Servicio de Neurología, Hospital de Cruces, Plaza de Cruces s/n, Barakaldo, Spain.
BMC Neurol. 2010 Sep 28;10:87. doi: 10.1186/1471-2377-10-87.
Behavioural and psychological symptoms of dementia (BPSD) are non-cognitive symptoms commonly associated to Alzheimer's disease (AD). The characterization of the clinical profile of AD patients might help to better understand disease evolution and to improve diagnosis and treatment. Thus, the aim of the present study is to describe the clinical profile of AD patients, and to correlate the presence of BPSD with the severity of the disease.
A cross-sectional, observational and multicenter study was conducted at 115 centres in Spain. Patients suffering from AD with higher and lower BPSD scores (ADAS-Noncog score 26-50 and ≤25, respectively) were included. Demographic and clinical data were collected, and dementia severity was assessed by the Mini Mental State Examination (MMSE) [mild 27-21, moderate 20-11, severe ≤10]. The use of ADAS-Noncog in clinical practice was also explored.
A total of 1014 patients (463 with higher and 551 with lower BPSD scores) were included (mean age 77 ± 7 years, 65% women). Almost all patients (90%) had BPSD at inclusion, 17% of which reported psychotic outbreaks. The most prevalent symptoms were lack of concentration (56%), tremors (56%), depression (44%), lack of cooperation (36%), and delusions (32%). Patients with higher BPSD scores showed a significantly higher prevalence of psychotic symptoms (delusions, hallucinations, and delirium) and tremors, while emotional symptoms (tearfulness and apathy) predominated in patients with lower BPSD scores. MMSE and ADAS-Noncog scores were negatively associated (p = 0.0284), suggesting a correlation between cognitive impairment and BPSD. Lack of concentration and appetite change significantly correlated with MMSE (p = 0.0472 and p = 0.0346, respectively). Rivastigmine and donepezil were the first choice therapies in mild to moderate dementia. ADAS-Noncog was generally considered better or similar to other scales (82%), and 68% of the investigators were willing to use it in the future.
Our study shows that patients with AD have a high prevalence of noncognitive symptoms, and that cognitive impairment and BPSD are correlated. Therefore, ADAS-Noncog is a useful evaluation tool.
行为和心理症状的痴呆症（BPSD）是非认知症状通常与阿尔茨海默病（AD）相关联。AD 患者的临床特征的描述可能有助于更好地了解疾病的演变，并改善诊断和治疗。因此，本研究的目的是描述 AD 患者的临床特征，并将 BPSD 的存在与疾病的严重程度相关联。
这是一项在西班牙 115 个中心进行的横断面、观察性和多中心研究。研究纳入了 AD 患者，这些患者的 BPSD 评分较高（ADAS-Noncog 评分 26-50）和较低（ADAS-Noncog 评分≤25）。收集了人口统计学和临床数据，并使用 Mini Mental State Examination（MMSE）评估痴呆严重程度[轻度 27-21，中度 20-11，重度≤10]。还探讨了 ADAS-Noncog 在临床实践中的应用。
共纳入 1014 例患者（高 BPSD 评分 463 例，低 BPSD 评分 551 例）（平均年龄 77±7 岁，65%为女性）。几乎所有患者（90%）在纳入时都有 BPSD，其中 17%有精神病发作。最常见的症状是注意力不集中（56%）、震颤（56%）、抑郁（44%）、合作困难（36%）和妄想（32%）。高 BPSD 评分的患者精神病症状（妄想、幻觉和谵妄）和震颤更为常见，而低 BPSD 评分的患者情绪症状（流泪和冷漠）更为常见。MMSE 和 ADAS-Noncog 评分呈负相关（p=0.0284），提示认知障碍与 BPSD 相关。注意力不集中和食欲改变与 MMSE 显著相关（p=0.0472 和 p=0.0346）。利伐斯的明和多奈哌齐是轻度至中度痴呆的首选治疗药物。ADAS-Noncog 通常被认为优于或等同于其他量表（82%），68%的研究者愿意在未来使用它。
我们的研究表明，AD 患者的非认知症状患病率较高，且认知障碍与 BPSD 相关。因此，ADAS-Noncog 是一种有用的评估工具。
