Current research aims to evaluate the relationship between the daily variation of salivary cortisol dosages and the level of stress in caregivers of patients with Alzheimer's disease (AD). Methods: A sociodemographic questionnaire was applied to 25 caregivers, as well as the 36 Item Short-Form Health Survey and Beck’s Depression Inventory. In the 25 patients of the caregivers, the Instrumental Activities of Daily Living of the patient and Clinical Dementia Rating were assessed. Saliva samples were collected to assess the cortisol level of the caregivers three times over one day for each caregiver, (morning, afternoon and evening) to investigate the correlation of the aforementioned questionnaires with the age and degree of kinship among caregivers of elderly patients to investigate the correlation with the results of the previously described tests, and the age and degree of relatedness of caregivers and elderly patients. Results: There was a significant positive correlation between daily cortisol levels and increasing caregiver age. However, the daily dosage of salivary cortisol was not significantly associated with the stress level of the caregivers of patients with AD, suggesting that this is not a good neuroendocrine marker of response to mood disorders. This fact can be related to intrinsic and extrinsic factors to the caregiver. Conclusions: Compared with previous studies that correlate cortisol and stress in humans, our findings suggest that the stress mechanism may be more complex and depend on more factors than the levels of this hormone. Thus, further work is required to delineate possible cortisol modulators, as well as the type of stress that target this population and their ability to adapt and face adversity in their work.

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