Predictors of Change in Behavioral Psychological Symptoms of Dementia in Patients With Alzheimer’s Disease in Korea
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Objective: The purpose of our study was to identify the correlation between clinical characteristics and behavioral psychological symptoms of dementia (BPSD) and to identify factors that predict BPSD changes. Methods: Demographic characteristics were collected and BPSD was assessed using the Korean version of Neuropsychiatric Inventory (K-NPI) for 213 patients with Alzheimer’s disease. BPSD was reassessed to identify changes in the K-NPI score for 65 of the 213 patients. Seoul Neuropsychological Screening Battery was conducted to evaluate specific cognitive functions. Correlation and stepwise regression analyses were conducted to identify the association between several factors and the baseline K-NPI total score. Logistic regression analysis was conducted to identify predictors of improvement of BPSD. Results: Stepwise analysis showed that the baseline K-NPI total score was significantly affected by higher Seoul-Instrumental Activities of Daily Living and having family history of dementia. Multivariate logistic regression analysis showed that improvement of BPSD was significantly associated with a higher baseline K-NPI total score. However, changes in BPSD were not predicted by any specific cognitive functions. Conclusion: Severe BPSD at baseline is a significant predictor of improvement of BPSD. The findings support that severe BPSD at baseline had more chance to benefit from the intervention. Therefore, clinicians need more intensive observation and early intervention for patients in the early stages of dementia.
Abstract
Objective: The purpose of our study was to identify the correlation between clinical characteristics and behavioral psychological symptoms of dementia (BPSD) and to identify factors that predict BPSD changes. Methods: Demographic characteristics were collected and BPSD was assessed using the Korean version of Neuropsychiatric Inventory (K-NPI) for 213 patients with Alzheimer’s disease. BPSD was reassessed to identify changes in the K-NPI score for 65 of the 213 patients. Seoul Neuropsychological Screening Battery was conducted to evaluate specific cognitive functions. Correlation and stepwise regression analyses were conducted to identify the association between several factors and the baseline K-NPI total score. Logistic regression analysis was conducted to identify predictors of improvement of BPSD. Results: Stepwise analysis showed that the baseline K-NPI total score was significantly affected by higher Seoul-Instrumental Activities of Daily Living and having family history of dementia. Multivariate logistic regression analysis showed that improvement of BPSD was significantly associated with a higher baseline K-NPI total score. However, changes in BPSD were not predicted by any specific cognitive functions. Conclusion: Severe BPSD at baseline is a significant predictor of improvement of BPSD. The findings support that severe BPSD at baseline had more chance to benefit from the intervention. Therefore, clinicians need more intensive observation and early intervention for patients in the early stages of dementia.
참고문헌 (33)
- Korean Dementia Observatory 2016, "Kim KW", National Institute of Dementia, 87~, pp.Report No.: NIDR-1603-0015 (2016)
- Cunningham EL, "Dementia", Ulster Med J, 84, pp.79~87 (2015)
- Han SH, "Behavioral and psychological symptoms of dementia : an overview", Dement Neurocogn Disord, 3, pp.1~4 (2004)
- Pinidbunjerdkool A, "Behavioral and psychological symptoms of dementia", J Med Assoc Thai, 97(Suppl 2), pp.S168~S174 (2014)
- Beeri MS, "The cost of behavioral and psychological symptoms of dementia(BPSD)in community dwelling Alzheimer’s disease patients", Int J Geriatr Psythiatry, 17, pp.403~408 (2002)
- Herrmann N, "The contribution of neuropsychiatric symptoms to the cost of dementia care", Int J Geriatr Psychiatry, 21, pp.972~976 (2006)
- Murman DL, "The economic impact of neuropsychiatirc symptoms in Alzheimer’s disease: can drugs ease the burden?", Pharmacoeconomics, 23, pp.227~242 (2005)
