Behavioural and psychological symptoms in vascular dementia; differences between small- and large-vessel disease.
OBJECTIVE
The authors investigated the prevalence of behavioural and psychological symptoms in vascular dementia (VaD) from baseline data of the VantagE study and compared the severity and relative frequency of symptoms between small-vessel VaD and large-vessel VaD.


METHODS
Behavioural and psychological symptoms of 484 VaD patients included in a large multicentre clinical trial (registration number NCT00099216) were determined using the 12-item Neuropsychiatric Inventory (NPI). Symptoms were considered present when the score was > or =1. Based on MRI, patients were classified as having small-vessel VaD (83%) or large-vessel VaD (17%).


RESULTS
Behavioural and psychological symptoms were reported in 92% of the VaD patients. The median NPI score of the total study population was 9 (0-76), with a median number of three symptoms per patient. Apathy (65%) was most prevalent, followed by depressive symptoms (45%), irritability (42%) and agitation/aggression (40%). Patients with small-vessel VaD reported more apathy, aberrant motor behaviour and hallucinations than patients with large-vessel VaD (p<0.05). In contrast, patients with large-vessel VaD reported a higher severity of agitation/aggression and euphoria (p<0.05).


CONCLUSIONS
Behavioural and psychological symptoms are common in VaD. Patients with small-vessel and large-vessel VaD demonstrate different profiles of symptoms, with especially more apathy in small-vessel VaD and more agitation/agression in large-vessel VaD.
Staekenborg
Salka S
SS
Department of Neurology and Alzheimer Centre, Vrije Universiteit Medical Centre, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. s.staekenborg@vumc.nl
Su
Tanja
T
van Straaten
Elisabeth C W
EC
Lane
Roger
R
Scheltens
Philip
P
Barkhof
Frederik
F
van der Flier
Wiesje M
WM
D000368:Aged; D002196:Capillaries / Q000473:pathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000473:pathology*; D015331:Cohort Studies; D015140:Dementia, Vascular / Q000473:pathology* / Q000523:psychology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D018696:Neuroprotective Agents / Q000627:therapeutic use; D048448:Phenylcarbamates / Q000627:therapeutic use; D000068836:Rivastigmine; D012959:Socioeconomic Factors
D018696:Neuroprotective Agents; D048448:Phenylcarbamates; D000068836:Rivastigmine