Gilley D W, Wilson R S, Bennett D A, Bernard B A, Fox J H
Rush Alzheimer's Disease Center, Chicago, Illinois.
J Gerontol. 1991 Nov;46(6):P362-71. doi: 10.1093/geronj/46.6.p362.
The relationship of behavioral disturbances in Alzheimer's disease to disease severity, age at onset, and the presence of extrapyramidal signs was investigated in three studies. Five categories of behavior disturbance were ascertained through structured interview with the patient's primary caregiver: apathy, agitation, psychotic symptoms, disinhibition, and irritability. In Study 1, measures of disease severity accounted for 42% of the variance in the Apathy scale but less than 20% of the variance in the remaining scales. In Study 2, the presence of extrapyramidal signs was associated with increased Apathy and moderated the association between disease severity and the Psychotic Symptoms and Irritability scales. In Study 3, age at onset was associated with the Agitation scale and moderated the association between disease severity and the Apathy, Psychotic Symptoms, and Irritability scales. The findings are discussed in terms of the clinical heterogeneity within Alzheimer's disease, the possible biological bases of these behavioral disturbances, and the psychometric issues pertinent to their measurement.
三项研究调查了阿尔茨海默病中的行为障碍与疾病严重程度、发病年龄以及锥体外系体征之间的关系。通过与患者主要照料者进行结构化访谈，确定了五类行为障碍：冷漠、激越、精神病性症状、脱抑制和易激惹。在研究1中，疾病严重程度指标占冷漠量表方差的42%，但在其余量表中占比不到20%。在研究2中，锥体外系体征的存在与冷漠增加相关，并缓和了疾病严重程度与精神病性症状量表和易激惹量表之间的关联。在研究3中，发病年龄与激越量表相关，并缓和了疾病严重程度与冷漠、精神病性症状和易激惹量表之间的关联。从阿尔茨海默病的临床异质性、这些行为障碍可能的生物学基础以及与其测量相关的心理测量问题等方面对研究结果进行了讨论。
