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Original Research Article

Neuropsychiatric Symptoms Underlying Caregiver Stress and Insight in Alzheimer’s Disease

Rocca P.a · Leotta D.b · Liffredo C.c · Mingrone C.a · Sigaudo M.a · Capellero B.b · Rocca G.a · Simoncini M.d · Pirfo E.c · Bogetto F.a

Author affiliations

aDepartment of Neuroscience, Psychiatric Section, University of Turin, bDepartment of Medicine, Neurology Unit, Azienda Sanitaria Locale TO1, cDepartment of Mental Health, Azienda Sanitaria Locale TO2, and dDepartment of Long-Term Attendance and Elderly, Geriatric Unit, Azienda Sanitaria Locale TO2, Turin, Italy

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Dement Geriatr Cogn Disord 2010;30:57–63

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Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Accepted: December 05, 2010
Published online: August 05, 2010
Issue release date: August 2010

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 1

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

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

Abstract

Objective: Cluster analysis based on Alzheimer’s disease (AD) neuropsychiatric profile demonstrated validity on caregiver burden, nursing-home placement and survival. The aims of our study were to explore the validity of this approach on caregiver burden, lack of insight and cognitive impairment and to examine the impact of neuropsychiatric profiles on these variables. Method: A data-driven approach (two-step cluster analysis) identified groups of patients based on similarities of their neuropsychiatric symptom profile, as assessed by the Neuropsychiatric Inventory (NPI). ANOVAs and χ2 tests were used to compare groups with regard to continuous and categorical variables. Linear regressions tested the relationships between NPI and clinical variables. Results: Psychotic/behavioral, depressive and minimally symptomatic clusters differed for caregiver burden and lack of insight. Patients in the minimally symptomatic cluster showed better insight than those in the depressive cluster. Caregivers of the psychotic/behavioral cluster experienced the highest burden. We found positive relationships between NPI and lack of insight in the depressive and minimally symptomatic clusters and between NPI and caregiver burden in all three clusters. Caregiver burden was influenced by the type of symptoms. Conclusions: The cluster analysis was valid for lack of insight and caregiver burden. Symptoms predominant on caregiver burden could become targets for therapy.

