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Quality of Life in relation to neuropsychiatric symptoms in Alzheimer's disease: 5‐year prospective ALSOVA cohort study 下载免费PDF全文
Kristiina Hongisto Ilona Hallikainen Tuomas Selander Soili Törmälehto Saku Väätäinen Janne Martikainen Tarja Välimäki Sirpa Hartikainen Jaana Suhonen Anne M. Koivisto 《International journal of geriatric psychiatry》2018,33(1):47-57
Objective
To examine the association between neuropsychiatric symptoms (NPS) with self‐ and caregiver‐rated Quality of Life (QoL) for patients with Alzheimer's disease (AD) during a 5‐year follow‐up.Methods
The ALSOVA 5‐year follow‐up study included, at baseline, 236 patients with either very mild (Clinical Dementia Rating Scale (CDR) 0.5), or mild (CDR 1) AD, together with their caregivers from three Finnish hospital districts. QoL was evaluated using patient self‐reported, and caregiver‐rated, QoL in AD (QoL‐AD) scores. NPS were assessed using the Neuropsychiatric Inventory (NPI), and AD severity was evaluated using the CDR, with cognition tested by the mini‐mental state examination. The performance of daily activities was assessed using the Alzheimer's Disease Cooperative Study–Activities of Daily Living Inventory.Results
Over the 5‐year follow‐up period, patient self‐reported QoL‐AD scores did not change significantly (p = 0.245), despite increases in their NPS. However, caregiver‐rated patient QoL‐AD scores declined significantly (p ≤ 0.001), as total NPI scores increased during follow‐up. No NPS at baseline, and only apathy at follow‐up, correlated significantly (p = 0.007) with patient self‐rated QoL‐AD scores. Caregiver‐rated patient QoL‐AD scores correlated significantly with most NPS, especially (p ≤ 0.001) apathy, agitation, anxiety, irritability, depression, and delusions at baseline, and delusions, hallucinations, apathy, appetite disturbances, and anxiety during follow‐up.Conclusions
Patient rated QoL‐AD scores are an unreliable tool with which to evaluate the success of therapy for NPS. Instead, caregiver‐rated scores for patients correlated well with NPI scores, and health care professionals in the clinic should preferentially use these. Copyright © 2017 John Wiley & Sons, Ltd. 相似文献4.
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Engelborghs S Maertens K Nagels G Vloeberghs E Mariën P Symons A Ketels V Estercam S Somers N De Deyn PP 《International journal of geriatric psychiatry》2005,20(11):1028-1037
OBJECTIVE: Given the rather limited knowledge on profiles of neuropsychiatric symptoms (behavioural and psychological signs and symptoms of dementia, BPSD) in several degenerative dementias, we designed a prospective study of which we here present the baseline data. METHODS: Diagnosed according to strictly applied clinical diagnostic criteria, patients with probable Alzheimer's disease (AD) (n = 205), frontotemporal dementia (FTD) (n = 29), mixed dementia (MXD) (n = 39) and dementia with Lewy bodies (DLB) (n = 23) were included. All patients underwent a neuropsychological examination and behavioural assessment by means of a battery of scales (Middelheim Frontality Score (MFS), Behave-AD, Cohen-Mansfield Agitation Inventory, Cornell Scale for Depression in Dementia). RESULTS: In AD and MXD, activity disturbances and aggressiveness occurred in more than 80% of the patients. With a prevalence of 70%, apathy was very common whereas delusions and hallucinations were rare in FTD patients. Frequently used behavioural assessment scales like the Behave-AD systematically underestimated BPSD in FTD whereas the MFS displayed high sensitivity for frontal lobe symptoms. Hallucinations discriminated DLB patients from other dementias. A high prevalence of disinhibition (65%) in DLB pointed to frontal lobe involvement. CONCLUSIONS: Behavioural assessment may help differentiating between different forms of dementia, further stressing the need for the development of new and more sensitive behavioural assessment scales. By means of the MFS, frontal lobe involvement was frequently observed in DLB. As 70% of FTD patients displayed apathy, prevalence was about two times higher compared to the other disease groups, meanwhile indicating that apathy is frequently observed in dementia, irrespective of its etiology. 相似文献
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Michael H. Connors Katrin M. Seeher John Crawford David Ames Michael Woodward Henry Brodaty 《Alzheimer's & dementia》2018,14(7):880-888
Introduction
Neuropsychiatric symptoms are common in Alzheimer's disease. Previous research has attempted to identify subsyndromes—sets of symptoms related to one another—to clarify underlying mechanisms and treatment targets. We examined the stability of these subsyndromes over time.Methods
We administered the Neuropsychiatric Inventory annually for 3 years to 447 patients with Alzheimer's disease recruited from memory clinics. We conducted principal component analyses at each time point and multiple-group confirmatory factor analyses across time.Results
Principal component analyses showed that no two time points shared the same factor structure. Factor solutions did not exhibit strong simple structures and substantial cross-loadings were common. Confirmatory analysis revealed significant differences in factor loadings and model fit over time.Discussion
Symptoms cannot be neatly partitioned into discrete clusters that are stable over time. The findings highlight the significant challenges that clinicians and caregivers face and may help explain the lack of success in intervention studies. 相似文献11.
Vascular risk factors and neuropsychiatric symptoms in Alzheimer's disease: the Cache County Study 下载免费PDF全文
Martin Steinberg Kyle Hess Chris Corcoran Michelle M. Mielke Maria Norton John Breitner Robert Green Jeannie Leoutsakos Kathleen Welsh‐Bohmer Constantine Lyketsos Joann Tschanz 《International journal of geriatric psychiatry》2014,29(2):153-159
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Psychosocial or clinico‐demographic factors related to neuropsychiatric symptoms in patients with Alzheimer's disease needing interventional treatment: analysis of the CATIE‐AD study 下载免费PDF全文
Tomoyuki Nagata Shinichiro Nakajima Shunichiro Shinagawa Eric Plitman Ariel Graff‐Guerrero Masaru Mimura Kazuhiko Nakayama 《International journal of geriatric psychiatry》2017,32(12):1264-1271
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Relationship between dementia severity and behavioural and psychological symptoms in early‐onset Alzheimer's disease 下载免费PDF全文
Hibiki Tanaka Mamoru Hashimoto Ryuji Fukuhara Tomohisa Ishikawa Yusuke Yatabe Keiichiro Kaneda Seiji Yuuki Kazuki Honda Shiho Matsuzaki Atsuko Tsuyuguchi Yutaka Hatada Manabu Ikeda 《Psychogeriatrics》2015,15(4):242-247
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Effects of anosognosia and neuropsychiatric symptoms on the quality of life of patients with Alzheimer's disease: a 24‐month follow‐up study 下载免费PDF全文
Josep L. Conde‐Sala Oriol Turró‐Garriga Sara Piñán‐Hernández Cristina Portellano‐Ortiz Vanesa Viñas‐Diez Jordi Gascón‐Bayarri Ramón Reñé‐Ramírez 《International journal of geriatric psychiatry》2016,31(2):109-119