Haupt M, Jänner M, Stierstorfer A, Kretschmar C
Psychiatrische Klinik, Heinrich-Heine-Universität Düsseldorf/Rheinische Kliniken Düsseldorf.
Fortschr Neurol Psychiatr. 1998 May;66(5):233-40. doi: 10.1055/s-2007-995259.
The purpose of this study was to investigate noncognitive symptoms in Alzheimer's disease in order to identify symptom patterns and to study stability of such patterns prospectively. Furthermore, variables were examined which could be associated with certain types of symptom patterns or could be predictors of change of these patterns. Forty-eight patients with the clinical diagnosis of probable Alzheimer's disease were included in this study and were assessed weekly over a three-week period. Noncognitive symptoms were rated according to the Behavioral Abnormalities in Alzheimer's Disease Rating Scale (BEHAVE-AD) and the Dementia Mood Assessment Scale (DMAS) and to a set of items specifically assessing misidentifications. By means of principal component factor analysis different noncognitive symptom patterns were obtained yielding a four-factor solution. They were mapped as rational domains with respect to clinical experience: 'depression', 'apathy', 'psychotic symptoms/aggression', 'misidentifications/agitation'. Demographic and clinical variables were not associated with the factor solutions and did not predict change of the factor values. The results demonstrate that in Alzheimer's disease there are distinct noncognitive symptom patterns with at least short-term prospective stability. None of the examined clinical variables, such as age at entry, the status of the patients (outpatient or inpatient) or dementia severity, exerted substantial influence on the noncognitive symptom patterns. Further investigations should concentrate on the pathological and prognostical correlates of noncognitive symptom patterns in Alzheimer's disease.
本研究的目的是调查阿尔茨海默病中的非认知症状,以识别症状模式并前瞻性地研究这些模式的稳定性。此外,还对一些变量进行了检查,这些变量可能与某些类型的症状模式相关,或者可能是这些模式变化的预测因素。本研究纳入了48例临床诊断为可能的阿尔茨海默病的患者,并在三周内每周进行评估。根据阿尔茨海默病行为异常评定量表(BEHAVE-AD)、痴呆情绪评估量表(DMAS)以及一组专门评估错误识别的项目对非认知症状进行评分。通过主成分因子分析,获得了不同的非认知症状模式,得出了一个四因子解决方案。根据临床经验,将它们映射为合理的领域:“抑郁”、“淡漠”、“精神病性症状/攻击行为”、“错误识别/激越”。人口统计学和临床变量与因子解决方案无关,也不能预测因子值的变化。结果表明,在阿尔茨海默病中存在明显的非认知症状模式,至少具有短期前瞻性稳定性。所检查的临床变量,如入院时年龄、患者状态(门诊或住院)或痴呆严重程度,均未对非认知症状模式产生实质性影响。进一步的研究应集中在阿尔茨海默病中非认知症状模式的病理和预后相关性上。