Risk Factors of Behavioral and Psychological Symptoms in Patients with Alzheimer Disease: The Clinical Research of Dementia of South Korea Study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Few studies have evaluated risk factors for behavioral and psychological symptoms of dementia at the initial assessment for Alzheimer disease in large patient samples. In this study, the factors influencing Alzheimer disease were examined using the Clinical Research of Dementia of South Korea data. Methods: This cross-sectional study was conducted using data of 1,128 patients with Alzheimer disease. The behavioral and psychological symptoms of dementia were examined using the Korean version of the Neuropsychiat-ric Inventory. Demographic characteristics, health-related behavior, neuropsychological tests, comorbidities, blood test results, and caregiver characteristics were assessed. Median logistic regression analysis with adjustment for covariates was conducted. Results: The behavioral and psychological symptoms of dementia were negatively associated with memory (P=0.022) and frontal/executive (P<0.001) function in the Seoul Neuropsychological Screening Battery-dementia, Barthel Index for Activities of Daily Living (P<0.001), Korean version of the Mini-Mental State Examination score (P=0.003), and caregiver age (P=0.005) after adjustment for confounding factors, and positively associated with the Seoul-Instrumental Activities of Daily Living score (P<0.001), Clinical Dementia Rating Sum of Box (P<0.001), Global Deterioration Scale score (P<0.001), abnormality of free T4 level (P<0.001), anemia (P<0.001), and family history of stroke (P=0.001). Patients with female caregivers exhibited more severe behavioral and psychological symptoms of dementia than those with male caregivers. Conclusion: Behavioral and psychological symptoms of dementia in Alzheimer disease patients were associated with various risk factors including the inability to live independently and Alzheimer disease severity. These findings suggest that prevention and treatment strategies for the behavioral and psychological symptoms of dementia should be comprehensive.
Abstract
Background: Few studies have evaluated risk factors for behavioral and psychological symptoms of dementia at the initial assessment for Alzheimer disease in large patient samples. In this study, the factors influencing Alzheimer disease were examined using the Clinical Research of Dementia of South Korea data. Methods: This cross-sectional study was conducted using data of 1,128 patients with Alzheimer disease. The behavioral and psychological symptoms of dementia were examined using the Korean version of the Neuropsychiat-ric Inventory. Demographic characteristics, health-related behavior, neuropsychological tests, comorbidities, blood test results, and caregiver characteristics were assessed. Median logistic regression analysis with adjustment for covariates was conducted. Results: The behavioral and psychological symptoms of dementia were negatively associated with memory (P=0.022) and frontal/executive (P<0.001) function in the Seoul Neuropsychological Screening Battery-dementia, Barthel Index for Activities of Daily Living (P<0.001), Korean version of the Mini-Mental State Examination score (P=0.003), and caregiver age (P=0.005) after adjustment for confounding factors, and positively associated with the Seoul-Instrumental Activities of Daily Living score (P<0.001), Clinical Dementia Rating Sum of Box (P<0.001), Global Deterioration Scale score (P<0.001), abnormality of free T4 level (P<0.001), anemia (P<0.001), and family history of stroke (P=0.001). Patients with female caregivers exhibited more severe behavioral and psychological symptoms of dementia than those with male caregivers. Conclusion: Behavioral and psychological symptoms of dementia in Alzheimer disease patients were associated with various risk factors including the inability to live independently and Alzheimer disease severity. These findings suggest that prevention and treatment strategies for the behavioral and psychological symptoms of dementia should be comprehensive.
