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Behavioural and psychological symptoms in vascular dementia; differences between small and large vessel disease
  1. Salka S Staekenborg1,*,
  2. Tanja Su1,
  3. Elisabeth CW van Straaten1,
  4. Roger Lane2,
  5. Philip Scheltens1,
  6. F Barkhof1,
  7. Wiesje M. van der Flier1
  1. 1 VU University Medical Centre, Netherlands;
  2. 2 Novartis Neuroscience, United States
  1. Correspondence to: Salka Sterre Staekenborg, Neurology, VU medical centre, Boelelaan 1117, Amsterdam, 1081 HV, Netherlands; s.staekenborg{at}vumc.nl

Abstract

Aim: We investigated the prevalence of behavioural and psychological symptoms in vascular dementia (VaD) from baseline data of the VantagE study and compared the severity and relative frequency of symptoms between small vessel VaD and large vessel VaD.

Methods: Behavioural and psychological symptoms of 484 VaD patients included in a large multicenter clinical trial (registration number NCT00099216) were determined using the 12-item Neuropsychiatric Inventory (NPI). Symptoms were considered present when the score was ≥1. Based on MRI, patients were classified as having small vessel VaD (83%) or large vessel VaD (17%).

Results: Behavioural and psychological symptoms were reported in 92% of the VaD patients. The median NPI score of the total study population was 9(0-76), with a median number of 3 symptoms per patient. Apathy (65%) was most prevalent, followed by depressive symptoms (45%), irritability (42%) and agitation/aggression (40%). Patients with small vessel VaD reported more apathy, aberrant motor behaviour and hallucinations than patients with large vessel VaD (p<0.05). In contrast, patients with large vessel VaD reported a higher severity of agitation/aggression and euphoria (p<0.05).

Conclusion: Behavioural and psychological symptoms are common in VaD. Patients with small vessel and large vessel VaD demonstrate different profiles of symptoms, with especially more apathy in small vessel VaD and more agitation/agression in large vessel VaD.

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