Dement Neurocogn Disord.  2012 Sep;11(3):87-94. 10.12779/dnd.2012.11.3.87.

Clinical Characteristics of Behavioral and Psychological Symptoms in Patients with Drug-naive Alzheimer's Disease

• Kwak YT
• Yang Y
• Kwak SG

• KMID: 2222352
• DOI: http://doi.org/10.12779/dnd.2012.11.3.87

Abstract

BACKGROUND
Behavioral and psychological symptoms of dementia (BPSD) are less well-defined aspects of Alzheimer's disease (AD). We designed this study to explore the followings: 1) the clinical profiles of BPSD 2) the clustered-groups domains of the Korean-Neuropsychiatric Inventory (K-NPI) assessment of BPSD 3) the clinical characteristics of the clustered-groups of BPSD in patients with drug-naive probable AD.
METHODS
Descriptive and cluster analyses of the 12 K-NPI domains were done in 220 patients with drug-naive probable AD. After clustering these domains, characteristics of these positive symptoms clustered-group of patients were compared with the negative symptoms groups of patients.
RESULTS
The mean Korean-Mini Mental Status Examination (K-MMSE), Clinical Dementia Rating (CDR) scale, and K-NPI scores were 15.0, 1.6, and 14.2, respectively. The CDR and K-MMSE scores correlated with total K-NPI scores, and depression was the most common symptom. According to cluster analysis, five major clusters were identified. Using the associated neuropsychological dysfunctions, characteristics of each group were defined.
CONCLUSIONS
This study identified the clustered-domains for K-NPI, and suggested the possible anatomical substrates for these groups in drug-naive AD patients. These attempts may clarify the complex and bizarre behavioral and psychological symptoms as more neurologically relevant symptoms.

Keyword

Behavioral and psychological symptoms of dementia; Drug-naive; Alzheimer's disease; Cluster analysis

MeSH Terms

Alzheimer Disease
Cluster Analysis
Dementia
Deoxycytidine
Depression
Humans
Deoxycytidine

Figure

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  Fig. 1 Flow diagram of patient screening and inclusion. AD, Alzheimer's disease.

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  Fig. 2 Caregiver burden (in K-NPI) according to behavior and psychiatric domain.

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  Fig. 3 Mean K-NPI total score according to CDR staging. Except for the difference between CDR 2 and 3 (p=0.18), all groups are significantly different (p<0.01). K-NPI, Korean Neuropsyhicatirc Inventory; CDR, Clinical Dementia Rating Scale.

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  Fig. 4 Dendrogram for clustered variable of K-NPI domains. Closely intercorrelated variables are joined at an early stage in the analysis (left of the dendrogram) and less closely intercorrelated variables are joined at a later stage in the analysis (right of the dendrogram). Fs, frequency x severity; K-NPI, Korean Neuropsyhicatirc Inventory.

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  Fig. 5 Hypothetical mapping for K-NPI domains.

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