참고문헌 (30)
- Cunningham EL, "Dementia", Ulster Med J, 84, pp.79~87 (2015)
- "Clinical Research Center for Dementia" (2012)[URL]
- Pinidbunjerdkool A, "Behavioral and psychological symptoms of dementia", J Med Assoc Thai, 97(Suppl 2), pp.S168~S174 (2014)
- Casanova MF, "Clinicopathological corre-lates of behavioral and psychological symptoms of dementia", Acta Neuropathol, 122, pp.117~135 (2011)
- 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)
- Son EJ, "Pathophysiology of behavioral and psychological symptoms of dementia", Dement Neurocogn Disord, 3, pp.5~8 (2004)
- 박희경, "Clinical Characteristics of a Nationwide Hospital-based Registry of Mild-to-Moderate Alzheimer’s Disease Patients in Korea: A CREDOS (Clinical Research Center for Dementia of South Korea) Study", Journal of Korean Medical Science, 26(9), pp.1219~1226 (2011), 대한의학회
- 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
- Collin C, "The Barthel ADL Index : a reliability study", Int Disabil Stud, 10, pp.61~63 (1988)
- 구형모, "일상활동평가-복합(Seoul-Instrumental Activities of Daily Living ; S-IADL)의 신뢰도 및 타당도 연구", 신경정신의학, 43(2), pp.189~199 (2004), 대한신경정신의학회
- Harwood DG, "Relationship of behavioral and psychological symptoms to cognitive impairment and functional status in Alzheimer’s disease", Int J Geriatr Psychiatry, 15, pp.393~400 (2000)
- Lopez OL, "Psychiatric symptoms vary with the severity of dementia in probable Alzheimer’s disease", J Neuropsychiatry Clin Neurosci, 15, pp.346~353 (2003)
- Tanaka H, "Relationship between dementia severity and behavioural and psychological symptoms in early-onset Alzheimer’s disease", Psychogeriatrics, 15, pp.242~247 (2015)
- Lenartowicz A, "The role of anterior cingulate cortex in working memory is shaped by functional connectivity", J Cogn Neurosci, 17, pp.1026~1042 (2005)
- Alves GS, "Neuroimaging findings related to behavioral disturbances in Alzheimer’s disease : a systematic review", Curr Alzheimer Res, 14, pp.61~75 (2017)
- Koppel J, "Relationships between behavioral syndromes and cognitive domains in Alzheimer disease : the impact of mood and psychosis", Am J Geriatr Psychiatry, 20, pp.994~1000 (2012)
- Butters MA, "The nature and determinants of neuropsychological functioning in late-life depression", Arch Gen Psychiatry, 61, pp.587~595 (2004)
- Booth JE, "Fivefactor personality dimensions, mood states, and cognitive performance in older adults", J Clin Exp Neuropsychol, 28, pp.676~683 (2006)
- Borroni B, "Haplotypes in cathechol-O-methyltransferase gene confer increased risk for psychosis in Alzheimer disease", Neurobiol Aging, 28, pp.1231~1238 (2007)
- Kotrla KJ, "SPECT findings on psychosis in Alzheimer’s disease", Am J Psychiatry, 152, pp.1470~1475 (1995)
- Tran P, "Neuropsychiatric symptoms and medical illness in patients with dementia : an exploratory study", J Am Osteopath Assoc, 106, pp.412~414 (2006)
- Kim J, "The role of cerebrovascular disease on cognitive and functional status and psychosis in severe Alzheimer’s disease", J Alzheimers Dis, 55, pp.381~389 (2017)
- Stern RA, "Preliminary study of the relationship between thyroid status and cognitive and neuropsychiatric functioning in euthyroid patients with Alzheimer dementia", Cogn Behav Neurol, 17, pp.219~223 (2004)
- De Jong FJ, "Thyroid hormones, dementia, and atrophy of the medial temporal lobe", J Clin Endocrinol Metab, 91, pp.2569~2573 (2006)
- De Jong FJ, "Thyroid function, the risk of dementia and neuropathologic changes : the Honolulu-Asia aging study", Neurobiol Aging, 30, pp.600~606 (2009)
- Shah RC, "Hemoglobin level in older persons and incident Alzheimer disease : prospective cohort analysis", Neurology, 77, pp.219~226 (2011)
- Li W, "Type 2 diabetes mellitus might be a risk factor for mild cognitive impairment progressing to Alzheimer’s disease", Neuropsychiatr Dis Treat, 12, pp.2489~2495 (2016)
- Li J, "Effects of diabetes mellitus on cognitive decline in patients with Alzheimer disease : a systematic review", Can J Diabetes, 41, pp.114~119 (2017)
- Storti LB, "Neuropsychiatric symptoms of the elderly with Alzheimer’s disease and the family caregivers’ distress", Rev Lat Am Enfermagem, 24, pp.e2751~ (2016)