Shimabukuro Jin, Awata Shuichi, Matsuoka Hiroo
Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.
Psychiatry Clin Neurosci. 2005 Jun;59(3):274-9. doi: 10.1111/j.1440-1819.2005.01371.x.
In order to clarify the characteristics of Behavioral and Psychological Symptoms of Dementia (BPSD) in patients with mild Alzheimer's disease (AD), BPSD among the severities of Clinical Dementia Rating (CDR) in 74 patients with AD were compared using the Neuropsychiatric inventory (NPI). The result, when compared between mild (CDR = 0.5, 1) and moderate or severe (CDR = 2, 3) AD, was a significant difference in frequency of euphoria, disinhibition and aberrant motor behavior, but no significant difference was found in frequency of delusions, hallucinations, agitation, dysphoria, anxiety, apathy and irritability. In addition, a significant difference was found in the mean scores of the composite score for euphoria, apathy, disinhibition and aberrant motor behavior, but no significant difference was found in the mean scores of the composite score for delusions, hallucinations, agitation, dysphoria, anxiety and irritability. That is, the mild AD groups (CDR 0.5 or 1) had delusions, hallucinations, agitation, dysphoria, anxiety, apathy and irritability as frequently as the moderate or severe AD groups (CDR 2 or 3), and had the equivalent level of composite scores to the moderate or severe AD groups (CDR 2 or 3) in delusion, hallucination, agitation, dysphoria, anxiety and irritability. Therefore, it was supposed that psychotic symptoms (delusion, hallucination) and emotional symptoms (agitation, dysphoria, anxiety, irritability) are important BPSD in patients with mild AD as well as those with moderate or severe AD, and there are needs for health, welfare and medical services for these symptoms.
为了阐明轻度阿尔茨海默病(AD)患者的痴呆行为和心理症状(BPSD)特征,使用神经精神科问卷(NPI)比较了74例AD患者临床痴呆评定量表(CDR)不同严重程度下的BPSD。结果显示,与轻度AD(CDR = 0.5,1)组相比,中度或重度AD(CDR = 2,3)组在欣快、脱抑制和异常运动行为的频率上存在显著差异,但在妄想、幻觉、激越、烦躁、焦虑、淡漠和易激惹的频率上未发现显著差异。此外,欣快、淡漠、脱抑制和异常运动行为综合评分的平均分存在显著差异,但妄想、幻觉、激越、烦躁、焦虑和易激惹综合评分的平均分未发现显著差异。也就是说,轻度AD组(CDR 0.5或1)出现妄想、幻觉、激越、烦躁、焦虑、淡漠和易激惹的频率与中度或重度AD组(CDR 2或3)相当,且在妄想、幻觉、激越、烦躁、焦虑和易激惹方面的综合评分水平与中度或重度AD组(CDR 2或3)相当。因此,可以认为精神病性症状(妄想、幻觉)和情绪症状(激越、烦躁、焦虑、易激惹)在轻度AD患者以及中度或重度AD患者中都是重要的BPSD,针对这些症状的健康、福利和医疗服务很有必要。