Psychological Symptoms In Alzheimer Research Articles

Review of Current Clinical Options for the Management of Behavioral and Psychological Symptoms of Dementia.

Dementia is a disease most prevalent in the older adult population. The cognitive symptoms of dementia include impairments in problem-solving, memory, and language. Some patients experience noncognitive symptoms in addition to the cognitive symptoms of dementia. These noncognitive symptoms are called behavioral and psychological symptoms of dementia or BPSD. The primary objective of our study was to examine the therapeutic options, guidelines, and clinical considerations for the management of BPSD. The existing literature about BPSD was reviewed with searches in PubMed, MEDLINE, and online search platforms. Dysregulation of neurotransmission involving acetylcholine, dopamine, and serotonin has been shown to cause behavioral and psychological symptoms of Alzheimer's disease. BPSD can include hallucinations, agitation, delusions, anxiety, apathy, abnormal body movements, irritability, depression, disinhibition, and sleep or appetite changes. Pharmacologic therapies used in the treatment of BPSD include antidepressants, antipsychotics, anxiolytics, and anticonvulsants. Treatment can be tailored to the specific noncognitive symptoms that are experienced. The use of these agents may be limited based on recommendations from the Beers Criteria®, STOPP criteria, treatment guidelines, and FDA warnings.

Practice recommendations to manage Alzheimer’s disease based on the targeted behavioral and psychological symptoms

IntroductionBehavioral and psychological symptoms (BPS) of Alzheimer’s disease, known as neuropsychiatric symptoms, involve a range of symptoms that include agitation, psychosis (hallucinations, delusions), affective symptoms (depression and anxiety), apathy, and sleep disturbances. These behavioral and psychological symptoms harm the patients’ daily lives and significantly burden their families. Managing BPS of Alzheimer’s disease requires a targeted approach focused on each symptom to achieve a better therapeutic response.ObjectivesProviding practice pharmacological recommendations targeted to each of the behavioral and psychological symptoms of Alzheimer’s disease.MethodsA literature review was conducted using Medline via PubMed, Embase, PsycINFO, and Cochrane databases until September 2023.ResultsThere is a consensus in the literature that non-pharmacological approaches should be recommended as the first-line treatment for most behavioral and psychological symptoms of Alzheimer’s.Second-generation antipsychotics (risperidone and olanzapine, with improved efficacy; aripiprazole and quetiapine, with better tolerance) are recommended for severe agitation states with a risk of self or hetero-aggression, as well as for persistent psychotic symptoms in Alzheimer’s disease. The benefit-risk balance of these agents must be assessed, with close monitoring of heart arrhythmias, metabolic risk, orthostatic hypotension, and extrapyramidal symptoms. The recommendations suggest tapering antipsychotics within the first three months of their prescription. Selective serotonin reuptake inhibitors (SSRIs) such as Escitalopram, Citalopram, and Sertraline can be considered a therapeutic option for persistent affective symptoms (depression and anxiety) with significant functional impairment or suicidal risk, severe apathy, or constant agitation. Minimum effective doses are recommended for Escitalopram and Citalopram due to the risk of QT interval prolongation. There is limited evidence regarding the effectiveness of benzodiazepines, mood stabilizers, cholinesterase inhibitors, and memantine for various behavioral and psychological symptoms; the benefit-risk ratio and therapeutic response do not support the prescription of these agents. Melatonin and Mirtazapine have limited benefits for sleep disturbances, while benzodiazepines, antihistamines, and antipsychotics should be avoided.ConclusionsThe pharmacological approach should target a thorough clinical assessment of the psychopathological dimensions of behavioral and psychological symptoms of Alzheimer’s disease. The prescription should be based on evaluating the benefit-risk balance and adherence to literature recommendations for patient safety.Disclosure of InterestNone Declared

Development and validation of a nutrition-related genetic-clinical-radiological nomogram associated with behavioral and psychological symptoms in Alzheimer's disease.

