Behavioral and psychological symptoms, cognitive impairment and caregiver burden related to Alzheimer's disease patients treated in an outpatient memory clinic

AIM: The relationships among behavioral and psychological symptoms of dementia (BPSD), cognitive impairment of Alzheimer's disease (AD) patients and the caregiver burden of their caregivers were investigated in an outpatient memory clinic. METHODS: Forty-six pairs of AD patients and their family caregivers were involved in this study. Neuropsychiatry Inventory (NPI) was used to estimate BPSD, to which memory symptoms were added as a subcategory of BPSD. MMSE, word fluency, clock drawing test and category-cued memory test were used for cognitive measurement. Zarit burden interview (ZBI) and CES-D were used to assess caregiver burden. RESULTS: Among 11 BPSD subcategories, memory symptoms, apathy, depression, delusion, aggression and anxiety were prevalent BPSD was a strong determinant of caregiver burden. Among BPSD symptoms, anxiety, aggression and aberrant motor behavior were significantly related to ZBL In terms of the relationship between BPSD and cognitive impairment, the scores for delusion and apathy were significantly related to the cognitive decline. On the other hand, patients who showed symptoms related to memory and depression had higher cognitive function than those who did not. CONCLUSION: These analyses will contribute to better assessment of AD patients and their caregivers, hopefully resulting in better support for them.     

Rehabilitation outcome in home-based versus supervised exercise programs for chronically dizzy patients

The authors performed a cross-sectional study to examine the relationship between specific cognitive domains and behavioral and psychological symptoms in dementia (BPSD) in 125 patients with probable AD. Cognitive deficits were evaluated with the mini mental state examination (MMSE), trail-making test (TMT), Rey auditory verbal learning test (RAVLT), and semantic fluency test (SFT) and phonemic fluency test (PhFT), whereas the neuropsychiatric inventory (NPI) was used to rate BPSD. Patients’ performance in cognitive tests significantly correlated with total NPI scores (p < 0.0001). After controlling for demographic and clinical characteristics, cognitive impairments in memory, executive function, and language (RAVLT, TMT, PhFT, SFT) importantly estimated total NPI scores (p < 0.001, multivariate regression models). These findings suggest that the evaluation of cognitive domains may have a predictive value for the occurrence of BPSD.     

痴呆及其心理、行为症状与血浆同型半胱氨酸水平关系

目的 探讨痴呆及痴呆心理和行为症状(Psychological and behavioral symptoms of dementia，BPSD)的可能发病机制，研究血浆同型半胱氨酸(homocysteine，Hcy)水平与痴呆及BPSD的关系。方法 阿尔茨海默病(Alzheimer Disease，AD)、混合性痴呆(Mixed dementia，MD)、血管性痴呆(Vascular dementia，VD)和正常对照组各30例参加本研究。采用Alzheimer病行为症状评定量表(The Behavioral Pathlology in Alzheimer Disease Rating Scale，BEHAVE-AD)评定痴呆患者BPSD。采用高压毛细血管电泳紫外检测法测定经2，4-二硝基氟苯(2，4-dimntrifluorobenzen，DNFB)衍生后的血浆Hcy水平。结果 AD、MD和VD患者血浆Hcy浓度均显著高于正常对照组，血浆高Hcy水平的痴呆患者BEHAVE-AD总分较高。结论 血浆高Hcy水平不仅与痴呆的发生发展有关，且在痴呆患者BPSD的发病机制中扮演了一个重要角色。     

Relationship between antihypertensive drug therapy and cognitive function in elderly hypertensive patients with memory complaints

