Showing papers by "Leszek Bidzan published in 2008"

Behavioral and psychological symptoms and the progression of dementia of the Alzheimer type in nursing home residents.

Abstract: Background Behavioral and psychological symptoms are common in the course of dementia of the Alzheimer's type (DAT). Some behavioral and psychological symptoms may be predictors of the progression of dementia and cognitive impairment in DAT. However, studies on this topic face serious methodological problems. The aim of our study was to investigate how aggressive and impulsive behaviors correlate with the progression of dementia and related cognitive impairments in DAT patients. Material/methods Using the Cohen-Mansfield Agitation Inventory (CMAI) and the ADAS-cog we examined 39 nursing home residents diagnosed with mild to moderate DAT. Of these participants, 26 were re-evaluated with the ADAS-cog two years after baseline. Results Aggressive and impulsive behaviors correlated with the degree of cognitive impairment. However, we also found that particular ADAS-cog items correlated differently with the CMAI score. Moreover, various CMAI categories were differently related to cognitive disorders. Impairments in cognitive functioning best explain the fluctuations of verbal aggression and physical agitation (non-aggressive). At baseline, the more demented subjects had a higher general score on the CMAI scale and showed greater rates of physical aggression, verbal aggression and non-aggressive physical agitation. Conclusions Particular items of the CMAI scale significantly differentiated our subjects in terms of progression of cognitive impairment. Aggressive behaviors in patients with DAT are linked to both the severity of dementia and the rate of its progression. At the same time, significant differences were noted with respect to particular behaviors.

Behavioral and psychological symptoms in the preclinical stage of Alzheimer's disease.

Abstract: Background: AD is preceded by a lengthy preclinical period. Neural degeneration may lead to the appearance of behavioral and psychological symptoms, even before other clinical symptoms are manifest. We attempted to evaluate this symptomatology in preclinical AD. Material/Methods: We recruited 291 care center residents who did not demonstrate dementia symptoms according to DSM-IV, whose MMSE score was at least 24, and who reached the first or second stage on the Global Deterioration Scale. Psychopathology was assessed using the AMDP, while the ADAS-cog was used to assess cognitive dysfunctions. Seven years later, 155 patients participated in the follow-up study (MMSE and ADAS-cog). If the MMSE was less than 24, a psychiatric workup was done to verify dementia. The AD group consisted of persons properly diagnosed with AD (n=25), while the control group consisted of persons in whom dementia had not developed. Results: The AD and control groups differed in the level of psychopathological symptoms at baseline. The disparities related both to the global AMDP score and to every particular symptom category. The analysis did not disclose a pathognomonic symptom for preclinical AD, but there were many symptoms whose intensity differentiated AD patients from the controls. The degree of cognitive dysfunction seems to correlate with the clinical manifestation of some psychopathological symptoms in preclinical AD. Conclusions: The degeneration process before the clinical manifestation of dementia leads not only to the impairment of several cognitive functions, but also the intensification of behavioral and psychological symptoms.