Hirono N, Mori E, Yasuda M, Ikejiri Y, Imamura T, Shimomura T, Ikeda M, Hashimoto M, Yamashita H
Division of Clinical Neurosciences, Hyogo Institute for Aging Brain and Cognitive Disorders, Himeji, Japan.
J Neurol Neurosurg Psychiatry. 1998 May;64(5):648-52. doi: 10.1136/jnnp.64.5.648.
Many clinical and biological factors have been reported to be associated with the presence of psychosis in patients with Alzheimer's disease, although the associations were variable. The aim of this study was to clarify factors associated with the presence of psychosis in patients with Alzheimer's disease.
Psychiatric functioning was studied in 228 patients with Alzheimer's disease based on the results of the behavioural pathology in Alzheimer's disease rating scale or the neuropsychiatric inventory. The effects of sex, education level, age, duration of illness, cognitive function, and apolipoprotein E genotype were investigated for dichotomous psychotic status with a multiple logistic regression analysis.
Of the 228 patients with Alzheimer's disease, 118 (51.8%) showed evidence of delusions or hallucinations. Of these, 94 had delusions only, three had hallucinations only, and 21 had both. Older age, female sex, longer duration of illness, and more severe cognitive impairment were the factors independently associated with the presence of psychosis. The presence of psychosis was not significantly related to either educational level or apolipoprotein E genotype.
Age, sex, and severity of illness were independent factors associated with the presence of psychosis in patients with Alzheimer's disease. The reason why some patients with Alzheimer's disease develop psychosis remains unclear. There may be distinctive subtypes of Alzheimer's disease or the presence of individual factors which affect the development of psychosis.
尽管已有报道称许多临床和生物学因素与阿尔茨海默病患者的精神病症状有关，但这些关联并不一致。本研究的目的是明确与阿尔茨海默病患者精神病症状存在相关的因素。
基于阿尔茨海默病行为病理学评定量表或神经精神科问卷的结果，对228例阿尔茨海默病患者的精神功能进行了研究。通过多因素逻辑回归分析，研究性别、教育程度、年龄、病程、认知功能和载脂蛋白E基因型对二分法精神病状态的影响。
在228例阿尔茨海默病患者中，118例（51.8%）有妄想或幻觉证据。其中，94例仅有妄想，3例仅有幻觉，21例两者皆有。年龄较大、女性、病程较长和认知障碍较严重是与精神病症状存在独立相关的因素。精神病症状的存在与教育程度或载脂蛋白E基因型均无显著相关性。
年龄、性别和疾病严重程度是与阿尔茨海默病患者精神病症状存在相关的独立因素。部分阿尔茨海默病患者出现精神病症状的原因尚不清楚。可能存在阿尔茨海默病的独特亚型或存在影响精神病症状发生的个体因素。
