Preview

Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Cognitive and non-cognitive neuropsychiatric disorders in dementia and methods of their correction

https://doi.org/10.14412/2074-2711-2017-2-65-70

Full Text:

Abstract

Dementia is an etiologically heterogeneous syndrome, the traditional evaluation of the severity of which is based on the degree of cognitive activity reduction and on impairments in functional abilities. In addition to cognitive impairment (CI), non-cognitive neuropsychiatric disorders, the prevalence of which is as high as 50–100%, form the clinical picture of dementia. Non-cognitive impairment is appreciably correlated with the severity, course, and poorest outcome of dementia. Non-cognitive neuropsychiatric impairment is characterized by different symptoms, which is associated with the heterogeneity of dementia. The main symptoms include aggression, agitation, wandering, hoarding, sexual disinhibition, apathy, depression, and anxiety. The paper considers the main clusters of neuropsychiatric disorders and their clinical manifestations. It provides data on the combination treatment of CI and non-cognitive disorders in dementia. 

About the Author

E. G. Mendelevich
Kazan State Medical University, Ministry of Health of Russia, Kazan
Russian Federation

Department of Neurology and Rehabilitation

49, Butlerov St., Kazan 420012 



References

1. Christensen K, Doblhammer G, Rau R, et al. Ageing populations: the challenges ahead. Lancet. 2009 Oct 3;374(9696):1196-208. doi: 10.1016/S0140-6736(09)61460-4.

2. Яхно НН, Захаров ВВ, Локшина АБ и др. Деменции: руководство для врачей. 3-е изд. Москва: МЕДпреcс-информ; 2011. 272 с. [Yakhno NN, Zakharov VV, Lokshina AB, et al. Dementsii: rukovodstvo dlya vrachei. [Dementia: a guide for physicians]. 3rd edition. Moscow: MEDprecs-inform; 2011. 272 p.]

3. Simpson JR. DSM-5 and Neurocognitive Disorders. J Am Acad Psychiatry Law. 2014; 42(2):159-64.

4. Diagnostic and statistical manual of mental dis￾eases. V ed. (DSM-V). London: American Psychiatric Association; 2013.

5. Santos C, Snyder P, Wu W, et al. Pathophysiologic relationship between Alzheimer's disease, cerebrovascular disease, and cardiovascular risk: A review and synthesis. Alzheimers Dement (Amst). 2017 Feb 9;7:69-87. doi: 10.1016/j.dadm. 2017.01.005. eCollection 2017.

6. Au R, Piers R, Lancashire L. Back to the future: Alzheimer’s disease heterogeneity revisited. Alzheimers Dement (Amst). 2015 Sep; 1(3):368-370.

7. Hersch E, Falzgraf S. Management of the behavioral and psychological symptoms of demen￾tia. Clin Interv Aging. 2007;2(4):611-21.

8. Emanuel J, Lopez O, Houck P, et al. Trajectory of cognitive decline as a predictor of psychosis in early Alzheimer disease in the cardiovascular health study. Am J Geriatr Psychiatry. 2011 Feb;19(2): 160-8. doi: 10.1097/JGP.0b013e3181e446c8.

9. Alzheimer A. Über einen eigenartigen schweren Er Krankungsprozeb der Hirnrinde. Neurologisches Centralblatt. 1906;(23):1129–36.

10. Neil W, Bowie P. Carer burden in dementiaassessing the impact of behavioural and psychologi￾cal symptoms via self-report questionnaire. Int J Geriatr Psychiatry. 2008 Jan;23(1):60-4.

11. Lyketsos C, Sheppard M, Steinberg M, et al. Neuropsychiatric disturbance in Alzheimer’s dis￾ease cluster into three groups: The Cache Countty Study. Int J Geriatr Psychiatry. 2001 Nov;16(11): 1043-53.

12. Lyketsos C, Lopez O, Jones B, et al. Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment, results from the cardio￾vascular health study. JAMA. 2002 Sep 25;288(12): 1475-83.

13. Tun S, Murman D, Long H, et al. Predictive validity of neuropsychiatric subgroups on nursing home placement and survival in patients with Alzheimer disease. Am J Geriatr Psychiatry. 2007 Apr;15(4):314-27.

14. Benoit M, Staccini P, Brocker P, et al. Behavioral and psychologic symptoms in Alzheimer’s disease: results of the REAL. FR study. Rev Med Interne. 2003 Oct;24 Suppl 3: 319s-324s.

15. Monastero R, Mangialasche F, Camarda C, et al. A systematic review of neuropsychiatric symptoms in mild cognitive impairment. J Alzheimers Dis. 2009;18(1):11-30. doi: 10.3233/JAD-2009-1120.

