배회증상을 보이는 알츠하이머병 환자의 신경심리적 특징
Neuropsychological Characteristics of Wandering in Patients with Drug-naïve Alzheimer’s Disease
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Background: Wandering represents one of a major problem occurring in patients with Alzheimer’s disease (AD). To find the disproportionate neuropsychological deficit and behavioral psychological symptoms in dementia (BPSD) of AD patients with wandering compared to AD patients without wandering, this study examined the set of neuropsychological tests and caregiver-administered neuropsychiatric inventory (CGA-NPI). Methods: Psychotropic-naïve (drug-naïve) probable AD patients with wandering (64) and without wondering (278) were assessed with the Seoul Neuropsychological Screening Battery, which included measures of memory, intelligence, and executive functioning. Results: Patients with wandering had lower scores in the Rey-Osterrieth Complex Figure copy, Fist-edge-palm, Alternating hand movement tests compared to patients without wandering. The degree of wandering in AD patients was significantly related with CGA-NPI subdomains of aggression, disinhibition, depression, and delusions. Conclusions: This study showed that 1) AD patients with wandering have disproportionately cognitive deficit suggesting frontal and right parietal dysfunctions, 2) wanderings are related with specific BPSD. Considering these results, AD patients with wandering may have specific neuronal anatomic substrates related with pathology of Alzheimer.
Abstract
Background: Wandering represents one of a major problem occurring in patients with Alzheimer’s disease (AD). To find the disproportionate neuropsychological deficit and behavioral psychological symptoms in dementia (BPSD) of AD patients with wandering compared to AD patients without wandering, this study examined the set of neuropsychological tests and caregiver-administered neuropsychiatric inventory (CGA-NPI). Methods: Psychotropic-naïve (drug-naïve) probable AD patients with wandering (64) and without wondering (278) were assessed with the Seoul Neuropsychological Screening Battery, which included measures of memory, intelligence, and executive functioning. Results: Patients with wandering had lower scores in the Rey-Osterrieth Complex Figure copy, Fist-edge-palm, Alternating hand movement tests compared to patients without wandering. The degree of wandering in AD patients was significantly related with CGA-NPI subdomains of aggression, disinhibition, depression, and delusions. Conclusions: This study showed that 1) AD patients with wandering have disproportionately cognitive deficit suggesting frontal and right parietal dysfunctions, 2) wanderings are related with specific BPSD. Considering these results, AD patients with wandering may have specific neuronal anatomic substrates related with pathology of Alzheimer.
참고문헌 (26)
- Hope T, "The structure of wandering in dementia", Int J Geriatr Psychiatry, 9, pp.149~155 (1994)
- Algase, "Wandering in dementia : state of science" (1999), Springer
- Algase DL, "Estimates of stability of daily wandering behavior among cognitively impaired longterm care residents", Nurs Res, 46, pp.172~178 (1997)
- Cooper JK, "Relation of cognitive status and abnormal behaviors in Alzheimer’s disease", J Am Geriatr Soc, 38, pp.867~870 (1990)
- Rowe MA, "Antecedents, descriptions and consequences of wandering in cognitively-impaired adults and the Safe Return (SR) program", Am J Alzheimers Dis Other Demen, 16, pp.344~352 (2001)
- Choi SH, "Korean version of the neuropsychiatric inventory: a scoring tool for neuropsychiatric disturbance in dementia patients", J Korean Med Sci, 15, pp.609~615 (2000)
- 구형모, "일상활동평가-복합(Seoul-Instrumental Activities of Daily Living ; S-IADL)의 신뢰도 및 타당도 연구", 신경정신의학, 43(2), pp.189~199 (2004), 대한신경정신의학회
- 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
- Cohen-Mansfield J, "The social environment of the agitated nursing home resident", Int J Geriatr Psychiatry, 7, pp.789~798 (1992)
- Algase DL, "Geriatric mental health nursing: current and future challenges", pp.61~74 (1992), SLACK Incorporated
- "J Adv Nurs", 2003, 173~182
- Kavcic V, "Attentional dynamics and visual perception : mechanisms of spatial disorientation in Alzheimer’s disease", Brain, 126, pp.1173~1181 (2003)
- Tetewsky SJ, "Visual loss and getting lost in Alzheimer’s disease", Neurology, 52, pp.958~965 (1999)
- Rolland Y, "A SPECT study of wandering behavior in Alzheimer’s disease", Int J Geriatr Psychiatry, 20, pp.816~820 (2005)
- Meguro K, "Cortical glucose metabolism in psychiatric wandering patients with vascular dementia", Psychiatry Res, 67, pp.71~80 (1996)
- Chiu YC, "Getting lost : directed attention and executive functions in early Alzheimer’s disease patients", Dement Geriatr Cogn Disord, 17, pp.174~180 (2004)
- Phillips VL, "The incremental effect of dementia-related problem behaviors on the time to nursing home placement in poor, frail, demented older people", J Am Geriatr Soc, 51, pp.188~193 (2003)
- Holtzer R, "Psychopathological features in Alzheimer’s disease : course and relationship with cognitive status", J Am Geriatr Soc, 51, pp.953~960 (2003)
- Hope T, "Wandering in dementia : a longitudinal study", Int Psychogeriatr, 13, pp.137~147 (2001)
- Song JA, "Wandering behaviour of persons with dementia in Korea: investigation of related factors", Aging Ment Health, 12, pp.36~373 (2008)
- Luria AR, "Higher cortical functions in man" (1966), Basic Books
- Chan RC, "The neural basis of motor sequencing : an fMRI study of healthy subjects", Neurosci Lett, 398(3), pp.189~194 (2006)
- Lachs MS, "Delusions and behavioral disturbances in cognitively impaired elderly persons", J Am Geriatr Soc, 40, pp.768~773 (1992)
- Kiely DK, "Resident characteristics associated with wandering in nursing homes", Int J Geriatr Psychiatry, 15, pp.1013~1020 (2000)
- Klein DA, "Wandering behaviour in community-residing persons with dementia", Int J Geriatr Psychiatry, 14, pp.272~279 (1999)
- 곽용태, "Clinical Characteristics of Behavioral and Psychological Symptoms in Patients with Drug-naïve Alzheimer’s Disease", Dementia and Neurocognitive Disorders(대한치매학회지), 11(3), pp.87~94 (2012), 대한치매학회