Relationship between dementia severity and behavioural and psychological symptoms in early-onset Alzheimer's disease.
BACKGROUND
The features of behavioural and psychological symptoms of dementia (BPSD) are influenced by dementia stage. In early-onset Alzheimer's disease (EOAD), the association between BPSD and dementia stage remains unclear because of the difficulty of recruiting subjects with a wide range of disease severity. We used a combination of community-based and hospital-based approaches to investigate the relationship between dementia severity and BPSD in EOAD patients.


METHODS
Sixty-three consecutive EOAD outpatients and 29 EOAD patients from a community-based survey were divided into three dementia severity groups according to the Clinical Dementia Rating scale (CDR): mild (CDR 0.5-1, n = 55), moderate (CDR 2, n = 17), and severe (CDR 3, n = 20). BPSD were rated using the Neuropsychiatric Inventory.


RESULTS
Scores of the Neuropsychiatric Inventory subscales agitation, euphoria, apathy, disinhibition, irritability, and aberrant motor behaviour increased significantly with increased dementia severity. Hallucinations were greater in the moderate group than in the mild group. For delusions, depression, and anxiety, no significant differences were observed among the three severity groups.


CONCLUSIONS
The pattern of apathy, agitation, disinhibition, irritability, and aberrant motor behaviour worsening with severity progression in EOAD is similar to the pattern in late-onset Alzheimer's disease. In contrast, hallucinations, depression, and anxiety showed different patterns in EOAD.
Department of Neuropsychiatry, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
Hibiki
H
Tanaka
Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Mamoru
M
Hashimoto
Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Ryuji
R
Fukuhara
Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Tomohisa
T
Ishikawa
Mental Health and Welfare Center in Kumamoto Prefecture, Kumamoto, Japan.
Yusuke
Y
Yatabe
Department of Psychiatry, Kumamoto Seimei Hospital, Kumamoto, Japan.
Keiichiro
K
Kaneda
Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Seiji
S
Yuuki
Department of Psychiatry, Kikuchi National Hospital, Kumamoto, Japan.
Kazuki
K
Honda
Department of Neuropsychiatry, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
Shiho
S
Matsuzaki
Department of Neuropsychiatry, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
Atsuko
A
Tsuyuguchi
Department of Neuropsychiatry, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
Yutaka
Y
Hatada
Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Manabu
M
Ikeda
D000342:Affective Symptoms / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology*; D001007:Anxiety / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D001526:Behavioral Symptoms / Q000523:psychology*; D003702:Delusions / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D003704:Dementia / Q000523:psychology*; D003863:Depression / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000523:psychology; D011618:Psychotic Disorders / Q000523:psychology; D012720:Severity of Illness Index
Alzheimer's disease; Neuropsychiatric Inventory (NPI); behavioural and psychological symptoms (BPSD); early-onset; severity of dementia