16. Lobo A, Lopez-Anton R, De-la-Camara C, et al. Non-Cognitive Psychopathological Symptoms Associated with Incident Mild Cognitive Impairment and Dementia, Alzheimer's Type. Neurotox Res. 2008 Oct; 14(2-3):263-72. doi: 10.1007/BF03033815.

17. Masters M, Morris J, Roe C. «Noncognitive» symptoms of early Alzheimer disease. A longitudi￾nal analysis. Neurology. 2015 Feb 10;84(6):617-22.

18. Rosenberg P, Mielke M, Appleby B, et al. Neuropsychiatric symptoms in MCI subtypes: the importance of executive dysfunction. Int J Geriatr Psychiatry. 2011 Apr;26(4):364-72. doi: 10.1002/gps.2535. Epub 2010 Sep 15.

19. Teng E, Lu P, Cummings J. Neuropsychiatric symptoms are associated with progression from mild cognitive impairment to Alzheimer's disease. Dement Geriatr Cogn Disord. 2007;24(4):253-9. Epub 2007 Aug 14.

20. Ismail Z, Nguyen M, Fischer C, et al. Neurobiology of delusions in Alzheimer’s disease. Curr Psychiatry Rep. 2011 Jun;13(3): 211-8. doi: 10.1007/s11920-011-0195-1.

21. Finkel S, Costa вe Silva J, Cohen G, et al. Behavioral and psychological signs and symptoms of dementia: a consensus statement on current knowledge and implications for research and treatment. Int Psychogeriatr. 1996;8 Suppl 3:497-500.

22. Pruszynski J. Non-cognitive symptoms of dementia. Postepy Nauk Medycznych. 2015;(7): 477-81.

23. Ford A. Neuropsychiatric symptoms of dementia: are pharmacological treatments effective and safe? J Neurol Neurosurg Psychiatry. 2015 Jan; 86(1):101-9. doi: 10.1136/ jnnp-2014-308112. Epub 2014 May 29.

24. Vega U, Marinho V, Engelhardt E, et al. Neuropsychiatric symptoms in dementias: preliminary report of a prospective outpatient evaluation in Brazil. Arq Neuropsiquiatr. 2007 Jun; 65(2B): 498-502.

25. Cerejeira J, Lagarto L, Mukaetova-Ladinska E. Behavioral and Psychological Symptoms of Dementia. Front Neurol. 2012 May 7;3:73. doi: 10.3389/fneur.2012.00073. eCollection 2012.

26. Lam L, Leung T, Lui V, et al. Association between cognitive function, behavioral syndromes and two-year clinical outcome in Chinese subjects with late-onset alzheimer’s disease. Int Psychogeriatr. 2006 Sep;18(3): 517-26. Epub 2006 Feb 8.

27. Lytetsos C, Lee H. Diagnosis and treatment of depression in Alzheimer’s disease: A practical update for the clinician. Dement Geriatr Cogn Disord. 2004;17(1-2):55-64. Epub 2003 Oct 15.

28. Prado-Jean A, Couratier P, Druet-Cabanac M, et al. Specific psychologicaland behavioral symptoms of depression in patients with dementia. Int J Geriatr Psychiatry. 2010 Oct;25(10):1065-72. doi: 10.1002/gps.2468.

29. Deutsch L, Rovner B. Agitation and other noncognitive abnormalities in Alzheimer’s disease. Psychiatr Clin North Am. 1991 Jun;14(2): 341-51.

30. Boyle P, Malloy P. Treating apathy in Alzheimer’s disease. Dement Geriatr Cogn Disord. 2004;17(1-2):91-9. Epub 2003 Oct 15.

31. Lobo A, Saz P, Marcos G, et al. The prevalence of dementia and depression in the elderly community in a Southern European population: the Zaragoza study. Arch Gen Psychiatry. 1995 Jun; 52(6):497-506.

32. Ganguli M, Du Y, Dodge H, et al. Depressive symptoms and cognitive decline in late life: a prospective epidemiological study. Arch Gen Psychiatry. 2006 Feb;63(2):153-60.

33. Reul J, Chandramohan Y. Epigenetic mecha￾nisms in stress-related memory formation. Psychoneuroendocrinology. 2007 Aug;32 Suppl 1:S21-5. Epub 2007 Jul 17.

34. Korczyn AD, Halperin I. Depression and dementia. J Neurol Sci. 2009 Aug 15;283(1-2):139- 42. doi: 10.1016/j.jns.2009.02.346. Epub 2009 Apr 5.

35. Wilson R, Barnes L, Mendes de Leon C, et al. Depressive symptoms, cognitive decline, and risk of AD in older persons. Neurology. 2002 Aug 13;59(3):364-70.

36. Kar N. Behavioral and psychological symptoms of dementia and their management. Indian J Psychiatry. 2009;51(1):77–86.

