Honjo Yasuyuki, Nagai Kuniaki, Yuri Takuma, Nakai Hideaki, Kawasaki Ippei, Harada Shun, Suganuma Ippei, Ogawa Noriyuki
Department of Memory Clinic, Kyoto Kaisei Hospital, Kyoto, Japan.
Department of Occupational Therapy, Faculty of Health Science, Kyoto Tachibana University, Kyoto, Japan.
Dement Geriatr Cogn Disord. 2025 Apr 21:1-9. doi: 10.1159/000545759.
Alzheimer's disease dementia (ADD) is a common cognitive disease in Japan. Mild cognitive impairment (MCI) is regarded as an early, but abnormal state of cognitive impairment, and amnestic MCI (aMCI) as a precursor of ADD. The Revised Hasegawa Dementia Scale (HDS-R) and the similar Mini-Mental State Examination (MMSE) are quick cognitive assessments widely used in Japan. Behavioral and psychological symptoms of dementia (BPSD) are commonly assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). However, when the different types of BPSD appear and how they progress with the progression of ADD is not clear.
A total of 553 outpatients with ADD or aMCI participated. We divided the patients into six cognitive function groups. We examined the relationship between the individual NPI-Q domain scores and cognitive function to reveal the appearance and progression of BPSD. We also examined the relationship of the NPI-Q domains with the HDS-R and MMSE domains to reveal the cognitive functions that affect the BPSD.
Our results suggested that hallucinations, agitation/aggression, anxiety, irritability/lability appeared in association with high MMSE scores and progressed slowly. Apathy/indifference and aberrant motor behaviors appeared in association with middle MMSE scores and progressed slowly. Delusions and nighttime behavior disturbances appeared in association with high MMSE score and progressed consistently with the ADD. Memory and orientation were the cognitive functions most related to NPI-Q domain scores and thus to progression of BPSD.
Memory and orientation may be the most important cognitive functions related to the progression of BPSD in patients with ADD.
阿尔茨海默病性痴呆（ADD）在日本是一种常见的认知疾病。轻度认知障碍（MCI）被视为认知障碍的早期但异常状态，遗忘型MCI（aMCI）被视为ADD的前驱。修订版长谷川痴呆量表（HDS-R）和类似的简易精神状态检查表（MMSE）是在日本广泛使用的快速认知评估工具。痴呆的行为和心理症状（BPSD）通常使用神经精神科问卷（NPI-Q）进行评估。然而，不同类型的BPSD何时出现以及它们如何随着ADD的进展而发展尚不清楚。
共有553名ADD或aMCI门诊患者参与。我们将患者分为六个认知功能组。我们检查了个体NPI-Q领域得分与认知功能之间的关系，以揭示BPSD的出现和进展。我们还检查了NPI-Q领域与HDS-R和MMSE领域的关系，以揭示影响BPSD的认知功能。
我们的结果表明，幻觉、激越/攻击、焦虑、易激惹/情绪不稳定与高MMSE得分相关且进展缓慢。淡漠/无动于衷和异常运动行为与中等MMSE得分相关且进展缓慢。妄想和夜间行为障碍与高MMSE得分相关且与ADD进展一致。记忆和定向是与NPI-Q领域得分以及因此与BPSD进展最相关的认知功能。
记忆和定向可能是与ADD患者BPSD进展最相关的重要认知功能。
