Objective: To determine whether persons with Alzheimer’s disease could be meaningfully classified according to their profile of behavioral and psychological symptoms.
Design: Latent class analysis.
Materials and Methods: 224 consecutive attendees at a memory clinic, who fulfilled NINCDS-ADRDA criteria for Alzheimer’s disease.
Assessments: Standard memory clinic assessment, including MMSE and CAMCOG, and the CDR to assess disease severity. Behavioral and psychological symptoms were assessed using BEHAVE-AD. It covers seven domains of behavioral symptoms: paranoid and delusional ideation, hallucinations, activity disturbance, aggressiveness, diurnal rhythm disturbances, affective disturbance and anxieties and phobias. Each domain includes several questions, each worth a maximum of three points. For the purpose of this study, however we assigned one if the behavioral domain was present and zero if it was absent.
Statistical analysis: Summary statistics of the sample. Latent Class Analysis was performed to see whether persons with AD could be meaningfully classified according to their profile of behavioral and psychological symptoms.
Results: The mean age was 75, with the mean MMSE and CAMCOG, 18 and 63.1 respectively, and the mean CDR 1.1. The 15/224 had no behavioral symptoms. Overall, activity disturbance was the most prevalent symptom, (69.2%), and hallucinations the least prevalent (8.9%).
Regarding the latent class analysis, three groups/classes best fit the data. It resulted in three groups of patients with different profiles of behavioral symptoms.
Conclusion: Using latent class analysis, the patients in this sample can be classified into three groups according to their behavioral symptoms. Group 1 with a low prevalence of behavioral symptoms, group 2 where the symptoms of activity disturbance, anxiety and aggression predominate. This group could be termed the agitation/anxiety group. The "aggression" domain includes agitation, verbal aggression and physical aggression in the BEHAVE –AD. Activity disturbance includes wandering, and repetitive and inappropriate behaviours. Frustration and anxiety about their cognitive deficits may precipitate aggression and agitation, and agitation and anxiety may result in wandering and repetitive behaviors. The final group is one with predominant psychotic symptoms.
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