Noncognitive Disturbances in Alzheimer's Disease: Frequency, Longitudinal Course, and Relationship to Cognitive Symptoms
OBJECTIVE: To investigate the frequency and longitudinal course of symptoms of depression, agitation, and psychosis in a longitudinally studied sample of patients with Alzheimer's disease (AD). DESIGN: Longitudinal study of AD patients with follow‐up assessments at 6‐month intervals for an aver...
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| Veröffentlicht in: | Journal of the American Geriatrics Society (JAGS) 1997-11, Vol.45 (11), p.1331-1338 |
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| container_title | Journal of the American Geriatrics Society (JAGS) |
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| creator | Marin, Deborah B. Green, Cynthia R. Schmeidler, James Harvey, Philip D. Lawlor, Brian A. Ryan, Theresa M. Aryan, Mohsen Davis, Kenneth L. Mohs, Richard C. |
| description | OBJECTIVE: To investigate the frequency and longitudinal course of symptoms of depression, agitation, and psychosis in a longitudinally studied sample of patients with Alzheimer's disease (AD).
DESIGN: Longitudinal study of AD patients with follow‐up assessments at 6‐month intervals for an average of more than 3 years.
SETTING: Alzheimer's Disease Research Center of the Mount Sinai Medical Center and the Bronx VA Medical Center, New York.
PARTICIPANTS: A total of 153 AD patients.
MEASUREMENTS: Blessed Test of Information, Memory and Concentration (BIMC) and the Alzheimer's Disease Assessment Scale cognitive (ADAS‐Cog) and noncognitive (ADAS‐NC) subscales.
RESULTS: At entry into the study, more than 90% of patients had a behavioral disturbance that was rated as mild or worse on one of the 10 ADAS noncognitive items; and 40% had at least one rating that was moderate or severe. Correlational analyses indicated that, with the exception of the two mood‐related items, noncognitive symptoms on the ADAS were not highly correlated with one another. Only one of the noncognitive items, concentration, was strongly correlated with the severity of cognitive impairment. On average, patients showed progressively worse cognitive functioning over time as measured both by the ADAS‐Cog and the BIMC. The mean severity of noncognitive symptoms did not change during the course of a 5‐year follow up. The severity of behavioral disturbance at any one evaluation was negatively correlated with change in behavior during the next 6 months and was not correlated with cognitive decline.
CONCLUSION: Mild behavioral disturbances are common, whereas moderate to severe behavioral symptoms are less frequent in this population of AD patients. Disturbances in mood and manifestations of agitation and psychotic symptoms are not closely related to one another and show little progressive worsening over time. Rather, they tend to be episodic such that increasing severity at one time is usually followed by improvement later. Concentration problems are a manifestation of cognitive dysfunction rather than behavioral disturbance in AD. Implications of these results for treatment of noncognitive disturbances in AD are discussed. J Am Geriatr Soc 45:1331–1338, 1997. |
| doi_str_mv | 10.1111/j.1532-5415.1997.tb02932.x |
| format | Article |
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DESIGN: Longitudinal study of AD patients with follow‐up assessments at 6‐month intervals for an average of more than 3 years.
SETTING: Alzheimer's Disease Research Center of the Mount Sinai Medical Center and the Bronx VA Medical Center, New York.
PARTICIPANTS: A total of 153 AD patients.
MEASUREMENTS: Blessed Test of Information, Memory and Concentration (BIMC) and the Alzheimer's Disease Assessment Scale cognitive (ADAS‐Cog) and noncognitive (ADAS‐NC) subscales.
RESULTS: At entry into the study, more than 90% of patients had a behavioral disturbance that was rated as mild or worse on one of the 10 ADAS noncognitive items; and 40% had at least one rating that was moderate or severe. Correlational analyses indicated that, with the exception of the two mood‐related items, noncognitive symptoms on the ADAS were not highly correlated with one another. Only one of the noncognitive items, concentration, was strongly correlated with the severity of cognitive impairment. On average, patients showed progressively worse cognitive functioning over time as measured both by the ADAS‐Cog and the BIMC. The mean severity of noncognitive symptoms did not change during the course of a 5‐year follow up. The severity of behavioral disturbance at any one evaluation was negatively correlated with change in behavior during the next 6 months and was not correlated with cognitive decline.
