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成瘾研究与治疗杂志

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Mood Symptoms are Related to Psychotic Symptoms in Severe Alzheimer's Disease

Koji Hori, Kimiko Konishi, Hiroi Tomioka, Masayuki Tani, Genshin Minegishi, Hiroaki Tanaka, Sachiko Yokoyama, Tomonori Oshio and Mitsugu Hachisu

The aim of the present study was to investigate the relationship between cognitive dysfunction and the behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer’s disease (AD). The subjects were 79 consecutive AD patients referred because of BPSD. First, we investigated the correlation between cognitive function and the severity of dementia or each symptom domain of BPSD. Then the AD patients were divided into a group with higher performance (n=40, HP group) and a group with lower performance (n=39, LP group). Subsequently, we compared BPSD between these two groups and a factor analysis of BPSD was conducted in each group. We found that disturbance of activity and disturbance of diurnal rhythm were negatively correlated with cognitive function (p<0.05), while affective disturbance was positively correlated with cognitive function (p<0.05). Factor analysis showed that a mood cluster (affective disturbance plus anxieties and phobias) was associated with a psychiatric cluster (paranoid and delusional ideation plus hallucinations) and with aggressiveness in the LP group. These results indicate that disease progress of AD infl uences the BPSD of AD patients in two ways. That is, behavioral symptoms become more severe and the mood cluster conversely becomes milder but is connected to the psychiatric cluster and aggressiveness.