Behaviour changes in dementia 1: Point of entry data of a prospective study

Abstract

Objective. This article analyses behaviour changes in dementia at the point of entry to a longitudinal study. Design. Prospective, longitudinal study of behaviour in dementia, with autopsy follow‐up. Setting. Subjects with dementia, living at home with a carer. All lived in Oxfordshire, UK. Participants. Ninety‐seven people with dementia (Alzheimer's disease and/or vascular dementia) who were living at home with a carer. Measures. At 4‐monthly intervals, the carers were interviewed and the subjects with dementia were assessed cognitively. Subjects' behaviour was assessed using the Present Behavioural Examination. This is an investigator‐based, semi‐structured interview consisting of eight main sections covering many different aspects of behaviour. The 121 main questions, with 66 further ‘nested’ questions, have been shown to have high reliability. Results. This article analyses the types of behaviour change reported by carers at the point of entry to this long‐term study. Few correlations were found between behaviour and age, gender and time since onset of dementia. Some types of behaviour were significantly more prevalent in those with greater cognitive impairment. Conclusions. Many of these changes create problems for carers, for example increased aggressive behaviour, wandering, wakefulness at night, incontinence and persecutory ideas. In general, they are more prevalent in people with more severe dementia. © 1997 John Wiley & Sons, Ltd.

Differential Involvement of 5-HT1B/1D and 5-HT6 Receptors in Cognitive and Non-cognitive Symptoms in Alzheimer's Disease

“…A total of 42 individuals were included in the study, 21 patients with a clinical diagnosis of dementia and 20 elderly normal control cases. Those patients with dementia were an autopsied subset of subjects included in a prospective study of behavioral changes in clinically diagnosed demented patients (Hope et al, 1997). Initially, all patients were living in community with a caregiver (usually spouse or daughter) who could accurately report day-to-day behavior.…”

“…Four behavioral and psychological syndromes were assessed using the Present Behavioral Examination (PBE) (Hope and Fairburn, 1992): depression, overactivity, psychosis, and aggressive behavior (Hope et al, 1997). Briefly, the PBE is a standardized, caregiver-based interview with high intra-and inter-rater reliability that covers in detail the observable behavior and mental state of the patient.…”

“…We have studied 5-HT 1B/1D and 5-HT 6 receptors binding in two cortical areas (Brodmann area 10 (BA10) and Brodmann 20 (BA20)) of AD patients with respect to cognitive impairment and four behavioral syndromes (psychosis, overactivity, aggressive behavior, and depression) prospectively assessed in this patient group (Hope et al, 1997). Cholinergic hypofunction was evaluated by comparing ChAT levels between control and AD patients.…”

Effect of Integrated Family Support Versus Day Care Only on Behavior and Mood of Patients With Dementia

“…increase as the dementia progresses (Hope et al, 1997;Hwang et al, 1997;Rubin et al, 1987;Teri et al, 1988). Teri and coworkers (1988) observed that only 8% of the mildly demented patients they examined exhibited three or more behavior problems, compared to 88% of patients with severe dementia.…”

Evaluation of cholinergic markers in Alzheimer's disease and in a model of cholinergic deficit

“…Those patients with dementia were an autopsied subset of subjects included in a prospective study of behavioural changes in clinically diagnosed as demented patients [16]. Cognitive status was assessed at 4 monthly intervals using the mini-mental state examination (MMSE) [8].…”