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Table of Contents
Vol. 17, No. 1-2, 2004
Issue release date: December 2003
Section title: Original Research Article
Dement Geriatr Cogn Disord 2004;17:14–20
(DOI:10.1159/000074080)

Agitation in Alzheimer’s Disease Is a Manifestation of Frontal Lobe Dysfunction

Senanarong V.a · Cummings J.L.b,c · Fairbanks L.b · Mega M.c · Masterman D.M.c · O’Connor S.M.c · Strickland T.L.b,d
aDivision of Neurology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand; Departments of bPsychiatry and Behavioral Sciences and cNeurology, UCLA School of Medicine, dDepartment of Psychiatry, Charles R. Drew School of Medicine, Los Angeles, Calif., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Received: June 02, 2003
Published online: December 11, 2003
Issue release date: December 2003

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 4

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: http://www.karger.com/DEM

Abstract

Objectives: (1) To investigate the prevalence and characteristics of agitation in patients with Alzheimer’s disease (AD) and other forms of dementia; (2) to explore the association between agitation and other clinical variables, including disease severity, functional impairment and other neuropsychiatric symptoms, and (3) to determine the predictors of agitation. Methods: Data for 427 men and women with dementia from outpatient clinics of the University of California, Los Angeles Alzheimer’s Disease Center were analyzed. There were 277 patients with AD, 43 with vascular dementia, 47 with mixed dementia, 45 with frontotemporal dementia and 15 with dementia with Lewy bodies. Patients were evaluated with the Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Functional Activities Questionnaire (FAQ), neuropsychological tests and the Caregiver Appraisal instrument. SPSS10 was utilized for statistical analysis. Results: There was no difference in agitation subscale scores among patients with dementia of various etiologies. In patients with AD, there was increased prevalence of agitation with increasing dementia severity. Agitation contributed substantially to caregiver burden and impact. There was a significant correlation between the FAQ and the NPI agitation subscale score after adjusting for MMSE scores. Delusion, disinhibition and irritability subscale scores in AD patients were correlated with agitation across disease severity. Subscale scores of frontally mediated behaviors including irritability, delusions and disinhibition predicted most of the variance in agitation levels. Conclusion: Agitation is common in AD and other dementias and has a marked impact on caregivers. It is related to dementia severity and to specific types of associated psychopathology implicating frontal lobe dysfunction. The present study is the largest and most comprehensive assessment of agitation reported. The data suggest that agitation in AD is a frontal lobe syndrome. Frontal lobe dysfunction may predispose AD patients to agitation by exaggerating behavioral responses to many types of coexisting psychopathology or environmental provocations.

© 2004 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Received: June 02, 2003
Published online: December 11, 2003
Issue release date: December 2003

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 4

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: http://www.karger.com/DEM


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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