Grouping and trajectories of neuropsychiatric symptoms in patients with Alzheimer's disease. Part II: Two-year patient trajectories

Josep Garre-Olmo, Secundino López-Pousa, Joan Vilalta-Franch, Manuel De Gracia Blanco, Antoni Bulbena Vilarrasa

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29 Citations (Scopus)

Abstract

Behavioral and psychological symptoms of dementia (BPSD) are characterized by fluctuations in their frequency and severity as well as by differences in the concurrent presentation of different symptoms. The goal of the current study was to identify groups of patients with Alzheimer's disease (AD) that had similar trajectories in the expression of BPSD. Over a 24-month period, an observational study was conducted using a population of ambulatory patients with AD of mild or moderate severity. The Neuropsychiatric Inventory (NPI) was administered every 6 months to the patient's caregiver. To classify patients according to changes in the frequency and severity of BPSD, growth mixture models were fitted to the applied to the grouping of NPI subscales in the following three categories: psychotic syndrome (hallucinations and delusions), affective syndrome (depression, anxiety, irritability, and agitation), and behavioral syndrome (disinhibition, euphoria, apathy, and aberrant motor behavior). The sample population consisted of 491 patients (70.9% women) that had an average age of 75.2 years (SD=6.6). Different trajectory patterns were identified based on differences in changes over the time in the frequency (stable, increasing, decreasing, or fluctuating in course) and severity (low, moderate, or elevated severity) for psychotic syndrome, emotional syndrome, and behavior syndrome. Patients with AD display a high degree of variability in the evolutionary course of BPSD. It is possible to identify groups of patients with similar evolutionary trajectories in terms of changes in the frequency and severity of BPSD. © 2010 - IOS Press and the authors. All rights reserved.
Original languageEnglish
Pages (from-to)1169-1180
JournalJournal of Alzheimer's Disease
Volume22
Issue number4
DOIs
Publication statusPublished - 1 Jan 2010

Keywords

  • Alzheimer's disease
  • latent growth mixture
  • longitudinal study
  • mood disorders
  • neurobehavioral manifestations
  • psychotic disorders
  • statistical model

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