Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Taoyuan, Taiwan.
School of Medicine, Chang Gung University, Taoyuan, Taiwan.
J Alzheimers Dis. 2020;78(2):711-719. doi: 10.3233/JAD-200507.
The behavioral and psychological symptoms of dementia (BPSD) seriously affect the quality of life of patients with Alzheimer's disease (AD) and their caregivers.
We aimed to identify associations between demographic/genetic factors and clinical presentations of BPSD.
In a cohort of 463 AD patients with BPSD, we retrospectively analyzed sex, education level, AD severity (assessed using the Clinical Dementia Rating and Mini-Mental Status Examination), and BPSD severity (assessed using the Neuropsychiatry Inventory, NPI). Severe BPSD was defined as NPI ≥10 for 3 consecutive years.
Among patients with severe BPSD (NPI ≥10), we observed more female patients (62.96%) and a lower level of education (6.03±4.77 years) as compared to those with mild BPSD (NPI <10) (female: 51.09%, p = 0.007; education years: 7.91±4.93, p < 0.001). Females had a lower level of education (5.72±4.50 years) and higher scores for depression/dysphoria (1.22±2.05) compared with males (education: 8.96±4.89 years, p < 0.001; depression/dysphoria: 0.78±1.42, p = 0.047). Patients with a high level of education (defined as ≥12 years) had higher scores for appetite/eating (0.90±2.02) than did those without (0.69±1.79; p = 0.001). Genetic analysis showed similar total and subscale NPI scores between patients with and without APOE4 and with and without the GRN rs5848 genotype.
Our findings indicate potential contributions of sex and education to the presentation of BPSD. Further study is warranted to provide models for tailoring therapeutic programs to individual AD patients according to these factors.
痴呆的行为和心理症状（BPSD）严重影响阿尔茨海默病（AD）患者及其照料者的生活质量。
我们旨在确定人口统计学/遗传学因素与 BPSD 的临床表现之间的关联。
在 463 例有 BPSD 的 AD 患者队列中，我们回顾性分析了性别、教育程度、AD 严重程度（使用临床痴呆评定量表和简易精神状态检查评估）和 BPSD 严重程度（使用神经精神病学问卷，NPI）。严重 BPSD 定义为连续 3 年 NPI≥10。
在 NPI≥10 的严重 BPSD 患者中，我们观察到更多的女性患者（62.96%）和较低的教育程度（6.03±4.77 年），而 NPI<10 的轻度 BPSD 患者则较少（女性：51.09%，p=0.007；教育年限：7.91±4.93，p<0.001）。女性的教育程度较低（5.72±4.50 年），抑郁/烦躁评分较高（1.22±2.05），而男性的教育程度较高（8.96±4.89 年，p<0.001；抑郁/烦躁评分：0.78±1.42，p=0.047）。受教育程度较高（定义为≥12 年）的患者的食欲/进食评分较高（0.90±2.02），而受教育程度较低的患者的食欲/进食评分较低（0.69±1.79；p=0.001）。基因分析显示，APOE4 患者和 GRN rs5848 基因型患者的总 NPI 评分和各亚量表评分相似。
我们的发现表明，性别和教育程度可能对 BPSD 的表现有影响。需要进一步研究，以便根据这些因素为个体 AD 患者量身定制治疗方案提供模型。
