BACKGROUND: Behavioral disturbances belong to the core symptoms of dementia and are also common in mild cognitive impairment (MCI). The identification of sets of symptoms is clinically interesting, as interventions targeting syndromes may be more effective than the management of individual symptoms. OBJECTIVE: This study aimed to identify, describe, measure, and compare the fundamental behavioral syndromes that underlie the observed behavioral symptoms in MCI and Alzheimer's disease (AD). METHODS: A cross-sectional analysis of baseline data from a prospective, longitudinal study on behavioral symptoms in MCI and dementia was performed. The study population consisted of 270 MCI and 402 AD patients. Behavioral assessment was performed by means of Middelheim Frontality Score (MFS), Behave-AD, Cohen-Mansfield Agitation Inventory (CMAI), and Cornell Scale for Depression in Dementia (CSDD). Principal components factor analysis with Direct Oblimin rotation was carried out on the MFS score ≥5, seven cluster scores of the Behave-AD and the total scores of the CMAI and the CSDD. RESULTS: We identified three factors explaining behavior in the MCI group: a depression, a psychosis, and an agitation syndrome. Similar factors were found in AD, but the order: an agitation, a depression, and a psychosis syndrome, respectively, and the structure differed slightly. Diurnal rhythm disturbances and frontal lobe symptoms loaded with the depression syndrome in MCI and in AD they loaded with the agitation syndrome. Behavioral syndromes correlated in AD, but not in MCI, and the prevalence and severity of the behavioral syndromes were higher in AD than in MCI, except for the severity of the depression syndrome. CONCLUSION: In both MCI and AD, three similar behavioral syndromes exist, but behavior in MCI is more dominated by a depression syndrome, while behavior in AD is more subject to an agitation syndrome.
BACKGROUND: Behavioral disturbances belong to the core symptoms of dementia and are also common in mild cognitive impairment (MCI). The identification of sets of symptoms is clinically interesting, as interventions targeting syndromes may be more effective than the management of individual symptoms. OBJECTIVE: This study aimed to identify, describe, measure, and compare the fundamental behavioral syndromes that underlie the observed behavioral symptoms in MCI and Alzheimer's disease (AD). METHODS: A cross-sectional analysis of baseline data from a prospective, longitudinal study on behavioral symptoms in MCI and dementia was performed. The study population consisted of 270 MCI and 402 ADpatients. Behavioral assessment was performed by means of Middelheim Frontality Score (MFS), Behave-AD, Cohen-Mansfield Agitation Inventory (CMAI), and Cornell Scale for Depression in Dementia (CSDD). Principal components factor analysis with Direct Oblimin rotation was carried out on the MFS score ≥5, seven cluster scores of the Behave-AD and the total scores of the CMAI and the CSDD. RESULTS: We identified three factors explaining behavior in the MCI group: a depression, a psychosis, and an agitation syndrome. Similar factors were found in AD, but the order: an agitation, a depression, and a psychosis syndrome, respectively, and the structure differed slightly. Diurnal rhythm disturbances and frontal lobe symptoms loaded with the depression syndrome in MCI and in AD they loaded with the agitation syndrome. Behavioral syndromes correlated in AD, but not in MCI, and the prevalence and severity of the behavioral syndromes were higher in AD than in MCI, except for the severity of the depression syndrome. CONCLUSION: In both MCI and AD, three similar behavioral syndromes exist, but behavior in MCI is more dominated by a depression syndrome, while behavior in AD is more subject to an agitation syndrome.
Authors: Stephanie J B Vos; Frans Verhey; Lutz Frölich; Johannes Kornhuber; Jens Wiltfang; Wolfgang Maier; Oliver Peters; Eckart Rüther; Flavio Nobili; Silvia Morbelli; Giovanni B Frisoni; Alexander Drzezga; Mira Didic; Bart N M van Berckel; Andrew Simmons; Hilkka Soininen; Iwona Kłoszewska; Patrizia Mecocci; Magda Tsolaki; Bruno Vellas; Simon Lovestone; Cristina Muscio; Sanna-Kaisa Herukka; Eric Salmon; Christine Bastin; Anders Wallin; Arto Nordlund; Alexandre de Mendonça; Dina Silva; Isabel Santana; Raquel Lemos; Sebastiaan Engelborghs; Stefan Van der Mussele; Yvonne Freund-Levi; Åsa K Wallin; Harald Hampel; Wiesje van der Flier; Philip Scheltens; Pieter Jelle Visser Journal: Brain Date: 2015-02-17 Impact factor: 13.501
Authors: Ma Shwe Zin Nyunt; Chang Yuan Soh; Qi Gao; Xinyi Gwee; Audrey S L Ling; Wee Shiong Lim; Tih Shih Lee; Philip L K Yap; Keng Bee Yap; Tze Pin Ng Journal: Front Med (Lausanne) Date: 2017-12-18
Authors: Alain D Dekker; Silvia Sacco; Angelo Carfi; Bessy Benejam; Yannick Vermeiren; Gonny Beugelsdijk; Mieke Schippers; Lyanne Hassefras; José Eleveld; Sharina Grefelman; Roelie Fopma; Monique Bomer-Veenboer; Mariángeles Boti; G Danielle E Oosterling; Esther Scholten; Marleen Tollenaere; Laura Checkley; André Strydom; Gert Van Goethem; Graziano Onder; Rafael Blesa; Christine Zu Eulenburg; Antonia M W Coppus; Anne-Sophie Rebillat; Juan Fortea; Peter P De Deyn Journal: J Alzheimers Dis Date: 2018 Impact factor: 4.472
Authors: Corinne E Fischer; Winnie Qian; Tom A Schweizer; Zahinoor Ismail; Eric E Smith; Colleen P Millikin; David G Munoz Journal: Alzheimers Dement (N Y) Date: 2017-06-21
Authors: Clive Ballard; Helen C Kales; Constantine Lyketsos; Dag Aarsland; Byron Creese; Roger Mills; Hilde Williams; Robert A Sweet Journal: Curr Neurol Neurosci Rep Date: 2020-10-13 Impact factor: 5.081