CONCLUSION: Mild behavioral disturbances are common, whereas moderate to severe behavioral symptoms are less frequent in this population of AD patients. Disturbances in mood and manifestations of agitation and psychotic symptoms are not closely related to one another and show little progressive worsening over time. Rather, they tend to be episodic such that increasing severity at one time is usually followed by improvement later. Concentration problems are a manifestation of cognitive dysfunction rather than behavioral disturbance in AD. Implications of these results for treatment of noncognitive disturbances in AD are discussed. J Am Geriatr Soc 45:1331–1338, 1997.</description><identifier>ISSN: 0002-8614</identifier><identifier>EISSN: 1532-5415</identifier><identifier>DOI: 10.1111/j.1532-5415.1997.tb02932.x</identifier><identifier>PMID: 9361658</identifier><identifier>CODEN: JAGSAF</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Activities of Daily Living ; Aged ; Aged, 80 and over ; Alzheimer Disease - complications ; Alzheimer Disease - physiopathology ; Alzheimer's disease ; Behavioural problems ; Biological and medical sciences ; Cognition & reasoning ; Cognition Disorders - complications ; Cognition Disorders - physiopathology ; Cognitive impairment ; Cross-Sectional Studies ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Depression - epidemiology ; Depression - etiology ; Elderly people ; Factor Analysis, Statistical ; Factors ; Female ; Follow-Up Studies ; Geriatrics ; Humans ; Longitudinal Studies ; Male ; Medical sciences ; Mental depression ; Mental Disorders - classification ; Mental Disorders - epidemiology ; Mental Disorders - etiology ; Neurology ; New York - epidemiology ; Older people ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Psychotic Disorders - epidemiology ; Psychotic Disorders - etiology</subject><ispartof>Journal of the American Geriatrics Society (JAGS), 1997-11, Vol.45 (11), p.1331-1338</ispartof><rights>1997 The American Geriatrics Society</rights><rights>1998 INIST-CNRS</rights><rights>Copyright Lippincott Williams & Wilkins Nov 1997</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4952-3ae87cb7d035eed9c28ae151efdfd6822dea7c49d721ec186bd88f6abd75a9e83</citedby><cites>FETCH-LOGICAL-c4952-3ae87cb7d035eed9c28ae151efdfd6822dea7c49d721ec186bd88f6abd75a9e83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1532-5415.1997.tb02932.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1532-5415.1997.tb02932.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,30979,45553,45554</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2049969$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9361658$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marin, Deborah B.</creatorcontrib><creatorcontrib>Green, Cynthia R.</creatorcontrib><creatorcontrib>Schmeidler, James</creatorcontrib><creatorcontrib>Harvey, Philip D.</creatorcontrib><creatorcontrib>Lawlor, Brian A.</creatorcontrib><creatorcontrib>Ryan, Theresa M.</creatorcontrib><creatorcontrib>Aryan, Mohsen</creatorcontrib><creatorcontrib>Davis, Kenneth L.</creatorcontrib><creatorcontrib>Mohs, Richard C.</creatorcontrib><title>Noncognitive Disturbances in Alzheimer's Disease: Frequency, Longitudinal Course, and Relationship to Cognitive Symptoms</title><title>Journal of the American Geriatrics Society (JAGS)</title><addtitle>J Am Geriatr Soc</addtitle><description>OBJECTIVE: To investigate the frequency and longitudinal course of symptoms of depression, agitation, and psychosis in a longitudinally studied sample of patients with Alzheimer's disease (AD).
DESIGN: Longitudinal study of AD patients with follow‐up assessments at 6‐month intervals for an average of more than 3 years.
SETTING: Alzheimer's Disease Research Center of the Mount Sinai Medical Center and the Bronx VA Medical Center, New York.
PARTICIPANTS: A total of 153 AD patients.
MEASUREMENTS: Blessed Test of Information, Memory and Concentration (BIMC) and the Alzheimer's Disease Assessment Scale cognitive (ADAS‐Cog) and noncognitive (ADAS‐NC) subscales.
RESULTS: At entry into the study, more than 90% of patients had a behavioral disturbance that was rated as mild or worse on one of the 10 ADAS noncognitive items; and 40% had at least one rating that was moderate or severe. Correlational analyses indicated that, with the exception of the two mood‐related items, noncognitive symptoms on the ADAS were not highly correlated with one another. Only one of the noncognitive items, concentration, was strongly correlated with the severity of cognitive impairment. On average, patients showed progressively worse cognitive functioning over time as measured both by the ADAS‐Cog and the BIMC. The mean severity of noncognitive symptoms did not change during the course of a 5‐year follow up. The severity of behavioral disturbance at any one evaluation was negatively correlated with change in behavior during the next 6 months and was not correlated with cognitive decline.
