Aarsland D, Cummings J L, Larsen J P
Section of Geriatric Psychiatry, Rogaland Psychiatric Hospital, PO 1163 Hillevåg, 4095 Stavanger, Norway.
Int J Geriatr Psychiatry. 2001 Feb;16(2):184-91. doi: 10.1002/1099-1166(200102)16:2<184::aid-gps304>3.0.co;2-k.
To compare the profile of neuropsychiatric symptoms in patients with Parkinson's disease with dementia (PDD) and patients with Alzheimer's disease (AD).
Cross-sectional survey of a population-based sample of patients with PDD and AD patients matched for age, sex, and Mini-Mental State Examination (MMSE) score.
Patients were diagnosed according to published criteria for PD and AD. The diagnosis of dementia in PD was made according to DSM-III-R, and was based on clinical interview of the patient and a relative, psychometric testing (including MMSE, Dementia Rating Scale and tests assessing memory, executive functions and visuospatial functioning) and physical examination. The Neuropsychiatric Inventory (NPI) was administered to all patients.
One or more psychiatric symptoms was reported in 95% of AD and 83% of PDD patients. Hallucinations were more severe in PD patients, while aberrant motor behavior, agitation, disinhibition, irritability, euphoria, and apathy were more severe in AD. In PDD, apathy was more common in mild Hoehn and Yahr stages, while delusions increased with more severe motor and cognitive disturbances. In PDD, only delusions correlated with the MMSE score.
Neuropsychiatric symptoms are common and severe in patients with PDD, with important implications for the management of these patients. AD and PDD patients have different neuropsychiatric profiles, suggesting different underlying mechanisms. Cognitive impairment, psychopathology, and motor features progress independently in PDD patients
比较帕金森病痴呆（PDD）患者与阿尔茨海默病（AD）患者的神经精神症状特征。
对基于人群的PDD患者样本和年龄、性别及简易精神状态检查表（MMSE）评分相匹配的AD患者进行横断面调查。
根据已发表的PD和AD诊断标准对患者进行诊断。PD患者的痴呆诊断依据《精神疾病诊断与统计手册》第三版修订本（DSM-III-R），基于对患者及其亲属的临床访谈、心理测量测试（包括MMSE、痴呆评定量表以及评估记忆、执行功能和视空间功能的测试）和体格检查。对所有患者使用神经精神科问卷（NPI）进行评估。
95%的AD患者和83%的PDD患者报告有一项或多项精神症状。幻觉在PD患者中更为严重，而异常运动行为、激越、脱抑制、易激惹、欣快和淡漠在AD患者中更为严重。在PDD中，淡漠在轻度Hoehn和Yahr分期中更为常见，而妄想则随着运动和认知障碍的加重而增加。在PDD中，只有妄想与MMSE评分相关。
神经精神症状在PDD患者中常见且严重，对这些患者的管理具有重要意义。AD和PDD患者具有不同的神经精神特征，提示潜在机制不同。PDD患者的认知障碍、精神病理学和运动特征独立进展。