Few evidence is available in the early prediction models of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD). This study aimed to develop and validate a novel genetic-clinical-radiological nomogram for evaluating BPSD in patients with AD and explore its underlying nutritional mechanism. This retrospective study included 165 patients with AD from the Chinese Imaging, Biomarkers, and Lifestyle (CIBL) cohort between June 1, 2021, and March 31, 2022. Data on demoimagedatas, neuropsychological assessments, single-nucleotide polymorphisms of AD risk genes, and regional brain volumes were collected. A multivariate logistic regression model identified BPSD-associated factors, for subsequently constructing a diagnostic nomogram. This nomogram was internally validated through 1000-bootstrap resampling and externally validated using a time-series split based on the CIBL cohort data between June 1, 2022, and February 1, 2023. Area under receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used to assess the discrimination, calibration, and clinical applicability of the nomogram. Factors independently associated with BPSD were: CETP rs1800775 (odds ratio [OR] = 4.137, 95% confidence interval [CI]: 1.276-13.415, P = 0.018), decreased Mini Nutritional Assessment score (OR = 0.187, 95% CI: 0.086-0.405, P <0.001), increased caregiver burden inventory score (OR = 8.993, 95% CI: 3.830-21.119, P <0.001), and decreased brain stem volume (OR = 0.006, 95% CI: 0.001-0.191, P = 0.004). These variables were incorporated into the nomogram. The area under the ROC curve was 0.925 (95% CI: 0.884-0.967, P <0.001) in the internal validation and 0.791 (95% CI: 0.686-0.895, P <0.001) in the external validation. The calibration plots showed favorable consistency between the prediction of nomogram and actual observations, and the DCA showed that the model was clinically useful in both validations. A novel nomogram was established and validated based on lipid metabolism-related genes, nutritional status, and brain stem volumes, which may allow patients with AD to benefit from early triage and more intensive monitoring of BPSD. Chictr.org.cn, ChiCTR2100049131.

Diminishment of High PD‐1 Expressing Peripheral Cytotoxic T Lymphocytes in Behavioral and Psychological Symptoms of Alzheimer’s Disease

AbstractBackgroundBehavioral and psychological symptoms of dementia (BPSD) are troublesome in managing Alzheimer’s disease (AD). Growing research strongly suggests the relationship between AD and immunity of peripheral blood. Immunotherapy with blockade of PD‐L1/PD‐1 axis restored cognitive performance in the murine tauopathy model. We analyzed cytotoxic T lymphocyte (CTL) activity or possibility to be regulated, expression of PD‐1 of peripheral blood, and tried to find the correlation between PD‐1 expression and BPSD severity of AD patients.Method16 AD patients meeting NIA‐AA criteria for probable AD dementia (mean age = 80.1, 5 males,11 females) were enrolled in our study. Cognitive function was assessed by clinical dementia rating scale (CDR) and clinical dementia rating scale sum of box (CDR‐SOB). BPSD was evaluated by total neuropsychiatric inventory (NPI) scores. Higher total NPI scores suggested more serious BPSD.Histograms of CTL PD‐1 median fluorescence intensity (MFI) of 16 AD patients were compared head‐to‐head to determine a cutoff MFI value. CTL with high and low PD‐1 expressing populations were seperated. Correlation between total NPI score and CTL PD‐1 expressing population was further analyzed.ResultThe CTL subset located at the peak with the lowest MFI was defined as PD‐1dim CTL, and this subset was positively correlated to total NPI score. The other CTL subset was defined as PD‐1bright CTL, which was negatively correlated to total NPI score. No correlation was found between PD‐1 expression and CDR‐SOB (data not shown)ConclusionOur results revealed that the PD‐1 expression level of CTL decreased with enlarged total NPI scores. Interestingly, CDR‐SOB positively correlated with AD disease progression, yet BPSD could happen in even mild cognitive impairment (MCI) and very early AD stage. Although our study had limitations in sex distribution and small sample size, the results raised concern that CTL might participate in clinical manifestations of BPSD. PD‐1 expressing CTL might not correlate to global dementia progression.Further studies are expected to evaluate how peripheral CTL interplays with inflammatory molecules, excitatory and inhibitory neurons, cerebral blood perfusion, and gating of choroid plexus in the demented brain.

Impact of behavioral and psychological symptoms of Alzheimer’s disease on caregiver outcomes

This study was to determine the prevalence of behavioral and psychological symptoms of dementia (BPSD) and its association with dementia severity and to explore the association between specific BPSD and caregiver stress, burden, and depression. A cross-sectional study involving the interviewing of the primary caregivers of patients with Alzheimer’s disease (AD) was conducted. Multivariable analysis was used to analyze the associations between specific symptoms of BPSD and caregiver outcomes. A total of 102 AD patients (age 79.4 ± 7.9 years, 70.6% female) and their caregivers were included. Nearly 46% had moderate-to-severe AD. Nearly all patients (99.0%) had at least one BPSD. Apathy was among the most common symptoms (74.5%), and hallucination was the only symptom associated with severity of AD (p = 0.017). After adjustment, agitation was associated with Patient Health Questionnaire-9 (PHQ-9) and Zarit Burden Interview (ZBI-22) (p = 0.021 and 0.007, respectively); sleep disorders were associated with only PHQ-9 (p = 0.049). In conclusion, the BPSD, especially agitation and sleep disorders, can give rise to difficulties for both patients and their caregivers. The prevalence of BPSD is high (99.0%), and the symptoms can start early. Routine screening of BPSD in all AD patients is advocated.

