title: Agitation-associated behavioral symptoms in mild cognitive impairment and Alzheimer's dementia.
abstract: OBJECTIVE
  The aim of this study is to determine the prevalence of agitation in mild cognitive impairment (MCI, Petersen's criteria) and patients with Alzheimer's dementia (AD), and to characterize the associated behavioral symptoms.
  
  
  METHODS
  A cross-sectional analysis of baseline data from a prospective, longitudinal study on behavioral symptoms was performed, including 268 MCI and 393 AD patients. Behavioral assessment was performed through Middelheim Frontality Score (MFS), Behavioral Pathology in Alzheimer's Disease Rating Scale (Behave-AD) and Cornell Scale for Depression in Dementia (CSDD). Agitated behavior was considered to be clinically relevant when one or more items of the Cohen-Mansfield Agitation Inventory (CMAI) occurred at least once a week.
  
  
  RESULTS
  The prevalence of agitation in AD (76%) was higher than in MCI (60%; p < 0.001). Patients with agitation showed more severe frontal lobe, behavioral and depressive symptoms (MFS, Behave-AD and CSDD total scores). In agitated AD patients, all behavioral symptoms and types of agitation were more severe compared to non-agitated AD patients, but in agitated MCI patients only for diurnal rhythm disturbances. This resulted in more severe Behave-AD global scores in patients with agitation as compared to patients without agitation. Comparing MCI and AD patients, MCI patients with agitation showed more severe behavioral and depressive symptoms than AD patients without agitation. The structure of agitation in AD consisted of more aggressive and physically non-aggressive behavior than in MCI.
  
  
  CONCLUSIONS
  Frontal lobe, behavioral and depressive symptoms are more severe in MCI and AD patients with clinically relevant agitation as compared to patients without agitation. However, this association is less pronounced in MCI.
authors: a Laboratory of Neurochemistry and Behavior, Reference Centre for Biological Markers of Dementia (BIODEM), Institute Born-Bunge , University of Antwerp (UA) , Antwerp , Belgium.
authors: Stefan
authors: S
authors: Van der Mussele
authors: Nathalie
authors: N
authors: Le Bastard
authors: Jos
authors: J
authors: Saerens
authors: Nore
authors: N
authors: Somers
authors: Peter
authors: P
authors: Mariën
authors: Johan
authors: J
authors: Goeman
authors: Peter P
authors: PP
authors: De Deyn
authors: Sebastiaan
authors: S
authors: Engelborghs
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression / Q000502:physiology*; D000544:Alzheimer Disease / Q000150:complications / Q000453:epidemiology*; D001526:Behavioral Symptoms / Q000453:epidemiology* / Q000209:etiology; D060825:Cognitive Dysfunction / Q000150:complications / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011595:Psychomotor Agitation / Q000453:epidemiology* / Q000209:etiology
keywords: AD; Cohen-Mansfield Agitation Inventory (CMAI); MCI; aggression; aggressiveness; neuropsychiatric symptoms