Abstract
BackgroundAlzheimer’s disease is characterised by a loss of cognitive function and behavioural problems as set out in the term “Behavioural and Psychological Symptoms of Dementia”. These behavioural symptoms have heavy consequences for the patients and their families.A greater understanding of behavioural symptoms risk factors would allow better detection of those patients, a better understanding of crisis situations and better management of these patients. Some retrospective studies or simple observations suggested that personality could play a role in the occurrence of behavioural symptoms. Finally, performance in social cognition like facial recognition and perspective taking could be linked to certain personality traits and the subsequent risks of behavioural symptoms.We propose to clarify this through a prospective, multicentre, multidisciplinary study.Main Objective:- To assess the effect of personality and life events on the risk of developing behavioural symptoms.Secondary Objectives:- To evaluate, at the time of inclusion, the connection between personality and performance in social cognition tests;- To evaluate the correlation between performance in social cognition at inclusion and the risks of occurrence of behavioural symptoms;- To evaluate the correlation between regional cerebral atrophy, using brain Magnetic Resonance Imaging at baseline, and the risk of behavioural symptoms.Methods/DesignStudy type and Population: Prospective multicentre cohort study with 252 patients with Alzheimer’s disease at prodromal or mild dementia stage.The inclusion period will be of 18 months and the patients will be followed during 18 months. The initial evaluation will include: a clinical and neuropsychological examination, collection of behavioural symptoms data (Neuropsychiatric-Inventory scale) and their risk factors, a personality study using both a dimensional (personality traits) and categorical approach, an inventory of life events, social cognition tests and an Magnetic Resonance Imaging. Patients will be followed every 6 months (clinical examination and collection of behavioural symptoms data and risk factors) during 18 months.DiscussionThis study aims at better identifying the patients with Alzheimer’s disease at high risk of developing behavioural symptoms, to anticipate, detect and quickly treat these disorders and so, prevent serious consequences for the patient and his caregivers.Trial registrationClincalTrials.gov: NCT01297140
Highlights
Alzheimer’s disease is characterised by a loss of cognitive function and behavioural problems as set out in the term “Behavioural and Psychological Symptoms of Dementia”
Population Inclusion criteria are: diagnostic criteria for Alzheimer’s disease (AD) at mild dementia stage, (NINCDS ADRDA and CDR 1) [31] or prodromal AD (CDR of 0.5) [32], age over 50 years, ability to complete the clinical and neuropsychological evaluations, and presence of a caregiver in sufficient contact with the subject to be able to note the onset of changes in behaviour
Its main objective is to evaluate the effect of premorbid personality on the phenomenology and the frequency of Behavioural and Psychological Symptoms of Dementia (BPSD)
Summary
Alzheimer’s disease is characterised by a loss of cognitive function and behavioural problems as set out in the term “Behavioural and Psychological Symptoms of Dementia”. Besides the apathy and depression frequently seen in patients with mild to moderate dementia, some of the other BPSD such as agitation, irritability, delusions, aberrant motor behaviour and hallucinations may be extremely upsetting for both the patient and his caregivers [2,3,4] When they occur early in the evolution of the disease, their frequency and the intensity of these BPSD can lead to increased difficulties in carrying out everyday tasks [5], an increasingly rapid decline in cognitive function [6], a reduction in the quality of life of both the caregiver and patient [7], an increased likelihood of depression in the caregiver, an increased risk of hospitalisation, premature institution placement [8] and increased health costs [9]. Current treatment for these BPSD is often difficult but is generally approached by medications and/or psycho-social support therapies that still need to be validated
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