알쯔하이머병의 진행 정동에 따른 행동심리적 증상의 변화
The Change of Behavioral and Psychological Symptoms according to the Progression of Alzheimer's Disease
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Abstract
The evaluation of behavioral and psychological symptoms (BPSD) is important for the diagnosis and management of Alzheimer's disease (AD). Previous studies have reported the prevalence and severity of BPSD changes. However, these studies have mainly focused on the AD patients with mild to moderate severity. Our study investigated the BPSD in AD patients with more advanced stages and looked at the prevalence and severity of BPSD with the progression of disease. Methods: One hundred thirty six patients with probable AD received the Korean version of the neuropsychiatric inventory along with the expanded version of the Korean Clinical Dementia Rating Scale (CDR) and the Korean version of the Mini-Mental State Examination (K-MMSE). Results: The mean K-MMSE, CDR and NPI scores were 10.1 (SD=7.1), 2.0 (SD=1.5) and 32.7 (SD=26.2), respectively. CDR and K-MMSE scores did not correlate with the total NPI score but did correlate with some of the subscale NPI scores. Apathy had the highest relationship to CDR (r=0.39, p<0.01). Aberrant motor was most correlated with the total score of NPI (r=0.65, p<0.01). The mean number of positive NPI items was 4.3, which ranged from 2.1 (CDR 5 group) to 5.4 (CDR 2 group). The most frequent symptom was apathy and the least was euphoria. The severity of BPSD increased as the dementia severity increased to CDR 2 except apathy. Night-time behavior and anxiety were frequent in the early stages whereas apathy and aberrant motor were frequent symptoms in later stages. Conclusions: These observations suggest that BPSD is relatively independent of cognitive functions. The prevalence and severity of BPSD with the exclusion of apathy, increased as the dementia severity increased from CDR 0.5 to CDR 2 and then declined declined except apathy.
참고문헌 (28)
- Fields DR, "Resident behavior and staff distress in nursing homes", 39, pp.792~798 (1991)
- Choi SH, "Introduction to Dementia Questionnaire,Activity of Daily Living,Neuropsychiatric Inventory", 17, pp.14~20 (1999)
- Franssen E, "Stage specific incidence of potentially remediable behavioral symptoms in aging and Alzheimer's disease.A study of 120 subjects using the BEHAVE-AD", 54, pp.95~112 (1989)
- Mega M, "The neuropsychiatric Inventory:comprehensive assessment of psychopathology in dementia", 44, pp.2308~2314 (1994)
- Mayeux R, "Predictor of disease course in patients with probable Alzheimer's disease", 37, pp.1649~1653 (1987)
- Forstl H, "Psychotic feature and the course of Alzheimer's disease relationship to cognitive, electroencephalograpic and computerized tomography finding Acta Psychiatr Scand", 87, pp.395~399 (1993)
- Cummings JL, "Neuropsychiatric feature of corticobasal degeneration", 65, pp.717~721 (1998)
- Mega M, "Neuropsychiatric aspects of progressive supranuclear palsy", 47, pp.1184~1189 (1996)
- Cummings JL, "Neuropsychiatric differences between Parkinson's disease with dementia and Alzheimer's disease", 16, pp.184~191 (2001)
- Na DL, "The Korean version of the neuropsychiatric inventory:a scoring tool for neuropsychiatric disturbance in dementia patients", 15, pp.609~615 (2000)
- Drachman D, "Clinical diagnosis of Alzheimer's disease report of the NINCDS-ADRDA Work Group Under the auspices of Department of Health and Human Services Task Force On Alzheimer's Disease", 34, pp.939~944 (1984)
- Na DL, "A validity study on the Korean Mini-Mental State Examination(K-MMSE)in dementia patients", 15, pp.300~307 (1997)
- Choi SH, "Estimating the validity of the Korean Version of Expanded Clinical Dementia Rating Scale （CDR）", 19, pp.585~591 (2001)
- Burn A, "Psychiatric phenomena in dementia of the Alzheimer type", 4, pp.43~54 (1992)
- Ishii T, "Relationship of behavioral complications and severity of dementia in Japanese elderly persons with dementia", 8, pp.46~53 (1994)
- Keene J, "Psychiatric symptoms in patients with dementia predict the later development of behavioural abnormalities", 28, pp.1119~1127 (1998)
- Cummings JL, "Relationship of aggressive behavior to other neuropsychiatric symptoms in patients with Alzheimer's disease", 153, pp.243~247 (1996)
- Devanand DP, "course of psychopathologic features in mild to moderate Alzheimer disease. Arch Gen Psychiatry", 54, pp.257~263 (1997)
- Lopez O, "Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment:results from the cardiovascular health study", 288, pp.1475~1483 (2002)
- Robert DT, "Alzheimer disease", 2nd ed, pp.25~32 (1999), Washington: Lippincott Wiliams & Wilkins
- Deutsch LH, "Agitation:Subtypes and Their Mechanisms", 1, pp.325~339 (1996)
- Thompson L, "Aggressive behaviors among the institutionalized elderly", 41, pp.853~856 (1993)
- Morris JC, "The progression of personality changes in senile dementia of the Alzheimer's type", 35, pp.721~725 (1987)
- Liu CK, "Neuropsychiatric symptoms of Alzheimer's disease differ in Chinese and American patients", 17, pp.22~28 (2002)
- Cummings JL, "The spectrum of behavioral change in Alzheimer's disease", 46, pp.130~135 (1996)
- Bylsma FW, "Psychosis and physical aggression in probable Alzheimer's disease", 148, pp.1159~1163 (1991)
- Meins W, "Premorbid personality traits in Alzheimer's disease: do they predispose to noncognitive behavioral symptoms?", 10, pp.369~378 (1998)
- Mega MS, "Behavioral disorders in Alzheimer disease: a transcultural perspective", 55, pp.539~544 (1998)