Quantitative evaluation of severity of behavioral and psychological symptoms of dementia in patients with vascular dementia

Wei-Dong Pan,Chun-Lan Wu,Jun Wang,Jin Zhu,Qian Liu,Sohei Yoshida,Ding-Fang Cai

doi:10.1186/2047-9158-2-9

Abstract

To quantitatively evaluate severity of behavioral and psychological symptoms of dementia (BPSD) for vascular dementia (VD). Changes of 51 patients with VD in BPSD between the first and 24th week were assessed using the Neuropsychiatric Inventory (NPI) and the behavioral pathology in Alzheimer’s disease (BEHAVE-AD) rating scale, in detrended fluctuation analysis (DFA) represented by diurnal activity (DA), evening activity (EA), and nocturnal activity (NA), and the relationships were analyzed. The subscores of activity disturbances, diurnal rhythm disturbances, and anxieties and phobias in the BEHAVE-AD score, and that of agitation, irritability, and sleep disorder in the NPI score were significantly increased compared with the first week, as was for the changes for EA in the DFA value. A linear correlation was observed between the changes of activity disturbances plus anxieties and phobias, and those of DA, and between the development of diurnal rhythm and those of EA, the vehement and autism scores and those of DA, and the difference in sleep disorder scores and those of EA, respectively. Analysis of DA, NA, and EA may reflect the fluctuational degrees of VD-BPSD, can provide a useful assessment of VD-BPSD accompanied by clinical scores for VD.

Highlights

With aging populations, the prevalence of dementia will continue to rise in the coming decades [1,2]
The aims of the present study were to assess the probability of changes in analytical parameters, such as the detrended fluctuation analysis (DFA) values of diurnal activity (DA), evening activity (EA), and nocturnal activity (NA) using this quantitative device, and to compare these values with the clinical scores of BEHAVE-Alzheimer’s disease (AD) and the Neuropsychiatric Inventory (NPI) to obtain a pilot, objective scale representing severity of Vascular dementia (VD)-behavioral and psychological symptoms of dementia (BPSD)
Significant and persistent increases compared with baseline were found in the BEHAVE-AD subscores of activity disturbances, diurnal rhythm disturbances, and anxieties and phobias, and in the NPI subscores of agitation, ignitability, and sleep disturbance (Figure 1A, B and Table 2)

Summary

Introduction

The prevalence of dementia will continue to rise in the coming decades [1,2]. The behavioral and psychological symptoms of dementia (BPSD), such as agitation, aggressive behavior, day-night rhythm disturbances, mood alterations, and hallucinations are among the most prominent clinical features seen during the late course of dementia such as AD or VD. Of all these symptoms, agitation places a particular burden on professional caregivers and family members during home care [3,4]. The behavioral pathology in Alzheimer’s disease (BEHAVE-AD) rating scale [5] is frequently used to in clinical care, as it causes minimal distress to the patient. The aims of the present study were to assess the probability of changes in analytical parameters, such as the detrended fluctuation analysis (DFA) values of diurnal activity (DA), evening activity (EA), and nocturnal activity (NA) using this quantitative device, and to compare these values with the clinical scores of BEHAVE-AD and the NPI to obtain a pilot, objective scale representing severity of VD-BPSD

Objectives

Methods

Results

Conclusion