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Abstract
BackgroundThe relationship between early life experience and the occurrence of neuropsychiatry symptoms (NPSs) in patients with Alzheimer disease (AD) is unclear.MethodsFrom 2012 to 2014, we prospectively recruited 250 patients with probable AD from the memory clinic of Taipei Veterans General Hospital. All patients underwent standard assessments, including brain magnetic resonance imaging or computed tomography, neuropsychological tests, neuropsychiatry inventory (NPI-Q) and related blood tests. A linear regression analysis was performed to investigate the relationship between NPSs and age, gender, disease severity, depression, language background (with or without Japanese education).ResultsAmong the 250 participants, 113 (45.2%) were women. Their average age was 82.6 years. Of all the participants, 93 (37.2%) had received formal Japanese education, whereas 157 (62.8%) did not receive Japanese education. The participants with Japanese education were slightly younger (83.1 ± 3.6 vs. 81.4 ± 3.4, P = 0.006), with a higher proportion of them were women (30.5% vs. 69.8%, P < 0.001) and fewer years of total education (10.8 ± 4.5 vs. 7.7 ± 3.2, P < 0.001), compared to the participants without Japanese education. NPI-Q scores significantly differed between the two groups (15.8 vs. 24.1, P = 0.024). Both disease severity and language background predicted NPI-Q scores.ConclusionsLanguage background in early life may be related to NPSs in patients with AD, and this effect is more significant in patients with a lower education level than in those with a higher education level. More NPSs may be the result of negative effects on dominant language or early life experiences.
Highlights
The relationship between early life experience and the occurrence of neuropsychiatry symptoms (NPSs) in patients with Alzheimer disease (AD) is unclear
The inclusion criteria included; 1) Patients who were proficient in Mandarin Chinese and were able to complete all our examinations in Chinese; and 2) Patients had to undergo a series of standard assessments, including a detailed clinical dementia history-taking, brain MRI or CT, laboratory tests, and neuropsychological tests
Clinical dementia rating scale and clinical dementia rating scale Sum of boxes We evaluated the functional severity of dementia by using the Clinical Dementia Rating (CDR) scale
Summary
The relationship between early life experience and the occurrence of neuropsychiatry symptoms (NPSs) in patients with Alzheimer disease (AD) is unclear. Neuropsychiatric symptoms (NPSs), which can be psychotic (delusions and hallucinations), affective (apathy, depressed mood, irritability and anxiety) and, behavioral (euphoria, disinhibition, agitation, aberrant motor activities, sleep disturbance and eating disorder), are the core symptoms of Alzheimer disease (AD) [1]. NPSs is once thought to emerge in people with advanced stage. Some studies have described both biological and environmental effects. Chinese Americans were less likely to be on treatment for depression than Caucasians. Depression is related to biological factors such as ethnicity and environmental factors like education and culture [11]. Few studies have focused on the linkage between early language experience and NPSs in dementia
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