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Neuropsychiatric profiles in patients with Alzheimer’s disease and vascular dementia
  1. J-L Fuh1,
  2. S-J Wang1,
  3. J L Cummings2
  1. 1Neurological Institute, Veterans General Hospital Taipei and National Yang-Ming University Schools of Medicine, Taipei, Taiwan
  2. 2UCLA Alzheimer’s Disease Center, Departments of Neurology and Psychiatry, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
  1. Correspondence to:
 Dr J-L Fuh
 Neurological Institute, Taipei Veterans General Hospital, Taiwan, Republic of China; jlfuhvghtpe.gov.tw

Abstract

Objective: To explore the neuropsychiatric manifestations in patients with Alzheimer’s disease (AD) and cortical and subcortical vascular dementia (VaD).

Methods: We investigated consecutive patients with dementia. All the participants received brain computed tomography. The diagnosis of dementia was confirmed by clinical criteria and the imaging findings. Only patients with probable AD, and subcortical and cortical VaD were included. The Mini Mental State Examination (MMSE) was used to evaluate global cognitive function, and the Neuropsychiatric Inventory (NPI) was used to assess neuropsychiatric symptoms.

Results: Of the 536 participants with dementia, 320 (59.7%) had AD, 161 (30%) had subcortical VaD, 35 (6.4%) had cortical VaD, and 16 (2.9%) had mixed cortical and subcortical VaD. Cortical VaD patients had the highest mean composite NPI scores in all domains and AD patients had the lowest composite scores in most domains. The mean composite scores of the apathy and sleep disturbance domains in patients with cortical VaD were significantly higher than those in the patients with AD after controlling for years of education and MMSE score (p<0.01).

Conclusions: There were few differences among the patients with AD, subcortical VaD and cortical VaD. The most consistent differences were the high sleep disturbance scores in those with cortical VaD.

  • AD, Alzheimer’s disease
  • CDR, Clinical Dementia Rating
  • CT, computed tomography
  • CVD, cerebrovascular diseases
  • DSM-IV, Diagnostic and statistical manual of mental disorders, 4th edition
  • MMSE, Mini Mental State Examination
  • NINCDS-ADRDA, National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer’s Disease and Related Disorders Association
  • NPI, Neuropsychiatric Inventory
  • VaD, vascular dementia
  • Dementia
  • vascular dementia
  • neuropsychiatric disturbance
  • Neuropsychiatric Inventory

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Footnotes

  • Competing interests: none declared.