Objective: Assessment of Behavioral and Psychological Signs and Symptoms of Dementia (BPSD) in Alzheimer’s Disease (AD). These symptoms increase the care-giver distress, the likelihood of institutionalization, and may be associated with more rapid cognitive decline.
Design: In this study (REAL FR for Réseau sur la maladie d'Alzheimer Français) we prospectively used the Neuropsychiatric Inventory NPI to evaluate BPSD.
Materials and Methods: A population of 510 patients with probable Alzheimer’s disease ( 254 patients with a Mini-Mental State Examination (MMSE) score between 11 and 20, 244 patients with a MMSE between 21 and 30, 12 patients with a MMSE less than 11) was included in the study. Assessment was performed at a six-month interval.
Results: BPSD were detected in 92.5% of the patients with a MMSE between 11 and 20, and in 84% of the patients with a MMSE between 21 and 30. Apathy was the most common abnormality at any stage, followed by anxiety, dysphoria, agitation. The evolution of apathy discriminated different subgroups according to the level of deterioration and the progression of NPI scores. Caregiver’s burden level was significantly higher for patients with BPSD. Factor analysis was carried out leading to three different syndromes according to the level of cognitive impairment.
Conclusion: These results in a French cohort of patients with AD underline the importance of the evaluation and finally of the treatment of BPSD.
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