RESEARCH PAPER
Neuropsychiatric symptoms in patients with Alzheimer’s disease with a vascular component
| 1 | Institute of Psychology, University of Gdansk, Poland |
| 2 | Clinic for Development Psychiatry, Psychotic Disorders and Advanced Age Studies, Medical University, Gdańsk, Poland |
| 3 | Department of Neuropsychology, Andrzej Frycz-Modrzewski University, Kraków, Poland, Center for Cognition and Communication, New York, USA |
Ann Agric Environ Med. 2014;21(2):412–415
KEYWORDS
ABSTRACT
objective. Vascular changes are observed in most cases of Alzheimer’s disease (AD). Observations of AD and vascular disease (VD) allow us to surmise that vascular changes may not only affect cognitive impairment in AD but may also have a negative influence on the neuropsychiatric symptoms which often occur in the course of the disease. The aim of the study was to evaluate the impact of vascular factors on the neuropsychiatric symptoms in Alzheimer’s Disease.
material and methods. The study included 48 people with a preliminary diagnosis of Alzheimer’s Disease on the basis of NINCDS/ADRDA criteria. The evaluation of impairments in cognitive functioning was carried out by means of the Alzheimer Disease Assessment Scale – the cognitive part (ADAS – cog), whereas the behavioural and psychological symptoms were evaluated by means of the Neuropsychiatric Inventory – the version adapted for residents of nursing homes for the elderly (Neuropsychiatric Inventory – Nursing Home Version) (NPI – NH). The score on the Hachinski scale was the basis for dividing the study participants into two groups – those with a mild vascular component (0–1 points on the Hachinski scale) and those with a severe vascular component (2–4 points).
results. The analyzed groups did not differ with respect to the intensity of cognitive impairments (ADAS-cog) or age of the participants. Scores obtained on the NPI – NH scale as well as some of its elements (depression/dysphoria and anxiety) had a discriminating value.
Studies show that vascular factors are a serious risk factor for neuropsychiatric symptoms in AD.
conclusions. Vascular factors in Alzheimer’s Disease influence the presence of neuropsychiatric symptoms. In the course of angiogenic dementia a greater frequency in depressive disorders was shown. The most visible differences between individuals with a greater and lesser burden of vascular factors was in the realm of depressive and dysphoric disorders.
REFERENCES (26)
1.
Braak H, Braak E. Neuropathological staging of Alzheimer-related changes. Neuropathologica. 1991; 82: 259.
2.
Rockwood K, Ebly E, Hackinski V, Hogan D. Presence and treatment of vascular risk factors in patients with vascular cognitive impairment. Arch Neurol. 1997; 54: 33–39.
3.
Rasmusson DX, Brandt J, Steele C, Hendreen JC, Troncoso JC, Folstein MF. Accuracy of clinical diagnosis of Alzheimer disease and clinical features of patients with non-Alzheimer disease neuropathology. Alzheimer Dis Assoc Disord. 1996; 10: 180–188.
4.
Kertesz A, Clydesdale S. Neuropsychological deficits in vascular dementia vs Alzheimer’s disease. Frontal lobe deficits prominent in vascular dementia. Arch Neurol. 1994; 51: 1226–31.
5.
Cummings JL. The Neuropsychiatry of Alzheimer’s Disease and Related Dementias. Martin Dunitz 2002.
6.
Cummings JL, Miller B, Hill MA, Neshkes R. Neuropsychiatric aspects of multi-infarct dementia and dementia of the Alzheimer type. Arch Neurol. 1987; 44: 389–93.
7.
Bidzan L, Bidzan M. Czynniki naczyniowe a obraz psychopatologiczny w otępieniu Alzheimera. Psychiatr Pol. 2006; 40(5): 823–831.
8.
Folstein MF, Folstein SE, McHugh PR. Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12: 189–198.
9.
Mc Khan G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease:report ofthe NINCDSADRDA Work Group under the suspicies of Department of Health Services Task Force on Alzheimer’s disease. Neurology. 1984; 34: 939–944.
10.
Hachinski VC. Multi-infarct dementia: a cause of mental deterioration in the elderly. Lancet 1974; 2: 207–209.
11.
Rosen WG, Mohs RC, Davis KL. A new rating scale for Alzheimer’s disease. Am J Psychiatry 1984; 141: 1356–1364.
12.
Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The Neuropsychiatric Inventory. Comprehensive assessment of psychology in dementia. Neurology. 1994; 44: 2308–2314.
13.
Wood S, Cummings JL Hsu M-A, Barclay T, Wheatley MV, Yarema KT. The use of the Neuropsychiatric Inventory in Nursing Home residents. Am J Geriatr Psychiatry 2000; 8: 75–83.
14.
Bidzan L, Bidzan M. Ocena rzetelności polskiej wersji językowej Inwentarza Neuropsychiatrycznego – wersja dla ośrodków opiekuńczych (Neuropsychiatric Inventory – Nursing Homes). Psychiatr Pol. 2005; 39: 1219–1229 (in Polish).
15.
Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Brit J Psychiatry 1979; 134: 382–389.
16.
Rockwood K, Moorhouse PK, Song X, MacKnight C, Gauthier S, Kertesz A, Montgomery P, Black S, Hogan DB, Guzman A, Bouchard R, Feldman H. Consortium to Investigate Vascular Impairment of Cognition (CIVIC) Cohort. Disease progression in vascular cognitive impairment: cognitive, functional and behavioural outcomes in the Consortium to Investigate Vascular Impairment of Cognition (CIVIC) cohort study. J Neurol Sci. 2007; 252: 106–112.
17.
Sneed JR, Culang-Reinlieb ME: The vascular depression hypothesis: An update. Am J Geriatr Psychiatry. 2011; 19(2): 99–103.
18.
Kim B, Lee D, Lee D, et al. The role of vascular risk factors in the development of Depression with Executive Dysfunction (DED) syndrome among an elderly community sample. Am J Geriatr Psychiatry. 2011; 19(2): 104–14.
19.
Rosler M. The efficacy of cholinesterase inhibitors In treating the behavioural symptoms of dementia. IJCP Supplement 2002; 127: 20–36.
20.
Perry EK, Perry RH, Roth M, Tomlinson B. Cholinergic neuronal deficits in dementia. J NeuroL Sci. 1977; 24: 145–153.
21.
Kalaria RN, Hedera P. Differential degeneration of the endothelium and basement membrane of capillaries in Alzheimer’s disease. Neuro Report. 1995; 6: 477–480.
22.
Perimutter LS, Chui HC. Microangiopathy the vascular basement membrane and Alzheimer’s disease: a review. Brain Res Bull. 1990; 24: 677–688.
23.
Berkenbosch F, Biewenga J, Brouns M, Rozemuller JM, Strijbos P, Dam AM. Cytokines and inflammatory proteins in Alzheimer’s disease. Res Immunol. 1992; 143: 657–662.
24.
McGeer PL, McGeer EG. Complement proteins and complement inhibitors in Alzheimer’s disease. Res Immunol. 1992; 143: 621–624.
25.
Błachnio A, Buliński L. Prejudices and elderly patients’ personality – the problem of quality of care and quality of life in geriatric medicine. Med Sci Mon. 2013; 19: 674–680.
26.
Tomaszewski W, Mańko G, Ziółkowski A, Pąchalska M. An evaluation of the health-related quality of life of patients aroused from prolonged coma when treated by physiotherapists with or without training in the “Academy of Life” program. Ann Agric Environ Med. 2013; 20(2): 319–323.
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