Comparison of cognitive functions and behavioral and psychological symptoms in patients with general paresis of insane and Alzheimer’s disease

Abstract

Objective To compare the cognitive impairment and behavioral and psychological symptoms between patients with general paresis of insane (GPI) and those with Alzheimer’s disease (AD). Methods Fifty patients with GPI and sixty-one patients with AD from Guangzhou Brain Hospital were recruited in this case-control study. The severity of dementia was determined by the Clinical Dementia Rating Scale (CDR). Cognitive functions and behavioral and psychological symptoms were evaluated by the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog) and Neuropsychiatric Inventory (NPI). Results (1) Cognitive assessments: There were statistically significant differences in different groups of patients classified by the CDR both in GPI and AD patients.In addition, with the increasing of the CDR degree, scores of MMSE and MoCA tended to drop down, but the scores of ADAS-cog tended to go up conversely. Comparing GPI with AD, the scores of MMSE in mild GPI groups were significantly higher than mild AD group (GPI: 20.63±5.87, AD: 14.32±5.05, F=7.697, P=0.008), while the scores of ADAS-cog memory factor in mild GPI groups were significantly lower than mild AD group (GPI: 13.66 (8.33), AD: 23.00 (10.50), Z=-3.205, P=0.001). (2) Assessments of behavioral and psychological symptoms: In GPI patients, the scores of NPI were increased with the degree of CDR; On the contrary, the scores stayed consistent relatively in patients with AD. In addition, comparing GPI with AD, patients with moderate degree were prominent in euphoria and eating disorders in GPI, rather than AD. What’s more, severe GPI patients had significantly higher score in hallucination, delusion, depression and the total of NPI than severe AD patients. Conclusion Patients with GPI and AD show different characteristics in behavioral and psychological symptoms, which could help clinicians better understand GPI and AD. Key words: Neurosyphilis; Alzheimer disease; Cognition disorders; Neurobehavioral manifestations; Diagnosis, differential