Behavioral and psychological symptoms of Alzheimer’s disease during the COVID‐19 pandemic in underserved settings

BackgroundThe behavioral and psychological symptoms of dementia (BPSD) are characterized by disturbances in perceptions, thought contents, moods, and behaviors. The causes for these symptoms are connected to factors related to the people with dementia (PWD), his/her caregivers, and environmental factors as well as the interrelationship between these three. Disruptions of routine due to confinements during the COVID‐19 pandemic has led to the onset/worsening of BPSD, thereby increasing distress levels in caregivers, and risks of self‐injury, hospitalization, and death for PWD. Our aim is to describe the onset/ worsening of BPSD during COVID‐19 pandemic confinement.MethodThis is a longitudinal study in patients and caregivers of people with Alzheimer’s disease from the Instituto Peruano de Neurociencias in Lima, Perú. A structured confinement interview was delivered to caregivers exploring how the caregiver's activities have been affected or modified by the confinement measures. All patients have neuropsychological, neuropsychiatric, and functional assessments performed six months before the onset of the confinement. BPSD was assessed using the neuropsychiatric inventory questionnaire (NPI).ResultA total of 91 patients with Alzheimer’s disease and caregivers participated in the study. The average age of the patients was 73.4 years. Most patients had a CDR score of 0.5‐1. Caregivers reported that the pandemic affected their mood by 74%. Percentage of time spent caring increased from 15% to 25% (p<0.001).Worsening and new onset of behavioral and psychological symptoms were reported. The NPI (Fig 1.) and ADCS_ADL scores increased significantly during quarantine from baseline (6.6 and 10, respectively) (p<0.001). Delusions (75%), sleep disorder (71.7%), and hallucinations were the most frequently reported worsening symptoms. Sleep disorder (71.1%), agitation (68.6%) and depression (53.3%) were the most frequently reported new symptoms (p<0.001) (Table 1). Profile of BPSD did not vary according to the CDR score.ConclusionQuarantine induces increases in behavioral and psychological symptoms in patients with early stages of Alzheimer’s disease. Caregivers spent more time with the patient with AD and their emotions were affected by the pandemic. We need to plan for strategies in order to address these needs.

301 - The diagnostic and treatment challenges of behavioral and psychological symptoms in Alzheimer’s disease; a qualitative study in memory clinic practice

Introduction:Behavioral and psychological symptoms in dementia (BPSD) have great impact on the daily lives of Alzheimer’s disease (AD) patients and their caregivers. Timely recognition and treatment of these symptoms may benefit quality of life, caregiver burden, and delay disease progression. In this qualitative study we examine the experiences of memory clinic physicians with the recognition and management of BPSD in early stages of AD.Methods:Semi-structured interviews were held with 8 physicians (5 neurologists, 3 geriatricians) employed at memory clinics of academic or general hospitals in the Netherlands. Two independent researchers coded verbatim transcripts of the interviews, followed by a consensus meeting on preliminary themes. In the upcoming months, additional interviews will be conducted until data saturation is reached.Results:Preliminary results indicate substantial variability in how memory clinic physicians recognize and diagnose BPSD in AD. Themes are: 1. Prevalence of BPSD in early stages of AD; e.g. ‘BPSD is more often present in late stages of AD […]’ vs. ‘I see this often, very often, I think these are the main problems people with AD face’). 2. Systematic assessment; some physicians consider it part of their clinical work-up to assess behavioral changes while other physicians do not touch upon BPSD. 3. Barriers for assessment; e.g. a lack of time, and not being able to observe BPSD occurring at home in a memory clinic setting. Treatment and management of BPSD in AD also differed greatly. Themes are 1. Treatment type; Two physicians discussed using a person-centered non-pharmacological approach, others refer patients with BPSD to daycare, a case manager or psychiatrist, or treat ‘problematic’ behaviors with psychotropic drugs. 2. Capabilities; some physicians experience managing BPSD in AD as very difficult, while others are confident about their capabilities. The majority suggests that collaboration with GPs or case managers may benefit treating these complex symptoms.Conclusion:There are remarkable differences in the recognition and management of BPSD in patients with AD visiting memory clinics in the Netherlands. Considering the potential benefit of early recognition and treatment, a first crucial step is discussing standardization of recognition and management of BPSD in memory clinics.