CONCLUSION: Mild behavioral disturbances are common, whereas moderate to severe behavioral symptoms are less frequent in this population of AD patients. Disturbances in mood and manifestations of agitation and psychotic symptoms are not closely related to one another and show little progressive worsening over time. Rather, they tend to be episodic such that increasing severity at one time is usually followed by improvement later. Concentration problems are a manifestation of cognitive dysfunction rather than behavioral disturbance in AD. Implications of these results for treatment of noncognitive disturbances in AD are discussed. J Am Geriatr Soc 45:1331–1338, 1997.</description><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Alzheimer Disease - complications</subject><subject>Alzheimer Disease - physiopathology</subject><subject>Alzheimer's disease</subject><subject>Behavioural problems</subject><subject>Biological and medical sciences</subject><subject>Cognition & reasoning</subject><subject>Cognition Disorders - complications</subject><subject>Cognition Disorders - physiopathology</subject><subject>Cognitive impairment</subject><subject>Cross-Sectional Studies</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Depression - epidemiology</subject><subject>Depression - etiology</subject><subject>Elderly people</subject><subject>Factor Analysis, Statistical</subject><subject>Factors</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Geriatrics</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental depression</subject><subject>Mental Disorders - classification</subject><subject>Mental Disorders - epidemiology</subject><subject>Mental Disorders - etiology</subject><subject>Neurology</subject><subject>New York - epidemiology</subject><subject>Older people</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Psychotic Disorders - epidemiology</subject><subject>Psychotic Disorders - etiology</subject><issn>0002-8614</issn><issn>1532-5415</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqVkl9v0zAUxSMEGmXwEZCiCcHLEvwnie29oKmwjlENxIZ4tBz7ZnNJ4mIn0PLpcdTSB14QfrGl87vnXvs4SU4wynFcr1c5LinJygKXORaC5UONiKAk3zxIZgfpYTJDCJGMV7h4nDwJYYUQJojzo-RI0ApXJZ8lm2vXa3fX28H-gPStDcPoa9VrCKnt0_P21z3YDvyrMGmgApylFx6-j9Dr7Wm6dP2dHUZje9Wmczf6AKep6k36GVo1WNeHe7tOBxe1Py1utt16cF14mjxqVBvg2X4_Tr5cvLudX2bLj4v38_NlpgtRkowq4EzXzCBaAhihCVeASwyNaUzFCTGgWEQNIxg05lVtOG8qVRtWKgGcHicvd75r7-LYYZCdDRraVvXgxiCZoIIX5N9gyRgWrGARPPkLXMWbxxcIkmBEGScURehsB2nvQvDQyLW3nfJbiZGcQpQrOSUlp6TkFKLchyg3sfj5vsNYd2AOpfvUov5ir6ugVdv4GJgNB4ygQohKROzNDvtpW9j-xwDyanEznaJDtnOI_wI2Bwflv8mKUVbKr9cLSan4dHs5_yCv6G9BYcps</recordid><startdate>199711</startdate><enddate>199711</enddate><creator>Marin, Deborah B.</creator><creator>Green, Cynthia R.</creator><creator>Schmeidler, James</creator><creator>Harvey, Philip D.</creator><creator>Lawlor, Brian A.</creator><creator>Ryan, Theresa M.</creator><creator>Aryan, Mohsen</creator><creator>Davis, Kenneth L.</creator><creator>Mohs, Richard C.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7QJ</scope><scope>7X8</scope></search><sort><creationdate>199711</creationdate><title>Noncognitive Disturbances in Alzheimer's Disease: Frequency, Longitudinal Course, and Relationship to Cognitive Symptoms</title><author>Marin, Deborah B. ; Green, Cynthia R. ; Schmeidler, James ; Harvey, Philip D. ; Lawlor, Brian A. ; Ryan, Theresa M. ; Aryan, Mohsen ; Davis, Kenneth L. ; Mohs, Richard C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4952-3ae87cb7d035eed9c28ae151efdfd6822dea7c49d721ec186bd88f6abd75a9e83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Alzheimer Disease - complications</topic><topic>Alzheimer Disease - physiopathology</topic><topic>Alzheimer's disease</topic><topic>Behavioural problems</topic><topic>Biological and medical sciences</topic><topic>Cognition & reasoning</topic><topic>Cognition Disorders - complications</topic><topic>Cognition Disorders - physiopathology</topic><topic>Cognitive impairment</topic><topic>Cross-Sectional Studies</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>Depression - epidemiology</topic><topic>Depression - etiology</topic><topic>Elderly people</topic><topic>Factor Analysis, Statistical</topic><topic>Factors</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Geriatrics</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mental depression</topic><topic>Mental Disorders - classification</topic><topic>Mental Disorders - epidemiology</topic><topic>Mental Disorders - etiology</topic><topic>Neurology</topic><topic>New York - epidemiology</topic><topic>Older people</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Psychotic Disorders - epidemiology</topic><topic>Psychotic Disorders - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marin, Deborah B.