C.H.U Nice, France.
J Nutr Health Aging. 2012 Feb;16(2):134-7. doi: 10.1007/s12603-011-0147-9.
The multicenter PHRC REAL-FR cohort study was designed to follow community-dwelling patients with a diagnosis of Alzheimer's Disease. The present study describes the evolution of neuropsychiatric symptoms (NPS) over 4 years.
686 patients were recruited at baseline from 16 French clinical centers. 151 patients were followed over the 4-year interval with 5 Neuropsychiatric evaluations. Neuropsychiatric symptoms were assessed using the Neuropsychiatric inventory (NPI). NPS symptoms were divided into 4 subgroups according to the European Alzheimer Disease Consortium NPI analysis; psychotic subgroup (hallucinations, delusions), hyperactivity subgroup (agitation, aggression, euphoria, disinhibition, irritability, aberrant motor behavior), apathy subgroup (apathy, eating) and affective subgroup (depression, anxiety). Secondly we studied the evolution of the population divided in 4 groups: Apathy only, Hyperactivity only, both Apathy and Hyperactivity, no Apathy no Hyperactivity.
At baseline, 100 patients (66%) presented with one or more clinically significant NPI symptoms. This figure increased to 88% at the end of 4-year follow-up (Linear by linear chi square, p<0, 0012). Five NPI symptoms showed significant increases in prevalence: agitation (17,9 to 29,1%), apathy (43,0 to 62,9%) , disinhibition (2,6 to 14,6%), hallucination (2 to 4,6%) and aberrant motor behavior (13,9 to 29,1%). Prevalence of hyperactivity and apathy subgroups increased significantly during the follow-up while the prevalence of affective and psychotic subgroups did not. The number of patients with both apathy and hyperactivity increased (27% to 44%) during the follow-up period whereas the number of patients without these symptoms decreased (p = .009).
The present study shows that 2 types of symptoms increased primarily over time: Apathy and Hyperactivity. The coexistence of such opposite symptoms over time according to our result should be taken into consideration by clinicians treating those patients.
多中心 PHRC REAL-FR 队列研究旨在随访社区居住的阿尔茨海默病患者。本研究描述了 4 年内神经精神症状（NPS）的演变。
686 例患者于基线时从 16 个法国临床中心招募。151 例患者在 4 年随访期间进行了 5 次神经精神病学评估。使用神经精神病学检查量表（NPI）评估神经精神症状。根据欧洲阿尔茨海默病联盟 NPI 分析，将 NPS 症状分为 4 个亚组：精神病亚组（幻觉、妄想）、多动亚组（激越、攻击、欣快、失抑制、易怒、异常运动行为）、淡漠亚组（淡漠、进食）和情感亚组（抑郁、焦虑）。其次，我们研究了分为 4 组的人群的演变：仅淡漠、仅多动、淡漠和多动、无淡漠无多动。
基线时，100 例（66%）患者出现 1 种或多种临床显著 NPI 症状。这一数字在 4 年随访结束时增加到 88%（线性线性卡方，p<0.0012）。5 种 NPI 症状的患病率显著增加：激越（17.9 至 29.1%）、淡漠（43.0 至 62.9%）、失抑制（2.6 至 14.6%）、幻觉（2 至 4.6%）和异常运动行为（13.9 至 29.1%）。随访期间，多动和淡漠亚组的患病率显著增加，而情感和精神病亚组的患病率没有增加。同时患有淡漠和多动的患者人数增加（27%至 44%），而无症状患者人数减少（p =.009）。
本研究表明，2 种症状主要随时间而增加：淡漠和多动。根据我们的结果，随着时间的推移，这些相反症状的共存应该被治疗这些患者的临床医生考虑。
