Bandyopadhyay Tushar Kanti, Biswas Atanu, Roy Arijit, Guin Deb Sankar, Gangopadhyay Goutam, Sarkhel Sujit, Ghoshal Malay Kumar, Senapati Asit Kumar
Department of Neurology, Bangur Institute of Neurosciences, Kolkata, West Bengal, India.
Institute of Psychiatry, IPGME&R, Kolkata, West Bengal, India.
Ann Indian Acad Neurol. 2014 Jul;17(3):325-30. doi: 10.4103/0972-2327.138520.
BACKGROUND/AIMS: The aim of the following study is to compare the behavioral and psychological symptoms of dementia (BPSD) in patients of Alzheimer disease (AD) and vascular dementia (VaD).
We used National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria for diagnosing AD and National Institute of Neurological Disorders and Stroke-Association International pour la Recherche et l'Enseignement en Neurosciences Criteria for diagnosing VaD. VaD cohort was further subcategorized into small vessel and large vessel disease. The severity of cognitive impairment and the BPSD were studied by means of the Clinical Dementia Rating Scale (CDR) and the Neuropsychiatric Inventory respectively.
We studied 50 AD and 50 VaD patients of whom 38 were small vessels and 12 were large vessels VaD. The severity of dementia was comparable in both groups. The agitation/aggression, depression/dysphoria, anxiety, apathy/indifference, irritability, aberrant motor behavior, appetite and eating behavior and night-time behaviors occurred significantly more frequently in patients with VaD than AD. We found a weak positive correlation between the CDR score and the number of neuropsychiatric symptoms per patient in both cohorts. Elation/euphoria, agitation/aggression was significantly more frequent in patients with large vessel in comparison to small vessel VaD.
BPSD are common in both types of dementia and they are more severe in VaD than AD when the groups have similar levels of cognitive impairment.
背景/目的:本研究旨在比较阿尔茨海默病(AD)和血管性痴呆(VaD)患者的痴呆行为和心理症状(BPSD)。
我们采用美国国立神经疾病与中风研究所-阿尔茨海默病及相关疾病协会标准诊断AD,采用美国国立神经疾病与中风研究所-国际神经科学研究与教学协会标准诊断VaD。VaD队列进一步细分为小血管病和大血管病。分别通过临床痴呆评定量表(CDR)和神经精神科问卷研究认知障碍的严重程度和BPSD。
我们研究了50例AD患者和50例VaD患者,其中38例为小血管性VaD,12例为大血管性VaD。两组痴呆严重程度相当。VaD患者的激越/攻击行为、抑郁/烦躁、焦虑、淡漠/无动于衷、易激惹、异常运动行为、食欲和饮食行为以及夜间行为的发生频率显著高于AD患者。我们发现两个队列中CDR评分与每位患者神经精神症状数量之间存在弱正相关。与小血管性VaD患者相比,大血管性VaD患者的欣快/狂喜、激越/攻击行为更为频繁。
BPSD在两种类型的痴呆中均很常见,当两组认知障碍水平相似时,VaD中的BPSD比AD中的更严重。