Brain Volume Predicts Behavioral and Psychological Symptoms in Alzheimer's Disease.

Behavioral and psychological symptoms of dementia (BPSD) are frequent and troublesome for patients and caregivers. Considering possible preventive approaches, a better understanding of underlying neural correlates of BPSD is crucial. The aim is to assess whether brain regional volume predicts behavioral changes in mild AD. This work took part from the PACO study, a multicenter and prospective study that included 252 patients with mild AD from 2009 to 2014. Fifty-three patients were retained. Forty healthy matched control subjects from the ADNI cohort were included as controls. Voxel-based morphometry analysis was conducted to assess regional brain volume using baseline MRI scans as a predictor of future behavioral changes over a period of 18 months. Behavior was assessed at baseline and longitudinally at 6-month intervals using the shortened form of the Neuropsychiatric Inventory (NPI). The volume of 23 brain structures in frontal, temporal, parietal, occipital, subcortical regions and cerebellum predicted the evolution of NPI scores. Frontal volume was the most powerful predictor with frontal gyri, anterior cingulate cortex, and orbital gyri being particularly involved. To our knowledge, this is the first study assessing regional brain volumes as predictors of behavioral changes considered at earlier stages of AD. Up to 23 brain structures were associated with an increased risk of developing BPSD. Frontal lobe volume was the strongest predictor of future evolution of NPI. The involvement of multiple structures in the prediction of behavior suggests a role of the main large-scale networks involved in cognition.

Effect of Extended Nursing on the Behavioral and Psychological Symptoms and Cognitive Dysfunction of Patients with Moderate and Severe Alzheimer's Disease

The purpose of this investigation is to study the effect of extended nursing on the behavioral and psychological symptoms and cognitive dysfunction of patients with moderate and severe Alzheimer's disease. A total of 102 patients with moderate and severe Alzheimer's disease admitted to the People’s Hospital of Nanjing Medical University from February 2016 to March 2018 were randomly divided into the observation group and the control group. The control group received routine health education and nursing guidance after discharge, while the observation group received additional extended nursing scheme for 1 y, including daily living ability training, body function training, language training, memory training, music therapy, psychological nursing support and offline collective activities of patients. The scores of behavioral pathology assessment scale of Alzheimer's disease, Montreal cognitive assessment, and Barthel activities of daily living were compared between the two groups. There was no significant difference in the scores of behavioral pathology assessment scale of Alzheimer's, Montreal cognitive assessment and Barthel activities of daily living between the two groups on admission. One year later, the behavioral pathology assessment scale of Alzheimer's disease scores of the observation group were significantly lower than that of the control group (p<0.05), the Montreal cognitive assessment scores and Barthel activities of daily living scores of the observation group were significantly higher than that of the control group (p<0.05). The extended nursing scheme of this study improved the behavioral and psychological symptoms of Alzheimer's disease patients significantly, including anxiety, fear, hallucination, delusion, emotional disorder, aggressive behavior, behavioral disorder and circadian rhythm disorder. It could also improve the cognitive ability of Alzheimer's disease patients significantly, and improve their ability to handle daily life activities.

Gender differences in presentation of behavioral and psychological symptoms in Alzheimer’s disease in Taiwan

Objectives: Behavioral and psychological symptoms of dementia (BPSD) are frequently met in Alzheimer’s disease (AD), especially in their late stages. BPSD has been reported to be associated with gender for its biological characteristics and severity of dementia. We aimed to investigate the gender differences in presentation of BPSD in AD in Taiwan.Methods: We recruited patients with clinically diagnosed AD by National Institute of Neurological Disorders and Stroke (NINCDS) - Alzheimer’s Disease and Related Disorders Association (ADRDA) criteria. Demographic data and annual psychometrics, including Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR) and Neuropsychiatric Inventory (NPI), consisting sub-items of delusions, hallucinations, aggression, depression, anxiety, elation, apathy, disinhibition, irritability, aberrant motor, nighttime behavior and eating were all administered to evaluate BPSD. Apolipoprotein E (APOE) allele was genotyped for each recruited AD subject. Differences between gender and variables were compared and significant NPI sub-items associated with gender were determined, while linear regression analyses were determined as the independent factor for BPSD.Results: In total, 280 female and 180 male AD patients were recruited into statistical analyses. Males had longer education duration and higher MMSE scores than females. Female had higher presence of delusion and disinhibition. In linear regression, being female and CDR stage were two independent factors for delusion (for female, B = 0.95, 95% CI = 0.17–1.73, p = 0.017) and disinhibition (for female, B = 0.49, 95% CI = 0.08–0.90, p = 0.019) after adjusting for confounding factors.Conclusions: The presentation of delusion and disinhibition in BPSD is associated with the female gender and staging of AD. Disinhibition was not necessarily associated with late stage of AD.