- Son EJ, "Pathophysiology of behavioral and psychological symptoms of dementia", Dement Neurocogn Disord, 3, pp.5~8 (2004)
- Archer N, "Premorbid personality and behavioral and psychological symptoms in probable Alzheimer disease", Am J Geriatr Psychiatry, 15, pp.202~213 (2007)
- Mark P, "Behavioral disturbances in dementia", Medical Post, 36, pp.1~12 (2000)
- Chen CS, "Apolipoprotein E polymorphism and behavioral and psychological symptoms of dementia in patients with Alzheimer disease", Alzheimer Dis Assoc Disord, 26, pp.135~139 (2012)
- Choi SH, "The Korean version of the neuropsychiatric inventory : a scoring tool for neuropsychiatric disturbance in dementia patients", J Korean Med Sci, 15, pp.609~615 (2000)
- 안현정, "Seoul Neuropsychological Screening Battery-Dementia Version (SNSB-D): A Useful Tool for Assessing and Monitoring Cognitive Impairments in Dementia Patients", Journal of Korean Medical Science, 25(7), pp.1071~1076 (2010), 대한의학회
- Devanand DP, "Behavioral complications and their treatment in Alzheimer’s disease", Geriatrics, 52(Suppl 2), pp.S37~S39 (1997)
- Fernández-Martínez M, "Prevalence of neuropsychiatric symptoms in Alzheimer’s disease and vascular dementia", Curr Alzheimer Res, 5, pp.61~69 (2008)
- Koppel J, "Relationships between behavioral syndromes and cognitive domains in Alzheimer disease : the impact of mood and psychosis", Am J Geriatr Psychiatry Off J Am Assoc Geriatr Psychiatry, 20, pp.994~1000 (2012)
- Conde-Sala JL, "Effects of anosognosia and neuropsychiatric symptoms on the quality of life of patients with Alzheimer’s disease : a 24-month follow-up study", Int J Geriatr Psychiatry, 31, pp.109~119 (2016)
- Kuzis G, "Neuropsychological correlates of apathy and depression in patients with dementia", Neurology, 52, pp.1403~1407 (1999)
- Finkel SI, "Behavioral and psychological signs and symptoms of dementia : a consensus statement on current knowledge and implications for research and treatment", Int Psychogeriatr, 3(Suppl 3), pp.497~500 (1996)
- Cerejeira J, "Behavioral and psychological symptoms of dementia", Front Neurol, 3, pp.73~ (2012)
- Thompson C, "Behavioral and psychological symptoms associated with dementia subtype and severity", Int Psychogeriatr, 22, pp.300~305 (2010)
- Tsai CF, "Category verbal fluency predicted changes in behavioral and psychological symptoms of dementia in patients with Alzheimer’s disease", Psychiatry Clin Neurosci, 64, pp.408~414 (2010)
- Rouch I, "Association between executive function and the evolution of behavioral disorders in Alzheimer’s disease", Int J Geriatr Psychiatry, 35, pp.1043~1050 (2020)
- 김진하, "서울시 치매 노인의 행동심리증상과 일상생활 수행능력 간의예측 관계", 노인간호학회지, 17(1), pp.1~9 (2015), 한국노인간호학회[DOI]
- Spalletta G, "Cognition and behavior are independent and heterogeneous dimensions in Alzheimer’s disease", J Neurol, 251, pp.688~695 (2004)
- García-Alberca JM, "Can impairment in memory, language and executive functions predict neuropsychiatric symptoms in Alzheimer’s disease (AD)? Findings from a crosssectional study", Arch Gerontol Geriatr, 52, pp.264~269 (2011)
- Starr JM, "Relationship between behavioural and psychological symptoms of dementia and cognition in Alzheimer’s disease", Dement Geriatr Cogn Disord, 24, pp.343~347 (2007)
- Swanberg MM, "Executive dysfunction in Alzheimer disease", Arch Neurol, 61, pp.556~560 (2004)
- Cooper JK, "Relation of cognitive status and abnormal behaviors in Alzheimer’s disease", J Am Geriatr Soc, 38, pp.867~870 (1990)
- Loi SM, "Alzheimer disease : nonpharmacological and pharmacological management of cognition and neuropsychiatric symptoms", Australas Psychiatry, 26, pp.358~365 (2018)
- Hsu TJ, "Predictors of non-pharmacological intervention effect on cognitive function and behavioral and psychological symptoms of older people with dementia", Geriatr Gerontol Int, 17(Suppl 1), pp.28~35 (2017)
- [URL]
- AGS Choosing Wisely Workgroup, "American Geriatrics Society identifies five things that healthcare providers and patients should question", J Am Geriatr Soc, 61, pp.622~631 (2013)
