Abstract
Alzheimer?s disease (AD), the most prevalent dementia, is characterized not only by cognitive but also behavioral changes that pose the heaviest burden to caregivers. Differences in the clinical picture depending on the time of disease onset have been observed. We correlated cognitive and behavioral deficits in patients with presenile- and senile-onset AD to explore the differences. We tested 60 AD patients, 19 male and 41 female, mean age 65.2 years with the Dementia Behavior Disturbance Scale (DBD) and a standard neuropsychological battery. The patients were divided according to their DBD score into two groups: group I - score 0-2 (n=24; 40%), group II - score 3? (n=36; 60%), comparable in disease duration and neurological findings. The cognitive scores were significantly higher in the group with less behavioral changes than in the group with more behavioral changes: Mini Mental State Examination score (p=0.0015), serial subtraction (p=0.0009), block design (p=0.0049), copy of complex figure (p=0.0125), complex visual organization (p=0.0099), divided attention, visual memory and speech comprehension. A significantly higher frequency of behavioral disturbances was registered in patients with senile onset than in the presenile-onset group (p<0.005). There were no sex differences. Our data show a correlation between cognitive decline and behavioral changes in late onset AD patients, indicating that more behavioral disturbances were associated with a more severe degree of cognitive decline, especially in non-verbal functions and attention deficits, compared to early onset patients.
Highlights
Alzheimer’s disease (AD) is a neurodegenerative disease that causes selective neuronal loss in brain regions involved in memory, language, personality and cognition in general (Feng and Wang, 2012)
We found no gender difference in regard to mean age, mean age at disease onset, mean of disease duration, mean Clinical Dementia rating (CDR) score and Mini Mental State Examination (MMSE) score (T-Test: p>0.05)
There was no significant difference between senile and presenile AD onset according to mean MMSE score (T-test: p>0.05), but patients with senile onset had significantly higher CDR scores (T-test: p
Summary
AD is a neurodegenerative disease that causes selective neuronal loss in brain regions involved in memory, language, personality and cognition in general (Feng and Wang, 2012). The earliest symptom of AD is typically a progressive memory loss of insidious onset, while other cognitive areas, usually language, executive function and visuospatial skills, are present during the course of the disease (von Gunten et al, 2006). The main pathological features in the cerebral cortex are neurofibrillary tangles (NFT), senile plaques (SP) and neuronal and synaptic loss. As these processes spread from medial temporal cortex along the neocortex, the spectrum of cognitive and behavioral symptoms broadens. The clinicohistopathological relationship has been well established and depends mostly on NFT density in specific regions (von Gunten et al, 2006)
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