Engelborghs Sebastiaan, Maertens Karen, Nagels Guy, Vloeberghs Ellen, Mariën Peter, Symons Anoek, Ketels Veerle, Estercam Sven, Somers Nore, De Deyn Peter P
Department of Neurology and Memory Clinic, Middelheim General Hospital, Antwerp, Belgium.
Int J Geriatr Psychiatry. 2005 Nov;20(11):1028-37. doi: 10.1002/gps.1395.
Given the rather limited knowledge on profiles of neuropsychiatric symptoms (behavioural and psychological signs and symptoms of dementia, BPSD) in several degenerative dementias, we designed a prospective study of which we here present the baseline data.
Diagnosed according to strictly applied clinical diagnostic criteria, patients with probable Alzheimer's disease (AD) (n = 205), frontotemporal dementia (FTD) (n = 29), mixed dementia (MXD) (n = 39) and dementia with Lewy bodies (DLB) (n = 23) were included. All patients underwent a neuropsychological examination and behavioural assessment by means of a battery of scales (Middelheim Frontality Score (MFS), Behave-AD, Cohen-Mansfield Agitation Inventory, Cornell Scale for Depression in Dementia).
In AD and MXD, activity disturbances and aggressiveness occurred in more than 80% of the patients. With a prevalence of 70%, apathy was very common whereas delusions and hallucinations were rare in FTD patients. Frequently used behavioural assessment scales like the Behave-AD systematically underestimated BPSD in FTD whereas the MFS displayed high sensitivity for frontal lobe symptoms. Hallucinations discriminated DLB patients from other dementias. A high prevalence of disinhibition (65%) in DLB pointed to frontal lobe involvement.
Behavioural assessment may help differentiating between different forms of dementia, further stressing the need for the development of new and more sensitive behavioural assessment scales. By means of the MFS, frontal lobe involvement was frequently observed in DLB. As 70% of FTD patients displayed apathy, prevalence was about two times higher compared to the other disease groups, meanwhile indicating that apathy is frequently observed in dementia, irrespective of its etiology.
鉴于对几种退行性痴呆的神经精神症状（痴呆的行为和心理症状，BPSD）特征的了解相当有限，我们设计了一项前瞻性研究，在此展示其基线数据。
根据严格应用的临床诊断标准进行诊断，纳入了可能患有阿尔茨海默病（AD）（n = 205）、额颞叶痴呆（FTD）（n = 29）、混合性痴呆（MXD）（n = 39）和路易体痴呆（DLB）（n = 23）的患者。所有患者均通过一系列量表（米德尔海姆额叶评分（MFS）、Behave - AD、科恩 - 曼斯菲尔德激越量表、康奈尔痴呆抑郁量表）进行神经心理学检查和行为评估。
在AD和MXD中，超过80%的患者出现活动障碍和攻击性。冷漠的患病率为70%，非常常见，而妄想和幻觉在FTD患者中很少见。常用的行为评估量表如Behave - AD系统性地低估了FTD中的BPSD，而MFS对额叶症状显示出高敏感性。幻觉可将DLB患者与其他痴呆区分开来。DLB中去抑制的高患病率（65%）表明额叶受累。
行为评估可能有助于区分不同形式的痴呆，进一步强调了开发新的、更敏感的行为评估量表的必要性。通过MFS，在DLB中经常观察到额叶受累。由于70%的FTD患者表现出冷漠，其患病率比其他疾病组高出约两倍，这同时表明无论病因如何，冷漠在痴呆中都很常见。