OBJECTIVE: To evaluate the relationship between antihypertensive treatments and cognitive function in elderly hypertensive patients with memory complaints. METHODS: The association between cognitive function and antihypertensive drug therapy was studied in 1241 hypertensive elderly patients with memory complaints attending a geriatric outpatient clinic. Cognitive function was assessed using the Mini Mental State Examination (MMSE) and validated neuropsychological tests (Cognitive Efficiency Profile; CEP). Patients were classified into four categories according to their cognitive status: normal cognitive function, mild cognitive impairment (MCI), Alzheimer's disease (AD) or vascular dementia (VaD). RESULTS: In this population aged 78 +/- 8 years, with a mean blood pressure of 152 +/- 19/86 +/- 12 mmHg, antihypertensive treatment was prescribed for 57% of patients. After adjustment for age, sex and education, treated hypertensive patients had better cognitive function than untreated patients (MMSE score 23.9 +/- 5.6/30 versus 22.7 +/- 6.4/30, P < 0.001, CEP score 49.1 +/- 24.9/100 versus 45.4 +/- 23.7/100, P < 0.001). This association was observed independently of the cognitive status, both in normal, MCI, AD and VaD hypertensive patients. The odds ratio (OR) for AD was 0.58 [95% confidence interval (CI) 0.42-0.81] in treated compared with untreated hypertensive patients. In patients on antihypertensive therapy, higher cognitive function was observed in patients using calcium antagonists compared with those without calcium antagonists (CEP 52.9 +/- 24.6/100 versus 46.4 +/- 23.4/100, P < 0.001; OR for AD 0.67; 95% CI 0.45-0.99), independently of blood pressure level. CONCLUSIONS: Antihypertensive therapy was associated with a lower risk of cognitive impairment and AD. In particular, the use of calcium antagonists was associated with a decreased risk of cognitive impairment and AD independently of the blood pressure level, suggesting a specific neuroprotective effect of these antihypertensive agents.     

阿尔茨海默病认知功能与磁共振成像测量海马和侧脑室颞角的相关性

目的探讨轻、中度阿尔茨海默病(AD)认知功能和MRI测量海马和侧脑室颞角的相关性。方法对31例AD患者(AD组)及30例健康体检者(对照组)进行认知功能量表的检测,包括简易智能状态检查表(MMSE)、日常生活能力量表(ADL)、Pfeffer功能活动调查表(POD)、Fuld物体记忆测验(FOM)、快速词汇测验(RVR)、数字广度测验(DS)、积木测验(BD)等,同时应用MRI测量颅腔的海马体积和侧脑室颞角宽度。结果海马体积、侧脑室颞角宽度AD组与对照组比较差异显著(P<0.01)。海马体积、侧脑室颞角宽度与MMSE、ADL、POD、FOM有相关性,其与DS、BD无相关性,其中海马体积与MMSE、FOM密切相关。结论AD患者的认知功能评定与MRI脑结构测量有一定的相关性,认知功能和MRI脑结构测量可为临床诊断和治疗提供可靠依据。     

轻度阿尔茨海默病持续性注意功能的相关性研究

目的 了解轻度阿尔茨海默病(AD)患者注意功能损害情况及其相关因素. 方法 对68例轻度AD病患者在入组时、入组治疗8周后和100例健康老年人进行了连续操作试验(CPT)测试,以简易精神状态量表(mini-mental state examination,MMSE)和AD病理行为评分表(BEHAVE-AD)评定病情,并对测试结果、病程、病情严重度、年龄等进行回归分析. 结果 AD患者的所有CPT指标视觉单目标持续性注意测验(VOT)、视觉连续目标持续性注意测验(VST)、听觉持续性注意测验(ET)的漏答率、误答率、反应时间和变异系数均高于健康对照组,人组治疗8周后略有好转,但仍比健康人高,人组时CPT结果与病程、病情严重程度有关. 结论 AD患者注意损害广泛而严重,注意损害与病程、精神行为症状有关.     

Behavioral and psychological symptoms of dementia (BPSD) in elderly demented subjects: is the long lasting use of atypical antipsychotic drugs useful and safe?

