The spectrum of behavioral changes in Alzheimer's disease

TLDR

The extent and cognitive‑correlation of behavioral disturbances in Alzheimer’s disease remain undefined. The study aimed to characterize the spectrum of behavioral abnormalities in Alzheimer’s disease versus age‑matched controls. Fifty Alzheimer’s patients across mild, moderate, and severe stages and 40 age‑matched controls were assessed for ten behavioral symptoms using the Neuropsychiatric Inventory, and correlations with cognitive impairment were examined. Eighty‑eight percent of Alzheimer’s patients exhibited measurable behavioral changes, all ten behaviors were significantly higher than controls, with apathy (72%) most common, followed by agitation (60%), anxiety (48%), irritability (42%), dysphoria and aberrant motor behavior (38% each), disinhibition (36%), delusions (22%) and hallucinations (10%), and agitation, dysphoria, apathy, and aberrant motor behavior correlated with cognitive impairment.

Abstract

We investigated the range of behavioral abnormalities in patients with Alzheimer's disease (AD) compared with normal age-matched control subjects. The range of behavioral disturbances manifested and the relationship between specific abnormalities with the level of cognitive impairment have not been established. Fifty consecutive outpatients with mild (n = 17), moderate (n = 20), and severe (n = 13) AD and 40 age-matched normal controls were evaluated for behavioral abnormalities occurring in the month preceding the interview. The caregivers of the patients and the spouses of the control subjects were interviewed with the Neuropsychiatric Inventory (NPI). The frequency and severity of the following 10 behaviors were assessed: delusions, hallucinations, agitation, dysphoria, anxiety, euphoria, apathy, disinhibition, irritability, and aberrant motor behavior. Correlations among these 10 behaviors and their relationship with cognitive impairment were also investigated. Eighty-eight percent of AD patients had measurable behavioral changes. All 10 behaviors were significantly increased in the AD patients compared with normal subjects. The most common behavior was apathy, which was exhibited by 72% of patients, followed by agitation (60%), anxiety (48%), irritability (42%), dysphoria and aberrant motor behavior (both 38%), disinhibition (36%), delusions (22%), and hallucinations (10%). Agitation, dysphoria, apathy, and aberrant motor behavior were significantly correlated wit cognitive impairment.