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Neuropsychiatric symptoms and quality of life in patients with very mild and mild Alzheimer's disease
- Authors:
- KARTTUNEN Kristina, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 26(5), May 2011, pp.473-482.
- Publisher:
- Wiley
The prevalence of neuropsychiatric symptoms (NPS) is believed to range from 50 to 90% in Alzheimer' s disease (AD). Studies suggest that a high proportion of subjects with mild cognitive impairment display clinically meaningful NPS. This study examined the prevalence and significance of NPS in very mild and mild AD patients focusing on their influence on the well-being of the patients and their caregivers. A total of 240 Finnish patient-caregiver dyads were enrolled. Assessment scales included three Quality of Life (QoL) instruments; generic 15D, disease-specific QoL-AD and Visual Analog Scale (VAS). NPS were present in 76.5% of patients with very mild AD and in 84.9% of patients with mild to moderate AD. 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 their ratings. The authors conclude that 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 unrecognised in AD patients, emphasising the need for careful assessment of NPS before deciding on the treatment.