Relationship between dementia severity and behavioural and psychological symptoms in early‐onset Alzheimer's disease

Abstract

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.

A Study for Comparison of Caregiver Burden and Behavioral and Psychotic Symptoms in Frontotemporal Dementia and Alzheimer’s Dementia

“…This study suggests that significant differences exist in caregiver burden and BPSD between two types of dementia and that BPSD contribute to caregiver burden. The behavioral changes noted in FTD patients in this study were similar to those observed in previous reports (Diehl, Forstl, Jansen, & Kurz, 2004;Tanaka et al, 2015). [8,9] In this study we found that the caregivers of FTD patients had higher burden scores than caregivers of AD patients.…”

“…The behavioral changes noted in FTD patients in this study were similar to those observed in previous reports (Diehl, Forstl, Jansen, & Kurz, 2004;Tanaka et al, 2015). [8,9] In this study we found that the caregivers of FTD patients had higher burden scores than caregivers of AD patients. Riedijk et al, [10] like us, found that the caregivers of patients with FTD experienced a greater burden than those of patients with AD.…”

Psychotropic drug use in community-dwelling people with young-onset dementia: two-year course and determinants

“…The cumulative use of antipsychotics was approximately 37% in the two-year follow-up which means that the number of participants using antipsychotics more than doubled (2.4 times) during our follow-up. Research in young-onset Alzheimer's dementia has shown no positive association of delusions, depression or anxiety with increasing dementia severity (Tanaka et al, 2015). Furthermore, we also found that the two-year dementia progression in the NeedYD cohort was limited to less than one point on the GDS (Gerritsen et al, 2018).…”

The factors associated with inappropriate prescription patterns of benzodiazepines and related drugs among patients with dementia

“…More than 70% of the patients in this study had moderate to severe dementia. Higher severity of dementia is often accompanied by increased behavioural and psychological symptoms, 29 administration of more medications, including BZDRs. 30 Up to 50% of nursing home residents with dementia were reported to be treated with BZDRs for BPSD.…”