Gender Difference in Behavioral and Psychological Symptoms of Alzheimer's Disease

Gender Difference in Behavioral and Psychological Symptoms of Alzheimer's Disease

Chapter 2 - Behavioral and psychological symptoms in Alzheimer's dementia and vascular dementia

Behavioral and psychological symptoms of dementia (BPSD) are highly prevalent and represent a significant burden for patients and their caregivers. Early recognition and management of these symptoms is crucial as they are associated with increased risk of institutionalization, impairments in daily functioning, reduced quality of life, and more rapid progression to severe dementia. This chapter will discuss the pathophysiology, proposed diagnostic criteria, clinical features, and management of BPSD, including apathy, depression, agitation/aggression, psychosis, and sleep disturbances. Apathy and depression are the most common overall, and apathy is associated with high symptom severity likely because of its greater persistence. Symptoms such as agitation, aggression, hallucinations, and delusions may be especially distressing and dangerous to patients and caregivers. Nonpharmacologic management should be considered first-line therapy in most cases due to the modest and inconsistent evidence base for pharmacologic agents and greater risk of harm. However, the judicious use of pharmacologic agents may be warranted when symptoms are dangerous and/or severely distressing.

Behavioural and psychological symptoms of Alzheimer’s disease associated with caregiver burden and depression

OBJECTIVE: The aim of the study was to investigate the relationship between behavioural and psychological symptoms of Alzheimer’s disease with caregiver burden and depression.METHODS: In this prosp...

Decreased perfusion of the posterior cingulate gyri shown by a cingulate island score is a possible marker of vulnerability to behavioural and psychological symptoms of Alzheimer's disease: a pilot study.

The cingulate island score (CIScore), which indicates the Z-score ratio of the posterior cingulate gyri to the medial occipital area, has been shown to be useful for differentiating dementia with Lewy bodies from Alzheimer's disease (AD). Our aim was to investigate associations between the clinical symptoms of AD and the CIScore as an index of the relative decrease in perfusion of the posterior cingulate gyri that occurs in the early stages of AD. Seventeen patients with early-stage AD and 13 patients with amnesic mild cognitive impairment were examined. Z-score maps of technetium-99m ethyl cysteinate dimer single-photon emission computed tomography images acquired from the patients were converted, and the CIScore was determined by using the easy Z-score imaging system. The relationships between the CIScore and clinical symptom scores were tested. A significant correlation was identified between the CIScore and the Neuropsychiatric Inventory Questionnaire score. No significant correlations were identified between the CIScore and other measures of cognitive function. Based on a CIScore of 0.39, we correctly differentiated patients with and without behavioural and psychological symptoms of dementia (BPSD), with a sensitivity of 72.2% and specificity of 75.0%. Using technetium-99m ethyl cysteinate dimer single-photon emission computed tomography, we observed that decreased posterior cingulate gyri perfusion, relative to the medial occipital area, in prodromal and early AD was closely associated with behavioural and psychological symptoms of dementia. Therefore, our findings suggest that CIScore is not only useful for discriminating dementia with Lewy bodies from AD, but it can also be clinically used as a specific indicator of the vulnerability to behavioural and psychological symptoms of dementia in the early stages of AD.

Medial temporal lobe atrophy is independently associated with behavioural and psychological symptoms in Alzheimer's disease.