The use of atypical antipsychotics (AA) is suggested in the treatment of BPSD, although controversial data are available on their safety and efficacy. The aim of this study was to assess the efficacy and safety of AA and whether this therapy could modify cognitive and functional domains in parallel with BPSD modifications. Out of 1,100 patients followed by the psychogeriatric ambulatory of our hospital, 69 patients (6.2%) were in therapy with AA and only 32 of them fulfilled the inclusion criteria of this study. Namely, the availability was required of a complete geriatric assessment, including the evaluation of cognitive (mini mental state examination=MMSE), emotional (the Italian "scala di valutazione del benessere emotivo nell'anziano"=SVEBA), functional (basic and instrumental activities of daily living=ADL and IADL), as well as behavioral (neuropsychological inventory=NPI) status, at the beginning (T(0)) and after a 6 month therapy (T(1)). The AA prescribed were risperidone (42.8%), olanzapine (31.3%), quetiapine (25.9%). The mean age was 80.1 years; 34.4% male; 65.6% female. Educational level was elementary in 90.6% of cases. Only 21.9% were institutionalized. 15.6% had 1 cardiovascular risk factor (CVRF), 50% more than 1, and the remaining with no CVRF. More than the half of them were diagnosed with degenerative dementia (D) (40.6% Alzheimer D=AD; 15.6% fronto-temporal dementia (FTD); 34.4% with vascular dementia (VD) (9.4%) or combined D (25%); 3,1 % with mild cognitive impairment (MCI), classified as F06.7 by the ICD-10 (International Classification of Diseases) and 6.2% with psychiatric disturbances. The most common BPSD were hallucinations, delusions, agitation, verbal and physical aggression. A paired t-test was applied to analyze data. There was a significant improvement with all 3 AA on NPI (mean NPI T(0)=27.50 vs. T(1)=12.13; t=7.49). An improvement was also observed on SVEBA (t=1.97), close to significance. Most people did not have any adverse effects; 5 patients (15.6%) had extrapyramidal symptoms and 1 (3.1%) showed ginecomasty, clinically so relevant to cause the interruption of the treatment. The profile of safety and efficacy described on the whole sample was confirmed when it was subdivided according to kind of drug, illness severity and presence/absence of CVRF. In a large sample of the "real" subjects attending a geriatric service for dementia, the accurate selection of patients treatable with AA leads to identification of a population with a negligible rate of adverse effects in presence of a high rate of efficacy with respect not only to BPSD but also to cognitive and functional domains.     

Clinical effect of cerebrovascular atherosclerosis on cognition in Alzheimer’s disease

BackgroundThe association between cerebrovascular atherosclerosis and Alzheimer’s disease (AD) has been examined in many cross-sectional studies; however, there are few data regarding the role of cerebrovascular atherosclerosis on the longitudinal course of cognitive decline in AD. The aim of this study was to examine the progression of cognitive function in AD patients with cerebrovascular atherosclerosis compared to those without atherosclerosis over a two-year period.MethodsForty-seven AD patients with cerebrovascular atherosclerosis and 81 AD patients without atherosclerosis were assessed for cognitive function at the time of diagnosis and again at follow-up after two years. The cognitive functions were evaluated by neuropsychological tests including mini-mental state examination (MMSE) and clinical dementia scale (CDR).ResultsRepeated-measures multivariate analyses showed that there was a significant group-by-time interactions for the temporal changes of the MMSE and CDR between the two groups. The group-by-time interactions remained significant when the atherosclerotic patients were sub-classified into either an extracranial stenosis (EC) group or an intracranial stenosis(IC) group. Comparing either the EC or IC group with the non-atherosclerosis group, there were no main effects by time or group alone, but there were significant group-by-time interactions for the MMSE and CDR.ConclusionsCognitive function worsened more in terms of progressive impairment in AD patients with cerebrovascular atherosclerosis compared to AD patients without cerebrovascular atherosclerosis, regardless of whether the atherosclerosis was extracranial or intracranial.     

Donepezil provides greater benefits in mild compared to moderate Alzheimer's disease: Implications for early diagnosis and treatment

We assessed the cognitive and functional outcomes of donepezil treatment in mild versus moderate Alzheimer's disease (AD) patients. We performed a 6-month prospective, observational, multicenter study of the progression of cognitive and functionality abilities in a large sample patients with AD who initiated treatment with donepezil in monotherapy. According to baseline mini mental state examination (MMSE), patients were divided in two groups: mild AD (MMSE ≥ 21) and moderate AD (MMSE < 21). Patients were evaluated with the memory alteration test (M@T) and the Alzheimer's disease functional assessment and change scale (ADFACS) at baseline and at 6 months. A total of 403 patients finished the study (mild AD = 152; moderate AD = 251). The MMSE total score and M@T score remained stable at 6 months in the whole sample, with MMSE memory domain and M@T free and cued recall domains improving significantly from baseline. Total ADFACS, instrumental (IADL) and basic activities of daily living (BADL) got significantly worse, with the worsening being significantly greater in the moderate AD group. Significant differences between the groups favoring mild AD were observed for MMSE memory, orientation and language domains, M@T temporal orientation and semantic memory domains, and for IADL. We concluded that in AD patients on donepezil, cognition remains stable at 6 months. The beneficial effect of donepezil treatment, in terms of cognition and functionality, is greater for mild than for moderate AD.     

