Neuropsychiatric symptoms and Quality of Life in patients with very mild and mild Alzheimer's disease

✍ Scribed by Kristiina Karttunen; Pertti Karppi; Asta Hiltunen; Matti Vanhanen; Tarja Välimäki; Janne Martikainen; Hannu Valtonen; Juhani Sivenius; Hilkka Soininen; Sirpa Hartikainen; Jaana Suhonen; Tuula Pirttilä; for the ALSOVA study group

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 156 KB
• Volume: 26
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/gps.2550

✦ Synopsis

Background: Neuropsychiatric symptoms (NPS) are common manifestations of Alzheimer' s disease (AD). Objective: To examine the prevalence and significance of NPS in very mild and mild AD patients with emphasis on their influence on the well-being of the patients and their caregivers. Methods: The participants were 240 patient-caregiver dyads who participated in a prospective, controlled rehabilitation study (ALSOVA). Three Quality of Life (QoL) instruments were used; generic 15D, disease-specific QoL-AD and Visual Analog Scale (VAS). The disease-specific QoL-AD was both selfrated and caregiver rated. Other scales used were Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), ADCS-ADL, Neuropsychiatric Inventory (NPI) and Beck Depression Inventory (BDI). Results: NPS were present in 76.5% of patients with very mild AD (CDR 0.5) and in 84.9% of patients with mild to moderate AD (CDR 1). The most frequent symptoms were apathy, depression, irritability, and agitation. The strongest predictor of self-reported QoL-AD scores was depressive symptoms whereas functional decline and presence of NPS predicted poor caregiver ratings of patients' QoL. However, caregiver depression also influenced significantly their ratings. Conclusion: NPS are common even in the early stages of AD. NPS were significantly associated with caregiver assessment of the patient's QoL but not with patients' self-assessed QoL. Depression decreases QoL, but may remain unrecognized in AD patients, emphasizing the need for careful and structured assessment of NPS before deciding on the appropriate treatment.