Behavioral alterations and vascular dementia.
BACKGROUND
Vascular dementia is one of the most frequent forms of dementia, where behavioral and cognitive symptoms coexist. Negative signs, such as apathy, abulia, opposition, and agnosia, are badly tolerated and dramatically experienced by caregivers, even worse than the other signs of cognitive decline.


RESULTS
We have studied 120 subjects affected by subcortical vascular dementia (group A) and 120 subjects suffering from multiinfarct dementia (group B) for 24 months. The main outcomes of the study were the global performance, the global behavioral symptoms, the caregiver stress, the depression status, and the insight in their clinical situation.


CONCLUSIONS
Group A manifested a reduction of depression, agitation and suicidal ideation during follow-up, with a constant tendency to refer somatic pain, to exhibit anxiety, and an evident increase in apathy, cognitive abulia, social withdrawal, and loss of insight. On the contrary, group B showed a constant tendency to manifest depression, somatic pain, anxiety, agitation, cognitive abulia, social withdrawal, and suicide ideations; they manifested a decrease of apathy and an increase in delusions, hallucinations, craving for food, and loss of insight and awareness. Their behavioral alterations were stronger than those exhibited by group A, and that was reflected by an increment of caregivers' burden score. Even from a behavioral perspective, multiinfarct dementia is not the same as subcortical vascular dementia. This opinion must be taken into account to find more suitable and tailored therapy to specific pathologies and not to a single, generic entity.
Dipartimento di Fisiologia e Patologia, Ambulatorio Disturbi Cognitivi, Università degli Studi di Trieste, Trieste, Italy. moretti@univ.trieste.it
Rita
R
Moretti
Paola
P
Torre
Rodolfo M
RM
Antonello
Giuseppe
G
Cazzato
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D015161:Dementia, Multi-Infarct / Q000523:psychology*; D015140:Dementia, Vascular / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D009483:Neuropsychological Tests; D013315:Stress, Psychological / Q000209:etiology