Vascular risk factors and progression in Alzheimer's disease

Aim: To determine whether vascular risk factors such as hypertension, diabetes and hypercholesterolemia affect the progression of Alzheimer's disease (AD). Methods: We followed up 150 consecutive outpatients with probable AD for 24–60 months. Severity of cognitive impairment was assessed using the Mini‐Mental State Examination (MMSE). We investigated the influence of vascular risk factors and other demographic and clinical conditions (including age, sex, education, initial MMSE score and follow‐up time) on annual MMSE score changes. Results: Multiple regression analysis revealed that age, education and hypertension were significant variables associated with annual MMSE score changes. Younger, more educated patients with hypertension showed greater decline in annual MMSE scores. There were no significant correlations of annual MMSE score changes with other vascular factors or demographics, including sex, initial MMSE score, diabetes or hypercholesterolemia. Conclusion: Younger, more educated patients are more likely to have faster cognitive decline. In addition, hypertension may also be associated with a greater rate of disease progression. Our results suggest the importance of prevention and treatment for hypertension in patients with AD. Geriatr Gerontol Int 2011; 11: 211–214 .     

老年性痴呆和轻度认知障碍患者时间地点定向力受损情况探讨

目的:了解老年性痴呆(AD)患者和轻度认知障碍(MCI)患者的时间地点定向力的受损情况。方法:收集51例AD患者、9例MCI患者和26例正常老人,进行MMSE检查,针对MMSE的总分和时间地点定向10个分项进行分析。结果:MCI组和对照组之间时间定向分、地点定向分、定向力总分无显著差异。MCI患者和轻度AD的时间定向分有显著性差异。轻度与中度AD之间比较,年份、月份、星期、街道和楼层这几个分项的回答正确率有差异。中度与重度AD之间比较,季度、省市、区、街道层、所在地这几个分项的回答正确率有显著差异。结论:随着认知障碍的进展AD和MCI患者的定向力受损也是逐渐加重。在早期认知减退的情况下,个体的时间定向力受损会较地点定向力更为明显。对于认知下降的患者,时间定向力是一个敏感的指标。随着病情的进展,患者的地点定向受损越来越明显。未发现某些分项较其他分项更为敏感。     

The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment

OBJECTIVES: To develop a 10-minute cognitive screening tool (Montreal Cognitive Assessment, MoCA) to assist first-line physicians in detection of mild cognitive impairment (MCI), a clinical state that often progresses to dementia. DESIGN: Validation study. SETTING: A community clinic and an academic center. PARTICIPANTS: Ninety-four patients meeting MCI clinical criteria supported by psychometric measures, 93 patients with mild Alzheimer's disease (AD) (Mini-Mental State Examination (MMSE) score > or =17), and 90 healthy elderly controls (NC). MEASUREMENTS: The MoCA and MMSE were administered to all participants, and sensitivity and specificity of both measures were assessed for detection of MCI and mild AD. RESULTS: Using a cutoff score 26, the MMSE had a sensitivity of 18% to detect MCI, whereas the MoCA detected 90% of MCI subjects. In the mild AD group, the MMSE had a sensitivity of 78%, whereas the MoCA detected 100%. Specificity was excellent for both MMSE and MoCA (100% and 87%, respectively). CONCLUSION: MCI as an entity is evolving and somewhat controversial. The MoCA is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing in the normal range on the MMSE.     

Assessment of behavioral and psychological symptoms of dementia by family caregivers

This study was designed to test the performance and related factors of a self-administered instrument in assessing behavioral and psychological symptoms of dementia (BPSD) by family caregivers. We recruited 173 patients with dementia and major caregivers from two neurological clinics. Information about clinical diagnosis, the Mini Mental State Examination (MMSE), the Clinical Dementia Rating (CDR), the Dementia Behavior Disturbance Inventory (DBDI), and global caregivers’ strain were collected from interview and chart review. We found that DBDI has acceptable construct validity and good internal consistency reliability. BPSD was more frequently found in patients with advanced dementia, poor cognitive function and highly correlated to caregivers’ strain. Multivariate analysis revealed that female patients and caregivers, advanced CDR stages, patient-caregiver relationship, types of dementia and MMSE score were related to the increase of frequency and disturbance index of DBDI. We concluded that BPSD could be evaluated by family caregivers using a self-administered instrument. Further study is indicated to clarify how caregiver characteristics affect the report of behavioral symptoms, and its clinical importance.     

