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Prognostic Implications of Symptomatic Behaviors in Alzheimer’s Disease

  • Conference paper
Heterogeneity of Alzheimer’s Disease

Part of the book series: Research and Perspectives in Alzheimer’s Disease ((ALZHEIMER))

Summary

Symptomatic behaviors frequently accompany Alzheimer’s disease (AD) and include disturbances of mood, perception, and motor activity. The frequency of such symptoms reported in the literature varies depending upon symptom definition and stage of illness, but usually ranges between 20 to 40%. The biological bases that underlie these disturbances are not well understood, but probably related to the presence of specific pathological and neurochemical substrates (e.g., disproportionate pathology in limbic/paralimbic structures of the frontal-temporal lobes or changes in biogenic amine systems). A number of investigators, using different strategies and analytic methods, have shown that symptomatic behaviors are associated with a faster rate of cognitive decline. The biological significance of this association between behavior and cognition is unknown. It is conceivable, however, that the same distribution of pathologic lesions and neurochemical changes that predispose to psychosis may also hasten the rate of cognitive decline.

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References

  • American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders-Revised 3rd ed. Washington, D. C: American Psychiatric Association.

    Google Scholar 

  • Bowen DM, Allen SJ, Benton JS, Goodhardt MJ, Haan EA, Palmer AM, Sins NR, Smith CC, Spillane JA, Esiri MM, Neary D, Snowdon JS, Wilcock GK, Davison AN (1983) Biochemical assessment of serotonergic and cholinergic dysfunction and cerebral atrophy in Alzheimer’s disease. J Neurochem 41:266–272

    Article  PubMed  CAS  Google Scholar 

  • Burns A, Jacoby R, Levy R (1990a) Psychiatric phenomena in Alzheimer’s disease. I: disorders of thought content. Brit J Psychiat 157:72–76

    Article  PubMed  CAS  Google Scholar 

  • Burns A, Jacoby R, Levy (1990b) Psychiatric phenomena in Alzheimer’s disease. II. Disorders of perception. Brit J Psychiat 157:76–81

    Article  PubMed  CAS  Google Scholar 

  • Carlsson A, Adofsson R, Aquilonius S-M, Goffries CG, Oreland L, Svennerholm L, Win-blad B (1980) Biogenic amines in human brain in normal aging, senile dementia and chronic alcoholism. In: Goldstein M et al. (eds) Ergot compounds and brain function: neuroendocrine and neuropsychiatric aspects. New York, Raven Press, pp 295–304

    Google Scholar 

  • Chen JY, Stern Y, Sano M, Mayeux R (1991) Cumulative risks of developing extrapyramidal signs, psychosis, or myoclonus in the course of Alzheimer’s disease. Arch Neurol 48:1141–1143

    Article  PubMed  CAS  Google Scholar 

  • Cohen-Mansfield J (1986) Agitated behaviors in the elderly. II. Preliminary results in the cognitively deteriorated. J Am Geriatr Soc 34:722–727

    PubMed  CAS  Google Scholar 

  • Cooper JK, Mungas D, Verma M, Weiler P (1991) Psychotic symptoms in Alzheimer’s disease. Internat J Ger Psychiat 6:721–726

    Article  Google Scholar 

  • Cummings JL (1985) Organic delusions: Phenomenology, anatomical correlations, and review. Brit J Psychiat 146:184–197

    Article  PubMed  CAS  Google Scholar 

  • Cummings JL, Miller B, Hill MA, Neshkes R (1987) Neuropsychiatric aspects of multiinfarct dementia and dementia of Alzheimer type. Arch Neurol 37:1649–1653

    Google Scholar 

  • Deutsch LH, Bylsma FW, Rovner BW, Steele C, Folstein MF (1991) Psychosis and physical aggression in probable Alzheimer’s disease. Am J Psychiat 148:1159–1163

    PubMed  CAS  Google Scholar 

  • Devanand DP, Sackheim HA, Brown RP, Mayeux R (1989) A pilot study of haloperidol treatment of psychosis and behavioral disturbance in Alzheimer disease. Arch Neurol 46:854–857

    Article  PubMed  CAS  Google Scholar 

  • Drachman DA, O’Donnell BF, Lew RA, Swearer JM (1990) The prognosis in Alzheimer’s disease: “How far” rather than “how fast” best predicts the course. Arch Neurol 47:851–856

    Article  PubMed  CAS  Google Scholar 

  • Drevets WC, Rubins EH (1989) Psychotic symptoms and the longitudinal course of senile dementia of Alzheimer type. Biol Psychiat 25:39–48

    Article  PubMed  CAS  Google Scholar 

  • Galzin AM, Davous P, Roudier M, Lamour Y, Poirier M-F, Langer S (1989) Platelet [3H-]- • imipramine binding is not modified in Alzheimer’s disease. Psychiat Res 28:289–294

    Article  CAS  Google Scholar 

  • Gustafson L (1975) Psychiatric symptoms in dementia with onset in the presenile period. Acta Psychiat Scand 257 (suppl): 8–35

    Google Scholar 

  • Jacoby RJ, Levy R (1980) Computed tomography in the elderly. 2. Senile dementia: diagnosis and functional impairment. Brit J Psychiat 136:256–269

    Article  PubMed  CAS  Google Scholar 

  • Jeste DV, Wragg RE, Salmon DP, Harris MJ, Tahl LJ (1992) Cognitive deficits of patients with Alzheimer’s disease with and without delusions. Am J Psychiat 149:184–189

    PubMed  CAS  Google Scholar 

  • Langer SZ, Javoy-Agid F, Raisman R, Briley MS, Agid Y (1981) Distribution of specific high-affinity binding sites for 3H-imipramine in human brain. J Neurochem 37:267–271

