title: Psychosis associated behavioral and psychological signs and symptoms in mild cognitive impairment and Alzheimer's dementia.
abstract: OBJECTIVE
  The aim of this study is to determine the prevalence of psychosis in mild cognitive impairment (MCI, Petersen's criteria) and patients with Alzheimer's dementia, and to characterize the associated behavioral and psychological signs and symptoms of dementia (BPSD).
  
  
  METHODS
  A cross-sectional analysis of baseline data from an ongoing, prospective, longitudinal study on BPSD was performed, including 270 MCI and 402 AD patients. BPSD assessment was performed through Middelheim Frontality Score (MFS), Behave-AD, Cohen-Mansfield Agitation Inventory (CMAI) and Cornell Scale for Depression in Dementia (CSDD). Psychosis was considered to be clinically relevant when delusions and/or hallucinations occurred at least once in the last two weeks prior to the BPSD assessment.
  
  
  RESULTS
  The prevalence of psychosis in AD (40%) was higher than in MCI (14%; p < 0.001). AD patients with psychosis showed more severe frontal lobe, BPSD, agitation and depressive symptoms (MFS, Behave-AD, CMAI and CSDD total scores), whereas MCI patients with psychosis only showed more severe frontal lobe and physically non-aggressive agitated behavior. In addition, only in psychotic AD patients, all BPSD and types of agitation were more severe compared to non-psychotic AD patients. Comparing MCI and AD patients, MCI patients with psychosis did not show more severe frontal lobe, behavioral and psychological (Behave-AD), depressive symptoms or agitation than AD patients without psychosis.
  
  
  CONCLUSIONS
  AD patients clearly display psychosis associated BPSD, whereas MCI patients only display more severe frontal lobe symptoms and physically non-aggressive agitated behavior, but also less pronounced than in AD.
authors.affiliation: a Reference Center for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behavior, Institute Born-Bunge , University of Antwerp (UAntwerp) , Antwerp , Belgium.
authors.forename: Stefan
authors.initials: S
authors.lastname: Van der Mussele
authors.forename: Peter
authors.initials: P
authors.lastname: Mariën
authors.forename: Jos
authors.initials: J
authors.lastname: Saerens
authors.forename: Nore
authors.initials: N
authors.lastname: Somers
authors.forename: Johan
authors.initials: J
authors.lastname: Goeman
authors.forename: Peter P
authors.initials: PP
authors.lastname: De Deyn
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Engelborghs
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology / Q000503:physiopathology*; D060825:Cognitive Dysfunction / Q000453:epidemiology / Q000503:physiopathology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011618:Psychotic Disorders / Q000453:epidemiology / Q000503:physiopathology*
keywords: AD; BPSD; MCI; delusions; hallucinations; psychosis