老年期抑郁症和轻度Alzheimer病的认知功能研究

目的 了解老年期抑郁症（SD）和轻度Alzheimer病（AD）的认知功能差异。方法 使用汉密顿抑郁量表（HAMD）、简易智能状态检查（MMSE）和Et常生活能力量表（ADL）、韦氏成人记忆量表（WAIS-RC）和中国临床记忆量表对60例SD患者、30例轻度AD患者和30例正常老年人进行评定。同时在治疗前对他们进行P300测量。结果 SD和轻度AD患者的MMSE、WAIS-RC和记忆量表评分均显著低于正常对照组，而ADL总分均显著高于正常对照组，但轻度AD患者的前3个量表总分又均显著低于SD患者，而ADL总分又均显著高于SD患者（P〈0．05或P〈0．01）。SD和轻度AD患者的P300的N1、P2、N2、P3潜伏期均显著长于正常对照组，SD患者的P3波幅显著低于轻度AD患者；但轻度AD患者的P300的N1、N2、P3潜伏期均显著长于SD患者；并且轻度AD患者的P300的P2波幅显著高于正常对照组（P〈0．05或P〈0．01），而SD的P2波幅与正常对照组无显著性差异。结论 SD和轻度AD患者均存在认知功能障碍，但轻度AD患者较SD患者重。     

Clinical backgrounds and morbidity of cognitive impairment in elderly diabetic patients

Despite numerous reports that have linked diabetes with cognitive impairment (CI), there are few studies that have attempted to clarify the morbidity of CI among elderly diabetic patients. The Mini-Mental State Examination (MMSE) was performed on 240 diabetic patients aged 65 years or older who had no diagnosis of dementia. The MMSE scores were 28-30 (normal range) in 151 patients (63%), 24-27 (suspected CI) in 77 (32%), and ≤ 23 (definite CI) in 12 (5%). Eight of the 12 patients with MMSE scores ≤ 23 underwent further detailed examination: the final diagnosis was Alzheimer's disease (AD) (N = 5), vascular dementia (N = 2), and mixed dementia (N = 1). Among 24 of the 77 patients with MMSE scores of 24-27 who were referred for further detailed examination, the final diagnosis was early AD (N = 5), cerebrovascular disease (CVD) (N = 10), and mild CI (N = 7). Only 2 of the patients were judged as being normal. The percentage of patients with a history of CVD, the rate of diuretic use, and the serum levels of non-high-density lipoprotein cholesterol were higher, and the percentage of patients with a history of habitual alcohol consumption was lower in the low MMSE score group than in the normal MMSE score group. Among elderly diabetic patients aged 65 years or older, 5% had evident CI and 32% had suspected CI. Medical staff involved in the care of diabetic patients should be highly aware of possible CI in this patient population.     

阿尔茨海默病精神障碍与叶酸和维生素B12的相关性

目的：探讨叶酸和维生素 B12与阿尔茨海默病精神障碍（ BPSD）的相关性。方法：对77例阿尔茨海默病（ AD）患者（ BPSD组40例,非BPSD组37例）及39例正常对照组进行叶酸和维生素B12测定,并分析其与BPSD及认知功能障碍的关系。结果： BPSD组和非BPSD组血浆叶酸水平明显低于对照组（ P〈0．05）,而BPSD组与非BPSD组未见明显差异（P〉0．05）。 BPSD组和非BPSD组血浆维生素B12水平明显低于对照组（P〈0．01）,且BPSD组显著低于非BPSD组（P〈0．01）。维生素B12水平与认知功能障碍呈正相关（ r =0．441,P 〈0．01）。结论：叶酸及维生素B12水平与BPSD的认知障碍有关。     

蒙特利尔认知评估量表在轻度认知功能障碍诊断中的价值

目的 探讨蒙特利尔认知评估量表在轻度认知功能障碍诊断中的价值. 方法 采用简明精神状态量表(MMSE)对徐州市532名60岁以上的社区老年人进行认知功能检查,在MMSE评分为轻度认知功能障碍及正常的456名老年人中随机抽取69名老年人进行蒙特利尔认知评估量表(MoCA)检查,并对MoCA量表的敏感度、特异度及与MMSE量表测量结果的一致性进行分析.结果 69名老年人均完成认知功能评估,按MMSE量表评判标准有轻度认知功能障碍19名(27.5%),认知功能正常50名(72.5%);按MoCA量表评判标准有轻度认知功能障碍58名(84.1%),认知功能正常11名(15.9%),两种量表的一致性较低,Kappa值为0.09.与MMSE量表相比,MoCA量表的灵敏度为94.7%,特异度为20.1%. 结论 在轻度认知功能障碍的诊断上MoCA量表较MMSE量表更灵敏.     