    Article  PubMed  CAS  Google Scholar 

  • Larson T, Sjogren T, Jacobson G (1963) Senile dementia. Acta Psychiat Scand 167 (Suppl): 1–259

    Google Scholar 

  • Lopez OL, Becker JT, Brenner RP, Rosen J, Bajulaiye Ol, Reynolds CF (1991) Alzheimer’s disease with delusions and hallucinations: neuropsychological and electroencephalographic correlates. Neurology 41:906–912

    PubMed  CAS  Google Scholar 

  • McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM (1984) Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology 34:939–944

    PubMed  CAS  Google Scholar 

  • Mellerup E, Langer SZ (1990) Validity of impipramine platelet binding sites as a biological marker of endogenous depression: a World Health Organization collaborative study. Pharmacopsychiatry 23:113–117

    Article  Google Scholar 

  • Mendez MF, Martin RJ, Smyth KA, Whitehouse PJ (1990) Psychiatric symptoms associated with Alzheimer’s disease. Neuropsychiat Clin Neurosci 2:28–33

    CAS  Google Scholar 

  • Merriam AE, Aronson MK, Gaston P, Wey S, Katz I (1988) The psychiatric symptoms of Alzheimer’s disease. J Am Ger Soc 36:7–12

    CAS  Google Scholar 

  • Rabins PV, Mace NL, Lucas MJ (1982) The impact of dementia on the family. JAMA 248:333–335

    Article  PubMed  CAS  Google Scholar 

  • Reisberg B, Borenstein J, Salob S, Ferris SH, Franssen E, Gorgotas A (1987) Behavioral symptoms in Alzheimer’s disease: phenomenology and treatment. J Clin Psych 48 (5, suppl): 9–15

    Google Scholar 

  • Rosen J, Zubenko GS (1991) Emergence of psychosis and depression in the longitudinal evaluation of Alzheimer’s disease. Biol Psychiat 29:224–232

    Article  PubMed  CAS  Google Scholar 

  • Rubin EH, Morris JC, Storandt M, Berg L (1987) Behavioral changes in patients with mild senile dementia of the Alzheimer’s type. Psychiat Res 21:55–62

    Article  CAS  Google Scholar 

  • Rubin EH, Drevets WC, Burke WJ (1988) The nature of psychotic symptoms in senile dementia of the Alzheimer type. J Geriatr Psych Neurol 1:16–20

    Article  CAS  Google Scholar 

  • Schneider LS, Severson JA, Chui HC, Pollock VE, Sloane RB, Fredrickson ER (1988) Platelet tritiated imipramine binding and MAO activity in Alzheimer’s disease patients with agitation and delusions. Psychiat Res 25:311–322

    Article  CAS  Google Scholar 

  • Steele C, Rovner B, Chase GA, Folstein M (1990) Psychiatric symptoms and nursing home placement of patients with Alzheimer’s disease. Am J Psychiat 147:1049–1051

    PubMed  CAS  Google Scholar 

  • Stern Y, Mayeux R, Sano M, Hause WA, Bush T (1987) Predictors of disease course in patients with probable Alzheimer’s disease. Neurology 37:1649–1653

    PubMed  CAS  Google Scholar 

  • Suddath RL, Casanova MF, Goldberg RE, Daniel DG, Kelsoe JR Jr, Weinberger DR (1989) Temporal lobe pathology in schizophrenia: a quantitative magnetic resonance imaging study. Am J Psychat 146:464–472

    CAS  Google Scholar 

  • Suranyi-Cadotte BE, Gauthier S, Lafaille F, DeFlores S., Dam TV, Naip NP, Quirion R (1985) Platelet 3H-imipramine binding distinguishes depression from Alzheimer dementia. Life Sci 37:2305–2311

    Article  PubMed  CAS  Google Scholar 

  • Swearer JM, Drachman DA, O’Donnell BF, Mitchell AL (1988) Troublesome and disruptive behaviors in dementia. J Am Geriatr Soc 36:784–790

    PubMed  CAS  Google Scholar 

  • Teri L, Larson EB, Reifler BV (1988) Behavioral disturbance in dementia of the Alzheimer’s type. J Am Ger Soc 36:1–6

    CAS  Google Scholar 

  • Teri L, Hughes JP, Larson EB (1990) Cognitive deterioration in Alzheimer’s disease: Behavioral and health factors. J Geron 45:58–63

    Google Scholar 

  • Victoroff JI (1989) Hyperactivity syndrome in Alzheimer’s disease. Bull Clin Neurosci 53:-34–42

    Google Scholar 

  • Wragg RE, Jeste DV (1989) Overview of depression and psychosis in Alzheimer’s disease. Am J Psychiat 146:1182–1186

    Google Scholar 

  • Zubenko GS, Moossy J, Martinez AJ, Rao G, Ciaassen D, Rosen J, Kopp U (1991) Neuropathologic and Neurochemical Correlates of Psychosis in Primary Dementia. Arch Neurol 48:619–624

    Article  PubMed  CAS  Google Scholar 

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© 1992 Springer-Verlag Berlin Heidelberg

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Chui, H.C., Lyness, S., Sobel, E., Schneider, L.S. (1992). Prognostic Implications of Symptomatic Behaviors in Alzheimer’s Disease. In: Boller, F., Forette, F., Khachaturian, Z.S., Poncet, M., Christen, Y. (eds) Heterogeneity of Alzheimer’s Disease. Research and Perspectives in Alzheimer’s Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-46776-9_3

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  • DOI: https://doi.org/10.1007/978-3-642-46776-9_3

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-46778-3

  • Online ISBN: 978-3-642-46776-9

  • eBook Packages: Springer Book Archive

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