Haupt M, Kurz A, Jänner M
Psychiatrische Klinik der Heinrich-Heine-Universität Düsseldorf, Deutschland.
Dement Geriatr Cogn Disord. 2000 May-Jun;11(3):147-52. doi: 10.1159/000017228.
The aim was to examine the longitudinal occurrence and persistence of behavioural and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD).
Following 60 patients with mild to severe AD over a period of 2 years with annual evaluations, the prospective occurrence and persistence of BPSD in AD were determined by using the Behavioural Abnormalities in AD Rating scale (BEHAVE-AD). Clinical and demographic features of the AD patients were analysed for their association with course features of these symptoms.
All of the 60 AD patients experienced BPSD at some point during the 2-year period, particularly agitation was present in every patient within this period. 2-year persistence of BPSD in AD was frequently observed in patients with agitation and with depressiveness, with less frequency in patients with anxiety and aggressiveness, but not in patients with delusions or hallucinations. 2-year persistent aggressiveness was associated with older age and more functional impairment. More functional impairment was also related to 2-year non-persistent hallucinations.
Counselling AD patients and their families and tailoring therapeutic strategies should take into account the different modi of BPSD in AD occurring and persisting longitudinally and interacting with functional disturbances.
目的是研究阿尔茨海默病（AD）中痴呆的行为和心理症状（BPSD）的纵向发生情况及持续存在情况。
对60例轻度至重度AD患者进行为期2年的随访，每年评估一次，使用AD行为异常评定量表（BEHAVE-AD）确定AD中BPSD的前瞻性发生情况及持续存在情况。分析AD患者的临床和人口统计学特征与这些症状病程特征之间的关联。
60例AD患者在2年期间均在某个时间点出现了BPSD，特别是在此期间每位患者均出现过激越症状。在有激越和抑郁症状的患者中经常观察到AD患者BPSD持续2年，焦虑和攻击症状患者中出现频率较低，而妄想或幻觉患者中则未出现。持续2年的攻击行为与年龄较大和功能损害更严重有关。功能损害更严重也与持续2年的非持续性幻觉有关。
为AD患者及其家属提供咨询并制定治疗策略时，应考虑到AD中BPSD纵向发生和持续存在的不同形式以及与功能障碍的相互作用。
