BackgroundAlzheimer's disease dementia (ADD) is the most common cognitive disease, but patients’ families may notice some symptoms yet not recognise that they indicate ADD. This study investigated the symptoms that families notice as ADD as the disease progresses.MethodsNew outpatients diagnosed with ADD (n = 315) at five memory clinics completed two cognitive assessments, the Revised Hasegawa Dementia Scale (HDS‐R) and Mini‐Mental State Examination (MMSE). During an interview, family members completed the Functional Assessment Staging Test (FAST), an observational assessment tool that classifies ADD progression into seven stages. We then examined the relationship of the family‐assessed FAST score with clinician‐assessed HDS‐R and MMSE domain scores by comparing between patients with FAST 1–3 and FAST 4–7. Next, we divided the FAST 4–7 group into the FAST 4–5 and FAST 6–7 subgroups and divided the FAST 1–3 group into the FAST 1–2 and FAST 3 subgroups.ResultsSurprisingly, half of the families did not recognise that the symptoms indicated ADD. Scores for orientation of time and place on the HDS‐R and MMSE and for visual memory on the HDS‐R were significantly related to family‐assessed FAST score. Moreover, the orientation of time and place score on both scales and visual memory on the HDS‐R were significantly worse in the FAST 4–7 group than in FAST 1–3 group. In the FAST 4–7 group, scores for age on the HDS‐R and for reading and drawing on the MMSE were significantly worse in the FAST 6–7 subgroup. In the analysis of the FAST 1–3 group, there was no significant difference among the HDS‐R and MMSE domains between the FAST 1–2 and FAST 3 subgroups.ConclusionsFamily members of patients with ADD tend to notice the progression of ADD from the symptoms of disorientation and visual memory.

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Some new outpatients with mild cognitive impairment (MCI) or Alzheimer’s disease (AD) do not regularly attend treatment appointments at memory clinics. To explore factors related to non-regular attendance, we divided new outpatients according to regular or non-regular attendance during the first 6 months of treatment and analyzed the relationship between individual patient factors and attendance. Approximately half of patients living alone did not regularly attend appointments. Living with family and longer duration of school education were significantly associated with regular attendance. Patients with mild or moderate AD attended appointments more regularly than patients with MCI or moderate-to-severe AD. Patients in Kyoto City had significantly better cognitive function than patients in satellite cities, and there were a significantly higher proportion of patients with MCI or AD at first visit in Kyoto City. Living arrangements and duration of education are important patient factors to consider to promote regular attendance at treatment appointments.

<b><i>Introduction:</i></b> Alzheimer’s disease (AD) is the most common cognitive disease, and behavioral and psychological symptoms of dementia (BPSD) can place a heavy burden on families. The presence of these symptoms related to AD is commonly assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). This study sought to clarify the relationship between scores on the 12-domain NPI-Q and individual factors in patients with AD. <b><i>Methods:</i></b> Participants were 218 new outpatients with AD at five memory clinics. Cognitive function was assessed using the Revised Hasegawa Dementia Scale (HDS-R) and Mini-Mental State Examination (MMSE). We examined which individual factors were associated with the total NPI-Q score and the number of domains. We also examined which domains were associated with the factors identified. <b><i>Results:</i></b> A higher total NPI score was significantly associated with lower scores on both cognitive assessments and a longer duration of education. Exhibiting symptoms on a greater number of domains was significantly associated with lower scores on both cognitive assessments, longer duration of education, and advanced age. The nighttime disturbances domain was significantly associated with lower scores on both cognitive assessments and advanced age. The delusions domain was significantly associated with lower education. <b><i>Conclusions:</i></b> BPSD may appear more easily with reduced quality of life and ongoing dissatisfaction. Effective individualized services are important for patients with AD, and therefore, we should account for age, cognitive function, and duration of education in the services provided.