The Prevalence of Neuropsychiatric Disorders in a Nursing Home Population

Chandler, James D.; Chandler, Julie E.

doi:10.1177/089198878800100203

Cited by 114 publications

(47 citation statements)

References 15 publications

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“…In the present prospective study, the prevalence of specific types of BPSD in AD was consistent with findings from other studies of outpatients with AD [1,20,21], though rated higher than in some other investigations [22,23]. Behavioural symptoms, particularly agitation, occurred in more than 4 out of 6 AD patients.…”

Section: Discussionsupporting

confidence: 81%

A 2-Year Follow-Up of Behavioural and Psychological Symptoms in Alzheimer’s Disease

Haupt

Kurz²,

Jänner

2000

Dement Geriatr Cogn Disord

129

119

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Background: The aim was to examine the longitudinal occurrence and persistence of behavioural and psychological symptoms of dementia (BPSD) in Alzheimer’s disease (AD). Methods: Following 60 patients with mild to severe AD over a period of 2 years with annual evaluations, the prospective occurrence and persistence of BPSD in AD were determined by using the Behavioural Abnormalities in AD Rating scale (BEHAVE-AD). Clinical and demographic features of the AD patients were analysed for their association with course features of these symptoms. Results: All of the 60 AD patients experienced BPSD at some point during the 2-year period, particularly agitation was present in every patient within this period. 2-year persistence of BPSD in AD was frequently observed in patients with agitation and with depressiveness, with less frequency in patients with anxiety and aggressiveness, but not in patients with delusions or hallucinations. 2-year persistent aggressiveness was associated with older age and more functional impairment. More functional impairment was also related to 2-year non-persistent hallucinations. Conclusions: Counselling AD patients and their families and tailoring therapeutic strategies should take into account the different modi of BPSD in AD occurring and persisting longitudinally and interacting with functional disturbances.

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Section: Discussionsupporting

confidence: 81%

A 2-Year Follow-Up of Behavioural and Psychological Symptoms in Alzheimer’s Disease

Haupt

Kurz²,

Jänner

2000

Dement Geriatr Cogn Disord

129

119

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“…Aggression, irritability, and agitation are among the most common and problematic symptoms of Alzheimer's disease. During the course of the illness, as many as 48% of AD patients develop these behavioral symptoms, forcing them out of outpatient care settings into institutions with close supervision (Reisberg et al, 1987;Chandler and Chandler, 1988). In the normal brain, several specific cortical and subcortical regions that contain high levels of NE (Pifl et al, 1991) are thought to be associated with the modulation and control of aggression.…”

Section: Discussionmentioning

confidence: 99%

Adrenergic Receptors in Alzheimer’s Disease Brain: Selective Increases in the Cerebella of Aggressive Patients

Russo-Neustadt

Cotman

1997

J. Neurosci.

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In this study, the distribution and concentration of ␤ 1 , ␤ 2 , and ␣ 2 adrenergic receptors were examined in the frontal cortex, hypothalamus, and cerebellum of Alzheimer's disease (AD) and age-matched control human brains by receptor autoradiography. The purpose of this study was to detect changes in adrenergic receptor concentrations in key areas of the brain known to affect behavior. For these studies, 3 H]UK-14,304 was used to localize the ␣ 2 sites. Essentially no significant difference in adrenergic receptor concentration was found between total AD cases taken together and control patients. It was found, however, that there were important distinctions within the AD group when cases were subdivided according to the presence or absence of aggression, agitation, and disruptive behavior. Aggressive AD patients had markedly increased (by ϳ70%) concentrations of ␣ 2 receptors in the cerebellar cortex compared with nonaggressive patients with similar levels of cognitive deficit. The levels of cerebellar ␣ 2 receptors in aggressive AD patients were slightly above the healthy elderly controls, suggesting that these receptors are preserved and perhaps increased in this subgroup of AD. ␤ 1 And ␤ 2 adrenergic receptors of the cerebellar cortex showed smaller but significant (ϳ25%) increases in concentration in aggressive AD subjects versus both nonaggressive AD patients and controls. No significant differences were found in adrenergic receptor concentrations within the frontal cortex or hypothalamus. These results point out the importance of distinguishing behavioral subgroups of AD when looking for specific neurochemical changes. These autoradiographic results may reflect the importance of the cerebellum in behavioral control.

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“…Behavioral problems are a frequent cause of institutionalization [26,27] and are highly prevalent among nursing home residents [28][29][30]. Dementia patients with behavioral disturbances are more likely to be restrained, may direct aggressive behavior to other residents and staff, require more nursing aid care time and are more costly, and contribute significantly to nurses' experiences of job-related strain [31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Olanzapine in the Treatment of Psychosis in Dementia with Lewy Bodies

Cummings

Street

Masterman

et al. 2002

Dement Geriatr Cogn Disord

114

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Objective: This study sought to determine whether patients with dementia with Lewy bodies (DLB) and psychosis responded to treatment with olanzapine. Methods: This was a post hoc analysis of a subgroup of patients with DLB included in a larger double-blind, placebo-controlled, randomized parallel group trial of olanzapine for the treatment of psychosis in patients with Alzheimer’s disease. Patients meeting the consensus criteria for DLB and exhibiting parkinsonism and visual hallucinations were selected from the initial study. Psychosis was assessed with the Neuropsychiatric Inventory/Nursing Home (NPI-NH) version and the Brief Psychiatric Rating Scale (BPRS). Extrapyramidal symptoms were evaluated with the Simpson-Angus scale. Results: Twenty-nine patients met the criteria for DLB; 10 were randomized to placebo, 5 received 5 mg of olanzapine, 7 received 10 mg of olanzapine and 7 received 15 mg of olanzapine. Patients with DLB treated with 5 mg of olanzapine showed significant reductions in delusions and hallucinations. Patients treated with 10 mg showed a significant reduction in the NPI-NH delusion subscale score. No significant differences were found between the 15-mg group and the placebo group. Confirmatory findings emerged from an analysis of the BPRS. Caregivers reported decreased disruptions in their occupational routines for the group receiving 5 or 10 mg of olanzapine. There was no significant exacerbation of parkinsonian symptoms in any study group, no decrement in Mini-Mental State Examination scores in any of the treatment groups, and symptoms suggestive of anticholinergic toxicity did not differ among treatment groups. Conclusions: This preliminary analysis suggests that olanzapine (5 or 10 mg) reduces psychosis in patients with DLB without worsening parkinsonism.

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The Prevalence of Neuropsychiatric Disorders in a Nursing Home Population

Cited by 114 publications

References 15 publications

A 2-Year Follow-Up of Behavioural and Psychological Symptoms in Alzheimer’s Disease

A 2-Year Follow-Up of Behavioural and Psychological Symptoms in Alzheimer’s Disease

Adrenergic Receptors in Alzheimer’s Disease Brain: Selective Increases in the Cerebella of Aggressive Patients

Efficacy of Olanzapine in the Treatment of Psychosis in Dementia with Lewy Bodies

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