伴有血管成分的阿尔茨海默病患者的神经精神症状

Neuropsychiatric symptoms in patients with Alzheimer's disease with a vascular component.

作者信息

Bidzan Mariola, Bidzan Leszek, Pachalska Maria

机构信息

Institute of Psychology, University of Gdansk, Poland.

Clinic for Development Psychiatry, Psychotic Disorders and Advanced Age Studies, Medical University, Gdańsk, Poland.

出版信息

Ann Agric Environ Med. 2014;21(2):412-5. doi: 10.5604/1232-1966.1108615.

DOI:10.5604/1232-1966.1108615

PMID:24959800

Abstract

OBJECTIVE

Vascular changes are observed in most cases of Alzheimer's disease (AD). Observations of AD and vascular disease (VD) allow us to surmise that vascular changes may not only affect cognitive impairment in AD but may also have a negative influence on the neuropsychiatric symptoms which often occur in the course of the disease. The aim of the study was to evaluate the impact of vascular factors on the neuropsychiatric symptoms in Alzheimer's Disease.

MATERIAL AND METHODS

The study included 48 people with a preliminary diagnosis of Alzheimer's Disease on the basis of NINCDS/ADRDA criteria. The evaluation of impairments in cognitive functioning was carried out by means of the Alzheimer Disease Assessment Scale - the cognitive part (ADAS - cog), whereas the behavioural and psychological symptoms were evaluated by means of the Neuropsychiatric Inventory - the version adapted for residents of nursing homes for the elderly (Neuropsychiatric Inventory - Nursing Home Version) (NPI - NH). The score on the Hachinski scale was the basis for dividing the study participants into two groups - those with a mild vascular component (0-1 points on the Hachinski scale) and those with a severe vascular component (2-4 points).

RESULTS

The analyzed groups did not differ with respect to the intensity of cognitive impairments (ADAS-cog) or age of the participants. Scores obtained on the NPI - NH scale as well as some of its elements (depression/dysphoria and anxiety) had a discriminating value. Studies show that vascular factors are a serious risk factor for neuropsychiatric symptoms in AD.

CONCLUSIONS

Vascular factors in Alzheimer's Disease influence the presence of neuropsychiatric symptoms. In the course of angiogenic dementia a greater frequency in depressive disorders was shown. The most visible differences between individuals with a greater and lesser burden of vascular factors was in the realm of depressive and dysphoric disorders.

摘要

目的

在大多数阿尔茨海默病（AD）病例中都观察到血管变化。对AD和血管疾病（VD）的观察使我们推测，血管变化可能不仅影响AD中的认知障碍，还可能对该疾病过程中经常出现的神经精神症状产生负面影响。本研究的目的是评估血管因素对阿尔茨海默病神经精神症状的影响。

材料与方法

该研究纳入了48名根据NINCDS/ADRDA标准初步诊断为阿尔茨海默病的患者。认知功能障碍的评估采用阿尔茨海默病评估量表——认知部分（ADAS-cog），而行为和心理症状则通过神经精神科问卷——适用于老年疗养院居民的版本（神经精神科问卷——疗养院版）（NPI-NH）进行评估。Hachinski量表得分是将研究参与者分为两组的依据——血管成分较轻的组（Hachinski量表得分为0-1分）和血管成分较重的组（2-4分）。