BACKGROUND/AIMS: The most devastating features of Alz-heimer's disease (AD) are often the behavioral and psychological symptoms in dementia (BPSD). There is controversy as to whether subcortical lesions contribute to BPSD. The aim of this study was to examine the relationship between BPSD and subcortical lesions (white-matter lesions and lacunes) in AD. METHODS: CT or MRI from 259 patients with mild-to-moderate AD were assessed with the Age-Related White Matter Changes scale. Linear measures of global and temporal atrophy and Mini-Mental State Examination scores were used to adjust for AD pathology and disease severity in logistic regression models with the BPSD items delusions, hallucinations, agitation, depression, anxiety, apathy and irritability. RESULTS: Lacunes in the left basal ganglia were associated with delusions (OR 2.57, 95% CI 1.21-5.48) and hallucinations (OR 3.33, 95% CI 1.38-8.01) and lacunes in the right basal ganglia were associated with depression (OR 2.13, 95% CI 1.01-4.51). CONCLUSION: Lacunes in the basal ganglia resulted in a 2- to 3-fold increased risk of delusions, hallucinations and depression, when adjusting for cognition and atrophy. This suggests that basal ganglia lesions can contribute to BPSD in patients with AD, independently of the AD process.
BACKGROUND/AIMS: The most devastating features of Alz-heimer's disease (AD) are often the behavioral and psychological symptoms in dementia (BPSD). There is controversy as to whether subcortical lesions contribute to BPSD. The aim of this study was to examine the relationship between BPSD and subcortical lesions (white-matter lesions and lacunes) in AD. METHODS: CT or MRI from 259 patients with mild-to-moderate AD were assessed with the Age-Related White Matter Changes scale. Linear measures of global and temporal atrophy and Mini-Mental State Examination scores were used to adjust for AD pathology and disease severity in logistic regression models with the BPSD items delusions, hallucinations, agitation, depression, anxiety, apathy and irritability. RESULTS: Lacunes in the left basal ganglia were associated with delusions (OR 2.57, 95% CI 1.21-5.48) and hallucinations (OR 3.33, 95% CI 1.38-8.01) and lacunes in the right basal ganglia were associated with depression (OR 2.13, 95% CI 1.01-4.51). CONCLUSION: Lacunes in the basal ganglia resulted in a 2- to 3-fold increased risk of delusions, hallucinations and depression, when adjusting for cognition and atrophy. This suggests that basal ganglia lesions can contribute to BPSD in patients with AD, independently of the AD process.
Authors: Zahinoor Ismail; Eric E Smith; Yonas Geda; David Sultzer; Henry Brodaty; Gwenn Smith; Luis Agüera-Ortiz; Rob Sweet; David Miller; Constantine G Lyketsos Journal: Alzheimers Dement Date: 2015-06-18 Impact factor: 21.566
Authors: Martin Steinberg; Kyle Hess; Chris Corcoran; Michelle M Mielke; Maria Norton; John Breitner; Robert Green; Jeannie Leoutsakos; Kathleen Welsh-Bohmer; Constantine Lyketsos; Joann Tschanz Journal: Int J Geriatr Psychiatry Date: 2013-05-17 Impact factor: 3.485
Authors: Katarina Nägga; Carina Wattmo; Yi Zhang; Lars-Olof Wahlund; Sebastian Palmqvist Journal: Alzheimers Res Ther Date: 2014-07-07 Impact factor: 6.982
Authors: Changtae Hahn; Hyun-Kook Lim; Wang Yeon Won; Kook Jin Ahn; Won-Sang Jung; Chang Uk Lee Journal: PLoS One Date: 2013-01-03 Impact factor: 3.240
Authors: Dennis C C Seow; Qi Gao; Philip Yap; Jia Min Gan; Hui Ling Chionh; Su Chi Lim; Lei Feng; Tze Pin Ng Journal: Dement Geriatr Cogn Dis Extra Date: 2016-02-17