Evidence describing the contribution of cerebral white matter disease and medial temporal atrophy (MTA) to behavioural and psychological symptoms of dementia (BPSD) has been conflicting. The aim of this study was to assess the relationship of white matter hyperintensities (WMH) and MTA observed on magnetic resonance imaging with BPSD among patients with Alzheimer's disease. In a cross-sectional study of a prospective cohort of patients attending a memory clinic, 46 patients with probable Alzheimer's disease (mean age: 72.38 ± 7.05 years) were studied. Sociodemographic, cognitive, and BPSD data were collected. BPSD were assessed using the Neuropsychiatric Inventory. Magnetic resonance imaging, WMH, and MTA were rated using the Scheltens scales for the assessment of signal hyperintensities and atrophy of medial temporal lobes. For multivariate analysis, two binary logistic regression analyses were carried out, with presence or absence of each BPSD as the dependent variable and with WMH or MTA as the predictor variable. Results of the logistic regression were analyzed to see if the significance of the WMH or MTA score was maintained in a model that factored in other possible confounding variables identified in univariate analysis. The results of binary logistic regression analysis showed that in models that accounted for confounding variables, increased total MTA was significantly associated with apathy (odds ratio = 1.605, adjusted P = 0.042) and disinhibition (odds ratio = 0.607, adjusted P = 0.042). WMH measures did not significantly predict any BPSD item. These findings indicate that MTA potentially contributes to the aetiology of BPSD, and they provide evidence to support the hypothesis that Alzheimer's disease pathology itself can contribute to BPSD.

The current status of prescriptions of memantine and herbal medicines for behavioral and psychological symptoms of Alzheimer’s disease

The current status of prescriptions of memantine and herbal medicines for behavioral and psychological symptoms of Alzheimer’s disease

Behavioral and psychological symptoms of Alzheimer’s disease

Background: Alzheimer's disease (AD) is one of the most feared disorders of later life. It’s associated not only with deficits in cognition and self-care, but also with psychiatric and behavioral symptoms (PBS), witch are diverse, and their occurrence is almost constant during the evolution.

The relationship between the premorbid personality traits and the behavioral and psychological symptoms of Alzheimer disease

AimIn this study, we have aimed to investigate the relationship between the premorbid personality traits and the behavioral and psychological symptoms of Alzheimer disease. Method147 dementia patients who have attended to Geriatric Psychiatry Department of Istanbul University Cerrahpaşa Medical Faculty have been selected randomly. Out of these patients, 45 Alzheimer type dementia patients whose family members or a relative could be reached are included in the study. Relatives of each patient have been asked to fill in the Munich Personality Test (MPT) – relatives form for the purpose of assessment of premorbid personality traits of the subjects. ResultsIt could be stated that high level of premorbid isolation tendency and schizoidia scores are the predictors of hallucinations and aggression. Low level of premorbid frustration tolerance is found to be associated with the present anxiety and the higher Behave–AD general assessment scores. ConclusionWe conclude that certain premorbid personality traits could be a risk factor for the later development of behavioral and psychological symptoms in Alzheimer’s disease or that psychopathologic symptoms could actually be exaggerations or morbid distortions of lifelong behavioral tendencies, and it may also be explained by reflection of neuropathological processes occurring in brain in dementia onto clinic practice, in reliance upon detection of similar findings in studies conducted on different types of dementia and in different cultures. Advanced studies conducted on a sufficient number of subjects in prospective design within a biopsychosociocultural model are needed.

Differences between the behavioral and psychological symptoms of Alzheimer's disease and Parkinson's disease

AimWe compared the behavioral and psychological symptoms of Alzheimer's disease (AD) and Parkinson's disease (PD) in order to determine the characteristic features of each disorder. MethodsFor this retrospective cohort study, we compared the behavioral and psychological symptoms of 288AD patients and 189 PD patients (mean age, 74.6±5.9 and 73.0±8.7years respectively). Symptoms were evaluated using the geriatric depression scale (GDS), apathy scale (AS), and Abe's behavioral and psychological symptoms of dementia score (ABS). ResultsAD patients had higher AS and ABS scores than PD patients. A gender-dependent comparison showed that ABS scores were worse in female AD patients than in female PD patients (p=0.001). A subscale analysis of ABS scores revealed that male AD patients were only significantly different from male PD patients in 1 item, whereas female AD patients were significantly different from female PD patients in 4 items. Among patients with mild cognitive decline, no differences in affective scores were observed. Alternatively, among patients with moderate cognitive decline, affective scores on all 3 scales were worse in PD patients than in AD patients. ConclusionsThe present age- and gender-matched retrospective analysis identified greater behavioral and psychological disease severity in female AD patients relative to female PD patients, and greater affective severity in PD patients versus AD patients with a similar degree of cognitive decline.

DO HIPPOCAMPAL SUBFIELD VOLUMES HAVE A RELATIONSHIP WITH BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS IN ALZHEIMER’S DISEASE?

DO HIPPOCAMPAL SUBFIELD VOLUMES HAVE A RELATIONSHIP WITH BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS IN ALZHEIMER’S DISEASE?