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Table of Contents
Vol. 24, No. 5, 2007
Issue release date: October 2007
Dement Geriatr Cogn Disord 2007;24:343–347
(DOI:10.1159/000108632)

Relationship between Behavioural and Psychological Symptoms of Dementia and Cognition in Alzheimer’s Disease

Starr J.M. · Lonie J.
aGeriatric Medicine Unit, Royal Victoria Hospital, and bLothian Memory Treatment Service, Jardine Clinic, Royal Edinburgh Hospital, Edinburgh, UK

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Abstract

Background: Behavioural and psychological symptoms of dementia (BPSDs) are common. It is unclear whether associations are stronger with the absolute cognitive level or that relative to premorbid mental ability. Methods: The Neuropsychiatric Inventory (NPI) was administered to carers of patients with Alzheimer’s disease (AD). Patients underwent cognitive testing with the National Adult Reading Test (NART) to estimate premorbid IQ and 6 tests of current cognitive function. Results: 556 patients, mean age 77.3 years, had NPI scores. The total NPI score correlated significantly with most cognitive test scores, but multi-linear regression identified NART-IQ as the only significant cognitive predictor (β = –0.17, p = 0.008). Principal component analysis of the 10 NPI domains extracted 3 components corresponding to mood, frontal and psychotic factors. The NPI mood factor correlated significantly with NART-IQ (ρ = –0.14, p = 0.014) and lexical verbal fluency (ρ = –0.09, p = 0.034) only. The NPI frontal factor correlation with NART-IQ approached significance (ρ = –0.11, p = 0.053). The NPI psychotic factor correlated significantly with the Mini-Mental State Examination (ρ = –0.15, p < 0.001) and the Hopkins verbal learning test (ρ = –0.11, p = 0.013) scores. Conclusion: The relationship between BPSDs and cognition in AD is weak and largely explained by premorbid IQ. There is a stronger relationship between current cognition and psychotic symptoms.



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References

  1. Lyketsos CG, Steinberg M, Tschanz JT, Norton MC, Steffens DC, Breitner JC: Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. Am J Psychiatry 2000;157:708–714.
  2. Chung JA, Cummings JL: Neurobehavioral and neuropsychiatric symptoms in Alzheimer’s disease: characteristics and treatment. Neurol Clin 2000;18:829–846.
  3. Spalletta G, Baldinetti F, Buccione I, Fadda L, Perri R, Scalmana S, Serra L, Caltagirone C: Cognition and behaviour are independent and heterogeneous dimensions in Alzheimer’s disease. J Neurol 2004;251:688–695.
  4. Srikanth S, Nagaraja AV, Ratnavalli E: Neuropsychiatric symptoms in dementia – frequency, relationship to dementia severity and comparison in Alzheimer’s disease, vascular dementia and frontotemporal dementia. J Neurol Sci 2005;236:43–48.
  5. Hirono N, Mori E, Yasuda M, Ikejiri Y, Imamura T, Shimomura T, Ikeda M, Hashimoto M, Yamashita H: Factors associated with psychotic symptoms in Alzheimer’s disease. J Neurol Neurosurg Psychiatry 1998;64:648–652.
  6. Piccininni MP, Di Carlo A, Baldereschi M, Zaccara G, Inzitari D: Behavioral and psychological symptoms in Alzheimer’s disease: frequency and relationship with duration and severity of disease. Dement Geriatr Cogn Disord 2005;19:276–281.
  7. Porter VR, Buxton WG, Fairbanks LA, Strickland T, O’Connor SM, Rosenberg-Thompson S, Cummings JL: Frequency and characteristics of anxiety among patients with Alzheimer’s disease and related dementias. J Neuropsychiatry Clin Neurosci 2003;15:180–186.
  8. Lyketsos CG, Sheppard JME, Steinberg M, Tschanz JA, Norton MC, Steffens DC, Breitner JC: Neuropsychiatric disturbance in Alzheimer’s disease clusters into three groups: the Cache County study. Int J Ger Psychiatr 2001;16:1043–1053.
  9. Frisoni GB, Rozzini L, Gozzetti A, Binetti G, Zanetti O, Bianchetti A, Trabucchi M, Cummings JL: Behavioral syndromes in Alzheimer’s disease: description and correlates. Dement Geriatr Cogn Disord 1999;10:130–138.
  10. Starr JM, Lonie J: The influence of pre-morbid IQ on Mini-mental State Examination score at time of dementia presentation. Int J Geriatr Psychiatry 2007;22:382–384.
  11. Starr JM: Cholinesterase inhibitor treatment and urinary incontinence in Alzheimer disease. J Am Geriatr Soc 2007;55:800-801.
  12. Nelson HE: The National Adult Reading Test (NART): Test Manual. Windsor, NFER-Nelson, 1982.
  13. McGurn B, Starr JM, Topfer JA, Pattie A, Whiteman MC, Lemmon HA, Whalley LJ, Deary IJ: Pronunciation of irregular words is preserved in dementia, validating premorbid IQ estimation. Neurology 2004;62:1184–1186.
  14. Folstein MF, Folstein SE, McHugh PR: ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
  15. Brandt J: The Hopkins verbal learning test: development of a new memory test with six equivalent forms. Clin Neuropsychol 1991;5:125–142.
  16. Lezak MD: Neuropsychological Assessment (ed 3). Oxford, Oxford University Press, 1995.
  17. Robbins T, James M, Owen A, Sahakian BJ, McInnes L, Rabbitt P: Cambridge Neuropsychological Test Automated Battery (CANTAB): a factor analytic study of a large number of normal elderly volunteers. Dementia 1994;5:266–281.
  18. Cummings JL, Mega MS, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J: The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994;44:2308–2314.
  19. Aalten P, de Vugt ME, Lousberg R, Korten E, Jaspers N, Senden B, Jolles J, Verhey FR: Behavioral problems in dementia: a factor analysis of the neuropsychiatric inventory. Dement Geriatr Cogn Disord 2003;15:99–105.
  20. Richards M, Deary IJ: A life course approach to cognitive reserve: a model for cognitive aging and development. Ann Neurol 2005;58:617–622.
  21. Blennow K, de Leon MJ, Zetterberg H: Alzheimer’s disease. Lancet 2006;368:387–403.
  22. Bain GH, Lemmon H, Teunisse S, Starr JM, Fox HC, Deary IJ, Whalley LJ: Quality of life in healthy old age: relationships with childhood IQ, minor psychological symptoms and optimism. Soc Psychiatry Psychiatr Epidemiol 2003;38:632–636.
  23. Meins W, Frey A, Thiesemann R: Premorbid personality traits in Alzheimer’s disease: do they predispose to noncognitive behavioral symptoms? Int Psychogeriatrics 1998;10:369–378.
  24. Starr JM, Loeffler B, Abousleiman Y, Simonotto E, Marshall I, Goddard N, Wardlaw JM: Episodic and semantic memory tasks activate different brain regions in Alzheimer’s disease. Neurology 2005;65:266–269.
  25. Shenkin SD, Bastin ME, MacGillivray TJ, Deary IJ, Starr JM, Wardlaw JM: Childhood and current cognitive function in healthy 80-year-olds: a DT-MRI study. Neuroreport 2003;14:345–349.
  26. Chow TW, Liu CK, Fuh JL, Leung VP, Tai CT, Chen LW, Wang SJ, Chiu HF, Lam LC, Chen QL, Cummings JL: Neuropsychiatric symptoms of Alzheimer’s disease differ in Chinese and American patients. Int J Geriatr Psychiatry 2002;17:22–28.


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