Pharmacological treatment of Alzheimer's Disease

BACKGROUND AND AIMS: The treatment of Alzheimer's disease (AD) is a challenge for physician, families, and patients. An individualized, multimodal treatment plan addressing the treatment of cognitive, behavioural and functional decline is essential. Aim of the paper is to describe the principal components of the treatment plan of AD patients. METHODS: A review of the recent literature was performed. RESULTS: Acetylcholinesterase inhibitors (AChEIs) play an important role in the improvement of cognitive decline in mild to moderate AD, even if the improvement is not permanent. Data obtained from the CRONOS project (involving about 500 Alzheimer Evaluation Units) replicate in the real world those obtained in controlled trials, confirming that AD patients may benefit from AChEI treatment. Treatment of behavioral and psychological symptoms of dementia (BPSD) requires education of caregivers, non pharmacological interventions, identification and treatment of medical illnesses or environmental precipitating conditions, specific pharmacological treatment. Traditional neuroleptics are widely used for BPSD treatment, but limited data support their use, and side-effects are frequent and severe. Atypical antipsychotics are effective in treating BPSD, and safer than traditional neuroleptics. However, the increased risk of cerebrovascular accident in patients taking risperidone or olanzapine limited currently their use in demented subjects. The use of antidepressant drugs, as well as behavioral approach, may improve depressive symptoms frequently accompanying AD. CONCLUSIONS: Although at present there is no cure for AD, several drug treatments and care strategies may improve or stabilize cognitive and behavioral symptoms, and improve the quality of life of patients and families.     

Donepezil for the treatment of behavioral disturbances in Alzheimer's disease: a 6-month open trial

Behavioral and psychological signs of dementia (BPSD) are common clinical characteristics of Alzheimer's disease (AD). They result in patient and caregivers distress, decreased quality of life and placement in nursing homes. Treatment of BPSD with antidepressant and antipsychotic medications is not without complications and serious adverse effects. The acetylcholinesterase inhibitors (AChEI) show preliminary promise as psychotropic agents possibly able to improve BPSD in AD patients. The present study aimed to evaluate the effect of donepezil (an AChEI) as an only treatment for AD patients with BPSD. Ten consecutive AD patients hospitalized at a psychogeriatric ward due to BPSD were treated with donepezil for 24 weeks. Effect was measured using the NeuroPsychiatric Inventory (NPI). Significant reduction in the presence of delusions, irritability/lability and disinhibition were achieved after 24 weeks of donepezil treatment. This was accompanied by reduction in caregivers distress. The drug was well tolerated and all patients completed the study. Our findings complement the preliminary data that donepezil as well as other AChEIs are promising candidates for further study as psychotropic agents positively affecting BPSD in AD patients.     

老年期痴呆的精神行为症状及美金刚的临床疗效研究

目的探讨老年期痴呆患者精神行为症状及美金刚的改善作用。方法选择老年期痴呆有精神行为症状的患者61例,随机分为2组,美金刚组(美金刚+多奈哌齐+尼莫地平)31例,对照组(多奈哌齐+尼莫地平)30例,分别在治疗前和治疗12周后进行简易智能状态检查量表(MMSE)、临床痴呆程度量表(CDR)及神经精神科问卷(NPI)的评估。结果老年期痴呆患者精神行为症状多见。美金刚组与对照组患者治疗前MMSE、CDR及各项症状的NPI评分差异无统计学意义(P>0.05)。美金刚组患者治疗12周后激越/攻击行为、焦虑、易激惹/不稳定性、情感高涨/欣快、夜间行为异常、食欲进食改变的NPI评分及NPI总分明显改善;对照组患者治疗12周后易激惹/不稳定性、夜间行为异常、食欲进食改变的NPI评分及NPI总分明显改善,差异有统计学意义(P<0.05)。美金刚组患者治疗12周后MMSE评分、激越/攻击行为、易激惹/不稳定性、食欲进食改变的NPI评分及NPI总分较对照组明显改善(P<0.05)。结论美金刚能有效改善老年期痴呆精神行为症状,减轻家庭负担。