Psychiatric and behavioral symptoms in Alzheimer’s disease and other dementias: Etiology and management

Aarsland, Dag; Sharp, Sally I.; Ballard, Clive

doi:10.1007/s11910-005-0058-4

Cited by 28 publications

(17 citation statements)

References 82 publications

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“…Gene studies indicate that dopaminergic, noradrenergic, serotonergic and cholinergic changes may be associated with other neuropsychiatric symptoms in AD [22] . Functional studies have reported apathy to be related to reduced cingulate metabolic activity and perfusion [23,24] .…”

Section: Discussionmentioning

confidence: 99%

Neuropsychiatric Correlates of Cerebrospinal Fluid Biomarkers in Alzheimer’s Disease

Skogseth

Mulugeta

Ballard

et al. 2008

Dement Geriatr Cogn Disord

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Background: The aim of this study was to explore the relationship between cerebrospinal fluid biomarkers and neuropsychiatric symptoms in people with Alzheimer’s disease. Psychosis, agitation, apathy and depression were assessed using standardised measures in 32 patients with mild Alzheimer’s disease. Methods: The levels of the 42-amino-acid form of β-amyloid (Aβ_1–42), tau and p-tau (phosphorylated at threonine 181) were quantified using the conventional enzyme-linked immunosorbent assay method. Results: Our result shows that apathy is significantly correlated with tau and p-tau but not with Aβ_1–42. There were no significant correlations between indices of psychosis/agitation,or depression and cerebrospinal fluid Aβ_1–42, tau or p-tau concentrations. Conclusion: Our finding suggests that apathy is associated with the level of neurofibrillary tangles in people with mild Alzheimer’s disease. In contrast, the overall levels of neurofibrillary tangles or amyloid plaques do not seem to be associated with depression or psychosis, indicating that other brain changes contribute to these symptoms.

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Section: Discussionmentioning

confidence: 99%

Neuropsychiatric Correlates of Cerebrospinal Fluid Biomarkers in Alzheimer’s Disease

Skogseth

Mulugeta

Ballard

et al. 2008

Dement Geriatr Cogn Disord

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“…Clinical experience suggests that patients with VCI can be managed using the same principles used to manage neuropsychiatric symptoms in other dementias such as AD. For review, see Aarsland and Ballard [30].…”

Section: Treatment General Considerationsmentioning

confidence: 99%

Treatment of Vascular Cognitive Impairment

Ritter

Pillai

2015

Curr Treat Options Neurol

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Cerebrovascular disease (CVD) is an important cause of cognitive dysfunction and dementia. The term vascular cognitive impairment (VCI) is used to describe the entire spectrum of cognitive dysfunction-ranging from mild impairment to dementia-attributable to all forms of cerebrovascular disease. Accurate assessment and management of vascular risk factors are a top priority in the treatment of VCI, particularly early in the disease when prevention strategies may prove to be more effective. There are limited treatment options to improve cognition and function in VCI. Several acetylcholinesterase inhibitors and the NMDA receptor antagonist memantine have been studied in large, well-designed trials. These agents are safe and provide modest cognitive benefits in vascular dementia (VaD) but have demonstrated inconsistent efficacy on functional measures. Other therapies, such as aspirin, calcium channel blockers, and vitamin supplementation, have less evidence to support their use in improving cognition in VCI. Although primary prevention trials suggest that treatment of hypertension, adherence to a Mediterranean diet, physical activity, and smoking cessation may reduce the risk of cognitive decline, there is limited evidence regarding these interventions in helping improve cognition in VCI. The pathophysiology and treatment of cerebral autosomal dominant arteriopathy with subcortical infarcts (CADASIL), cerebral amyloid angiopathy (CAA), and subcortical white matter disease (SWMD) deserves special consideration.

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“…Current strategies to manage behavioral problems in patients with AD include the use of pharmacological [10,11,[35][36][37][38][39][40][41] and behavioral interventions [11][12][13][14]42] . Commonly prescribed drugs include antidepressants, antipsychotics, anticonvulsants, and anxiolytics [42,43] ; however, these pharmacological agents are not specifically indicated for use in patients with AD.…”

Section: Treatmentmentioning

confidence: 99%

Memantine Therapy of Behavioral Symptoms in Community-Dwelling Patients with Moderate to Severe Alzheimer’s Disease

Grossberg

Pejovic

Miller

et al. 2009

Dement Geriatr Cogn Disord

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Memantine is a moderate-affinity, uncompetitive antagonist of N-methyl-D-aspartate receptors, approved for the treatment of moderate to severe Alzheimer’s disease (AD). Available data suggest that, in addition to its benefits on cognition, function, and global status, memantine treatment may also help alleviate behavioral symptoms. This article provides an overview of the prevalence, assessment, and treatment of behavioral disturbances in AD, and summarizes current knowledge regarding the effects of memantine on the behavior of community-dwelling patients. We searched EMBASE and PubMed (January 1992 to October 2008) for reports on memantine trials that involved outpatients with moderate to severe AD. All previously unpublished data were obtained from Forest Laboratories, Inc. Behavioral outcomes were assessed in three completed, double-blind, placebo-controlled trials.Overall, patients who received memantine performed better on behavioral measures than those treated with placebo. Post-hoc analyses suggest that memantine treatment was associated with a reduced severity or emergence of specific symptoms, particularly agitation and aggression. Prospective, well-designed trials are warranted to evaluate the efficacy of memantine in patients with significant behavioral symptoms.

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Psychiatric and behavioral symptoms in Alzheimer’s disease and other dementias: Etiology and management

Cited by 28 publications

References 82 publications

Neuropsychiatric Correlates of Cerebrospinal Fluid Biomarkers in Alzheimer’s Disease

Neuropsychiatric Correlates of Cerebrospinal Fluid Biomarkers in Alzheimer’s Disease

Treatment of Vascular Cognitive Impairment

Memantine Therapy of Behavioral Symptoms in Community-Dwelling Patients with Moderate to Severe Alzheimer’s Disease

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