</creatorcontrib><creatorcontrib>Green, Cynthia R.</creatorcontrib><creatorcontrib>Schmeidler, James</creatorcontrib><creatorcontrib>Harvey, Philip D.</creatorcontrib><creatorcontrib>Lawlor, Brian A.</creatorcontrib><creatorcontrib>Ryan, Theresa M.</creatorcontrib><creatorcontrib>Aryan, Mohsen</creatorcontrib><creatorcontrib>Davis, Kenneth L.</creatorcontrib><creatorcontrib>Mohs, Richard C.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marin, Deborah B.</au><au>Green, Cynthia R.</au><au>Schmeidler, James</au><au>Harvey, Philip D.</au><au>Lawlor, Brian A.</au><au>Ryan, Theresa M.</au><au>Aryan, Mohsen</au><au>Davis, Kenneth L.</au><au>Mohs, Richard C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Noncognitive Disturbances in Alzheimer's Disease: Frequency, Longitudinal Course, and Relationship to Cognitive Symptoms</atitle><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle><addtitle>J Am Geriatr Soc</addtitle><date>1997-11</date><risdate>1997</risdate><volume>45</volume><issue>11</issue><spage>1331</spage><epage>1338</epage><pages>1331-1338</pages><issn>0002-8614</issn><eissn>1532-5415</eissn><coden>JAGSAF</coden><abstract>OBJECTIVE: To investigate the frequency and longitudinal course of symptoms of depression, agitation, and psychosis in a longitudinally studied sample of patients with Alzheimer's disease (AD).
DESIGN: Longitudinal study of AD patients with follow‐up assessments at 6‐month intervals for an average of more than 3 years.
SETTING: Alzheimer's Disease Research Center of the Mount Sinai Medical Center and the Bronx VA Medical Center, New York.
PARTICIPANTS: A total of 153 AD patients.
MEASUREMENTS: Blessed Test of Information, Memory and Concentration (BIMC) and the Alzheimer's Disease Assessment Scale cognitive (ADAS‐Cog) and noncognitive (ADAS‐NC) subscales.
RESULTS: At entry into the study, more than 90% of patients had a behavioral disturbance that was rated as mild or worse on one of the 10 ADAS noncognitive items; and 40% had at least one rating that was moderate or severe. Correlational analyses indicated that, with the exception of the two mood‐related items, noncognitive symptoms on the ADAS were not highly correlated with one another. Only one of the noncognitive items, concentration, was strongly correlated with the severity of cognitive impairment. On average, patients showed progressively worse cognitive functioning over time as measured both by the ADAS‐Cog and the BIMC. The mean severity of noncognitive symptoms did not change during the course of a 5‐year follow up. The severity of behavioral disturbance at any one evaluation was negatively correlated with change in behavior during the next 6 months and was not correlated with cognitive decline.
CONCLUSION: Mild behavioral disturbances are common, whereas moderate to severe behavioral symptoms are less frequent in this population of AD patients. Disturbances in mood and manifestations of agitation and psychotic symptoms are not closely related to one another and show little progressive worsening over time. Rather, they tend to be episodic such that increasing severity at one time is usually followed by improvement later. Concentration problems are a manifestation of cognitive dysfunction rather than behavioral disturbance in AD. Implications of these results for treatment of noncognitive disturbances in AD are discussed. J Am Geriatr Soc 45:1331–1338, 1997.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>9361658</pmid><doi>10.1111/j.1532-5415.1997.tb02932.x</doi><tpages>8</tpages></addata></record> |
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| subjects | Activities of Daily Living Aged Aged, 80 and over Alzheimer Disease - complications Alzheimer Disease - physiopathology Alzheimer's disease Behavioural problems Biological and medical sciences Cognition & reasoning Cognition Disorders - complications Cognition Disorders - physiopathology Cognitive impairment Cross-Sectional Studies Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Depression - epidemiology Depression - etiology Elderly people Factor Analysis, Statistical Factors Female Follow-Up Studies Geriatrics Humans Longitudinal Studies Male Medical sciences Mental depression Mental Disorders - classification Mental Disorders - epidemiology Mental Disorders - etiology Neurology New York - epidemiology Older people Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychotic Disorders - epidemiology Psychotic Disorders - etiology |
| title | Noncognitive Disturbances in Alzheimer's Disease: Frequency, Longitudinal Course, and Relationship to Cognitive Symptoms |
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