Relationship between Dementia Severity and Behavioral and Psychological Symptoms of Dementia in Dementia with Lewy Bodies and Alzheimer's Disease Patients

Abstract

Background/Aims: Behavioral and psychological symptoms of dementia (BPSD) are common in the clinical manifestation of dementia. Although most patients with dementia exhibit some BPSD during the course of the illness, the association of BPSD with the stage of dementia remains unclear. It was the aim of this study to evaluate the impact of severity of dementia on the expression of BPSD in patients with dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). Methods: Ninety-seven patients with DLB and 393 patients with AD were recruited from 8 dementia clinics across Japan. BPSD were assessed by the Neuropsychiatric Inventory (NPI). A relationship between BPSD and dementia stage classified by the Clinical Dementia Rating (CDR) in each type of dementia was assessed. Results: No significant difference was seen in NPI total score across CDR staging in the DLB group. On the other hand, the NPI total score significantly increased with dementia stage in the AD group. Conclusion: The relationship of dementia stage with the expression of BPSD was different according to the type of dementia. BPSD and dementia stage were correlated in AD subjects, in whom psychiatric symptoms increase as the disease progresses, but not in DLB subjects.

Behavioral and psychological symptoms of dementia in older residents in long-term care facilities in Japan: a cross-sectional study

“…In a previous study, in contrast, AD was associated with a lower prevalence of agitation, depression, and disinhibition compared with non-AD participants (Steinberg et al, 2006). Another study showed that patients with AD had less severe BPSD than those with DLB (Hashimoto et al, 2015). Thus, the relationship between the underlying cause of dementia and BPSD warrants further study.…”

“…It has also been revealed that different symptoms are frequently observed at different levels of dementia severity although there is no overall difference in the prevalence of BPSD between different severity levels (Margallo-Lana et al, 2001). Another study showed that BPSD increased with advancing dementia stage in patients with AD, but not in those with DLB (Hashimoto et al, 2015). These imply that impaired ADL or cognitive function, which are the determinants of more severe dementia, could influence BPSD.…”

Correcting miR92a-vGAT-Mediated GABAergic Dysfunctions Rescues Human Tau-Induced Anxiety in Mice

“…Another most recent study shows that the relationship between dementia stage and expression of behavioral and psychological symptoms of dementia (BPSD) can be variational according to the type of dementia. 76 That may also explain why not every single AD patient has anxiety disorder as seen in different types of APP-related AD animal models. [24][25][26]77 However, several recent studies indicate that 3XTg AD mice show significant anxiety.…”

Severity and prevalence of behavioral and psychological symptoms among patients of different dementia stages in Taiwan

“…Hashimoto et al 19 reported that seven of the 12 BPSD domains assessed by NPI revealed increased severity as dementia progressed. However, these results were only present for the patients in the very early stages (CDR = 0.5) to middle stages (CDR = 2) of dementia.…”