J Korean Neuropsychiatr Assoc.  2013 Jan;52(1):42-49. 10.4306/jknpa.2013.52.1.42.

Association between Insight and Neuropsychiatric Symptoms in Alzheimer's Dementia : A Clinical Research Center for Dementia of South Korea Study (CREDOS)

• Yoon H
• Myung W
• Song J
• Choi JB
• Kang HS
• Na DL
• Kim SY
• Lee JH
• Han SH
• Choi SH
• Kim SY
• Kim DK

• KMID: 2194186
• DOI: http://doi.org/10.4306/jknpa.2013.52.1.42

Abstract

OBJECTIVES
The aim of this study was to identify the association between insight and neuropsychiatric symptoms in patients with Alzheimer's dementia (AD).
METHODS
We examined 2607 patients with AD in the Clinical Research Center for Dementia of South Korea study and designed a cross-sectional study. Each patient underwent psychiatric, neurological, and medical examination, interview for caregivers, laboratory tests, neuropsychological tests, and brain MRI. Cognitive function was measured using the Korean version of the Mini-Mental State Examination, Global Deterioration Scale, and Clinical Dementia Rating. Behavioral and psychological symptoms were measured using the Korean version of the Neuropsychiatric Inventory. Daily Living was measured using the Barthel Index for daily living activities and Seoul-Instrumental Activities of Daily Living. Insight was classified according to 'with insight', 'partial insight', and 'without insight' by interview with caregivers.
RESULTS
Among the 2607 patients, 990 were included in the 'with insight' group, 1191 were included in the 'Partial insight' group, and the 'without insight' group included 426 patients. The 'without insight' group had a significantly higher aggression level than the 'with insight' group, but not the 'partial insight' group [odds ratio (OR)=1.46, 95% confidence interval (CI) : 1,14-1.88]. A significantly lower prevalence of depression was observed in the 'Partial insight' group and the 'without insight' group, compared to the 'with insight' group (OR=0.51, 95% CI : 0.43-0.61/OR=0.61, 95% CI : 0.48-0.78). The 'partial insight' group showed a lower anxiety level than the 'with insight' group (OR=0.63, 95% CI : 0.53-0.75).
CONCLUSION
Findings of this study confirmed that insight level was associated with aggression, depression, and anxiety in patients with Alzheimer' dementia.

Keyword

Alzheimer's dementia; Insight; Aggression; Depression; Anxiety

MeSH Terms

Activities of Daily Living
Aggression
Anxiety
Brain
Caregivers
Cross-Sectional Studies
Dementia
Depression
Humans
Neuropsychological Tests
Prevalence
Republic of Korea

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