Lopez Oscar L, Becker James T, Sweet Robert A, Klunk William, Kaufer Daniel I, Saxton Judith, Habeych Miguel, DeKosky Steven T
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
J Neuropsychiatry Clin Neurosci. 2003 Summer;15(3):346-53. doi: 10.1176/jnp.15.3.346.
This cross-sectional study examines relationships among the constellation of psychiatric syndromes in Alzheimer's disease (AD) as a function of dementia severity in 1155 patients with probable AD. The frequency of major depression decreased in severe stages, while agitation, aggression, and psychosis were more frequent in late stages. Major depression was associated with anhedonia, sleep disorders, depressed mood, low self-esteem, anxiety, and hopelessness in mild/moderate and severe stages. Agitation was associated with aggression and psychosis in mild/moderate stages, and psychosis was associated with aggression in moderate/severe stages. In addition, there was a constellation of psychiatric symptoms (e.g., anxiety, wandering, irritability, inappropriate behavior, uncooperativeness, emotional lability) associated with agitation, aggression, and psychosis, which varied according to the severity of the dementia, suggesting a progressive deterioration of frontal-temporal limbic structures. Education and race were independently associated with psychosis. However, while education was associated with psychosis in mild/moderate stages, race was associated with psychosis in moderate/severe stages.
这项横断面研究调查了1155例可能患有阿尔茨海默病（AD）的患者中，精神综合征的组合与痴呆严重程度之间的关系。重度抑郁的发生率在疾病严重阶段有所下降，而激越、攻击行为和精神病性症状在疾病后期更为常见。在轻度/中度和重度阶段，重度抑郁与快感缺失、睡眠障碍、情绪低落、自尊低下、焦虑和绝望相关。在轻度/中度阶段，激越与攻击行为和精神病性症状相关，在中度/重度阶段，精神病性症状与攻击行为相关。此外，存在一组与激越、攻击行为和精神病性症状相关的精神症状（如焦虑、徘徊、易怒、不适当行为、不合作、情绪不稳定），这些症状会根据痴呆的严重程度而有所不同，提示额颞叶边缘结构逐渐退化。受教育程度和种族与精神病性症状独立相关。然而，受教育程度与轻度/中度阶段的精神病性症状相关，而种族与中度/重度阶段的精神病性症状相关。
