title: A Comparison of the Behavioral and Psychological Symptoms of Dementia (BPSD) in Early-Onset and Late-Onset Alzheimer's Disease - A Study from South East Asia (Kashmir, India).
abstract: BACKGROUND
  A gradual increase in the longevity due to advancement of treatment modalities and a subsequent surge in elderly population in India have led to a growing curiosity in the geriatric age group with Alzheimer's disease (AD). Behavioral and psychological symptoms of dementia (BPSD) represent epiphenomena of AD. However, no comprehensive study has been carried out in South East Asia (Kashmir, India), to assess the behavioral and psychological symptoms in subtypes of AD.
  
  
  OBJECTIVE
  The purpose of this study was to assess BPSD in early-onset Alzheimer's disease (EOAD) and late-onset Alzheimer's disease (LOAD).
  
  
  METHODS
  The study was conducted in the Memory clinic of the postgraduate department of psychiatry, Government Medical College, Kashmir, India from January 2012 to March 2014. The diagnosis of AD patients was done according to NINCDS-ADRDA criteria. A total of 80 patients of AD were screened (40 with age of onset less than 65, and 40 with age of onset greater than 64). Neuropsychiatric inventory (NPI) was the instrument used for evaluating symptoms of BPSD. The data was analyzed using paired t-test.
  
  
  RESULTS
  The mean age of presentation of EOAD and LOAD was 63.10 years and 84.28 years, respectively, and the difference between the two was found to be statistically significant. The LOAD group had significantly higher symptom severity for delusions, agitation, anxiety, disinhibition, and nighttime behavioral disturbances (NBD) than the EOAD group (p ≤.0001).
  
  
  CONCLUSIONS
  The behavioral and psychological symptoms are significantly severe in late onset subtype compared to the early onset subtype of Alzheimer's disease in the Kashmiri (Indian) population.
authors.affiliation: Memory Clinic and Geriatric Clinic, Postgraduate Department of Psychiatry, Government Medical College, Srinagar, J & K, India.
authors.forename: Raheel
authors.initials: R
authors.lastname: Mushtaq
authors.affiliation: Department of Psychiatry, TN Medical College and BYL Nair Hospital, Mumbai.
authors.forename: Charles
authors.initials: C
authors.lastname: Pinto
authors.affiliation: MBBS, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, J & K, India.
authors.forename: Shah Faisal Ahmad
authors.initials: SF
authors.lastname: Tarfarosh
authors.affiliation: Department of Psychiatry, Government Medical College, Srinagar, J & K, India.
authors.forename: Arshad
authors.initials: A
authors.lastname: Hussain
authors.affiliation: Memory Clinic and Geriatric Clinic, Postgraduate Department of Psychiatry, Government Medical College, Srinagar, J & K, India.
authors.forename: Sheikh
authors.initials: S
authors.lastname: Shoib
authors.affiliation: MBBS, Government Medical College, Srinagar, J & K, India.
authors.forename: Tabindah
authors.initials: T
authors.lastname: Shah
authors.affiliation: MBBS, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, J & K, India.
authors.forename: Sahil
authors.initials: S
authors.lastname: Shah
authors.affiliation: MBBS, SKIMS Medical College, Srinagar, J & K, India.
authors.forename: Mushbiq
authors.initials: M
authors.lastname: Manzoor
authors.affiliation: Postgraduate Department of Radiology, Government Medical College, Srinagar, J & K, India.
authors.forename: Mudassir
authors.initials: M
authors.lastname: Bhat
authors.affiliation: Medical Officer, Government Health Services, Kashmir, J & K, India.
authors.forename: Tasleem
authors.initials: T
authors.lastname: Arif
keywords: alzheimer disease; bpsd; dementia; geriatric neurology; memory; nbd; neuropsychiatry; psychology