© 2010 S. Karger AG, Basel


References

  1. Cummings JL, Back C: The cholinergic hypothesis of neuropsychiatric symptoms in Alzheimer’s disease. Am J Geriatr Psychiatry 1998;6(suppl 1):S64–S78.
  2. Matsumoto N, Ikeda M, Fukuhara R, Shinagawa S, Ishikawa T, Mori T, Toyota Y, Matsumoto T, Adachi H, Hirono N, Tanabe H: Caregiver burden associated with behavioural and psychological symptoms of dementia in elderly people in the local community. Dement Geriatr Cogn Disord 2007;23:219–224.
  3. Tun SM, Murman DL, Long HL, Colenda CC, von Eye A: Predictive validity of neuropsychiatric subgroups on nursing home placement and survival in patients with Alzheimer disease. Am J Geriatr Psychiatry 2007;15:314–327.
  4. Onder G, Finne-Soveri H, Soldato M, Liperoti R, Lattanzio F, Bernabei R, Landi F: Distress of caregivers of older adults receiving home care in European Countries: results from the Aged in Home Care Study. Am J Geriatr Psychiatry 2009;17:899–906.
  5. Shimabukuro J, Awata S, Matsuoka H: Behavioural and psychological symptoms of dementia characteristic of mild Alzheimer patients. Psychiatry Clin Neurosci 2005;59:274–279.
  6. Takechi H, Yamada H, Sugihara Y, Kita T: Behavioural and psychological symptoms, cognitive impairment and caregiver burden related to Alzheimer’s disease patients treated in an outpatient memory clinic. Nippon Ronen Igakkai Zasshi 2006;43:207–216.
    External Resources
  7. Lövheim H, Sandman PO, Karlsson S, Gustafson Y: Behavioural and psychological symptoms of dementia in relation to level of cognitive impairment. Int Psychogeriatr 2008;20:777–789.
    External Resources
  8. 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.
  9. Ito T, Meguro K, Akanuma K, Meguro M, Lee E, Kasuya M, Ishii H, Mori E: Behavioral and psychological symptoms assessed with the BEHAVE-AD-FW are differentially associated with cognitive dysfunction in Alzheimer’s disease. J Clin Neurosci 2007;14:850–865.
  10. Starr JM, Lonie J: Relationship between behavioural and psychological symptoms of dementia and cognition in Alzheimer’s disease. Dement Geriatr Cogn Disord 2007;24:343–347.
  11. Cummings JL, Ross W, Absher J, Gornbein J, Hadjiaghai L: Depressive symptoms in Alzheimer disease: assessment and determinants. Alzheimer Dis Assoc Disord 1995;9:87–93.
  12. Stark stein SE, Sabe L, Chemerinski E, Jason L, Leiguarda R: Two domains of anosognosia in Alzheimer’s disease. J Neurol Neurosurg Psychiatry 1996;61:485–490.
  13. Zanetti O, Vallotti B, Frisoni GB, Geroldi C, Bianchetti A, Pasqualetti P, Trabucchi M: Insight in dementia: when does it occur? Evidence for a nonlinear relationship between insight and cognitive status. J Gerontol B Psychol Sci Soc Sci 1999;54:P100–P106.
  14. Harwood DG, Barker WW, Ownby RL, St George-Hyslop P, Mullan M, Duara R: Relationship of behavioral and psychological symptoms to cognitive impairment and functional status in Alzheimer’s disease. Int J Geriatr Psychiatry 2000;15:393–400.
  15. Arkin S, Mahendra N: Insight in Alzheimer’s patients: results of a longitudinal study using three assessment methods. Am J Alzheimers Dis Other Demen 2001;16:211–224.
  16. Razani J, Kakos B, Orieta-Barbalace C, Wong JT, Casas R, Lu P, Alessi C, Josephson K: Predicting caregiver burden from daily functional abilities of patients with mild dementia. J Am Geriatr Soc 2007;55:1415–1420.
  17. Aarsland D, Brønnick K, Ehrt U, Bronnick K, Gjerstad MD, Larsen JP: Neuropsychiatric symptoms in patients with Parkinson’s disease and dementia: frequency, profile and associated care giver stress. J Neurol Neurosurg Psychiatry 2007;78:36–42.
  18. Neil W, Bowie P: Carer burden in dementia – assessing the impact of behavioural and psychological symptoms via self-report questionnaire. Int J Geriatr Psychiatry 2008;23:60–64.
  19. Tun SM, Murman DL, Colenda CC: Concurrent validity of neuropsychiatric subgroups on caregiver burden in Alzheimer disease patients. Am J Geriatr Psychiatry 2008;16:594–602.
  20. Hurt C, Bhattacharyya S, Burns A, Camus V, Liperoti R, Marriott A, Nobili F, Robert P, Tsolaki M, Vellas B, Verhey F, Byrne EJ: Patient and caregiver perspectives of quality of life in dementia: an investigation of the relationship to behavioural and psychological symptoms in dementia. Dement Geriatr Cogn Disord 2008;26:138–146.
  21. Gitlin LN, Winter L, Burke J: Tailored activities to manage neuropsychiatric behaviors in persons with dementia and reduce caregiver burden: a randomized pilot study. J Am J Geriatr Psychiatry 2008;16:229–239.
  22. Lyketsos CG, Sheppard JM, Steinberg M, Tschanz JA, Norton MC, Steffens DC, and Breitner JC: Neuropsychiatric disturbance in Alzheimer’s disease clusters into three groups: the Cache County study. Int J Geriatr Psychiatry 2001;16:1043–1053.
  23. Archer N, Brown RG, Reeves SJ, Boothby H, Nicholas H, Foy C, Williams J, Lovestone S: Premorbid personality and behavioral and psychological symptoms in probable Alzheimer disease. Am J Geriatr Psychiatry 2007;15:202–213.
  24. 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.
  25. Aalten P, de Vugt ME, Lousberg R, Korten E, Jaspers N, Senden B, Jolles J, Verhey FR: Behavioural problems in dementia: a factor analysis of the neuropsychiatric inventory. Dement Geriatr Cogn Disord 2003;15:99–105.
  26. Moran M, Walsh C, Lynch a, Coen RF, Coakley D, Lawlor BA: Syndromes of behavioural and psychological symptoms in mild Alzheimer’s disease. Int J Geriatr Psychiatry 2004;19:359–364.
  27. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders IV-TR ed. Washington, American Psychological Association, 2000.
  28. First MB, Gibbon M, Spitzer RL, Williams JBW, Benjamin LS: Structured Clinical Interview for DSM-IV Disorders (SCID). Washington, American Psychiatric Press, DC, 1997.
  29. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM: Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology 1984;34:939–944.
  30. Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J: The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994;44:2308–2314.
  31. Folstein MF, Folstein SE, McHugh PR: Mini-Mental State: a practical method for grading the cognitive state of patients by the clinician. J Psychiatr Res 1975;12:189–198.
  32. Otto BR, Lafleche G, Whelihan WM, Buongiorno GW, Albert MS, Fogel BS: Impaired awareness of deficits in Alzheimer’s disease. Alzheimer Dis Assoc 1996;10:68–76.
    External Resources
  33. Novak M, Guest C: Application of a multidimensional caregiver burden inventory. Gerontologist 1989;29:798–803.
  34. Marvardi M, Mattioli P, Spazzafumo L, et al: The Caregiver Burden Inventory in evaluating the burden of caregivers of elderly demented patients: results from a multicenter study. Aging Clin Exp Res 2005;17:46–53.
  35. Chiu T, Fang D, Chen J, Wang Y, Jeris C: A robust and scalable clustering algorithm for mixed type attributes in large database environment. Proc 7th ACM SIGKDD Int Conf Knowledge Discovery and Data Mining. San Francisco, 2001, pp 263–268.
  36. Theodoritis S, Koutroumbas K (eds): Pattern Recognition. New York, Academic Press, 1999.
  37. Onyike CU, Sheppard JM, Tschanz JT, Norton MC, Green RC, Steinberg M, Welsh-Bohmer KA, Breitner JC, Lyketsos CG: Epidemiology of apathy in older adults: the Cache County Study. Am J Geriatr Psychiatry 2007;15:365–375.
  38. Davis JD, Tremont G: Impact of frontal systems behavioral functioning in dementia on caregiver burden. J Neuropsychiatry Clin Neurosci 2007;19:43–49.
  39. Lane-Brown AT, Tate RL: Apathy after acquired brain impairment: a systematic review of non-pharmacological interventions. Neuropsychol Rehabil 2009;15:1–36.

Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Accepted: December 05, 2010
Published online: August 05, 2010
Issue release date: August 2010

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 1

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

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


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