37. Jeste D, Finkel S. Psychosis of Alzheimer’s disease and related dementias: Diagnostic criteria for a distinct syndrome. Am J Geriatr Psychiatry. 2000 Winter;8(1):29-34.

38. Cohen-Mansfield J, Billing N. Agitated behaviors in the elderly: A concep-tual reviev. J Am Geriatr Soc. 1986 Oct;34(10):711-21.

39. Cohen-Mansfield J, Marx M, Dakheel-Ali M, et al. Can agitated behavior of nursing home residents with dementia be prevented with the use of standardized stimuli? J Am Geriatr Soc. 2010 Aug;58(8):1459-64. doi: 10.1111/j.1532-5415.2010. 02951.x. Epub 2010 Jun 23.

40. Rozzini L, Chilovi V, Conti M, et al. Neuropsychiatric symptoms in amnestic and non￾amnestic mild cognitive impairment. Dement Geriatr Cogn Disord. 2008;25(1):32-6. Epub 2007 Nov 19.

41. Lishman W. Organic Psychiatry: The Psychological Consequences of Cerebral Disorder. Oxford: Blackwell Scientific Publication; 1987. 745 p.

42. Cummings JL. The neuropsychiatric inventory: assessing psychopathology in dementia patients. Neurology. 1997 May;48(5 Suppl 6):S10-6.

43. Anor C, O'Connor S, Saund A, et al. Neuropsychiatric Symptoms in Alzheimer Disease, Vascular Dementia, and Mixed Dementia. Neurodegener Dis. 2017 Mar 1;17(4-5):127-134. doi: 10.1159/000455127. [Epub ahead of print].

44. Staekenborg S, Su T, van Straaten E, et al. Behavioural and psychological symptoms in vascular dementia; differences between small- and large￾vessel disease. J Neurol Neurosurg Psychiatry. 2010 May;81(5):547-51. doi: 10.1136/jnnp.2009.187500. Epub 2009 Dec 3.

45. Aalten P, de Vugt M, Jaspers N, et al. The course of neuropsychiatric symptoms in dementia. Part II: relationships among behavioural sub-syndromes and the influence of clinical variables. Int J Geriatr Psychiatry. 2005 Jun;20(6):531-6.

46. Devanand D, Jacobs D, Tang M, et al. The course of psychopathologic features in mild to moderate Alzheimer disease. Arch Gen Psychiatry. 1997 Mar;54(3):257-63.

47. Alexopoulos G. Depression in the elderly. Lancet. 2005 Jun 4-10;365(9475):1961-70.

48. Casanova M, Starkstein S, Jellinger K. Clinicopathological correlates of behavioral and psychological symptoms of dementia. Acta Neuropathol. 2011 Aug;122(2):117-35. doi: 10.1007/s00401-011-0821-3. Epub 2011 Apr 1.

49. O'Brien J, Holmes C, Jones M, et al. Clinical practice with anti-dementia drugs: A revised (third) consensus statement from the British Association for Psychopharmacology. J Psychopharmacol. 2017 Feb;31(2):147-168. doi: 10.1177/0269881116680924. Epub 2017 Jan 20.

50. Гаврилова СИ. Мемантин в лечении болезни Альцгеймера: 20 лет клинического применения. Журнал неврологии и психиатрии им. С.С. Корсакова. 2016;116(6):10-8. [Gavrilova SI. Memantine in treatment of Alzheimer's disease: 20 years of clinical use. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2016;116(6):10-8. (In Russ.)].

51. McShane R, AreosaSastre A, Minakaran N. Memantine for dementia. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD003154.

52. Deardorff W, Grossberg G. Pharmacotherapeutic strategies in the treatment of severe Alzheimer's disease. Expert Opin Pharmacother. 2016 Sep;17(13):1789-800. doi: 10.1080/14656566. 2016.1215431. Epub 2016 Jul 29.

53. Yabuki Y, Matsuo K, Hirano K, et al. Combined Memantine and Donepezil Treatment Improves Behavioral and Psychological Symptoms of Dementia-Like Behaviors in Olfactory Bulbectomized Mice. Pharmacology. 2017;99(3-4): 160-171. doi: 10.1159/000452839. Epub 2017 Jan 4.

54. Haussmann R, Donix M. Memantine as addon medication to acetylcholinesterase inhibitor therapy for Alzheimer dementia. Nervenarzt. 2017 Jan;88(1):40-45. doi: 10.1007/s00115-016-0237-3.

55. Desmidt T, Hommet C, Camus V. Pharmacological treatments of behavioral and psychological symptoms of dementia in Alzheimer's disease: role of acetylcholinesterase inhibitors and memantine. Geriatr Psychol Neuropsychiatr Vieil. 2016 Sep 1;14(3):300-6. doi: 10.1684/pnv.2016.0621.

56. Cumbo E, Ligori LD. Differential Effects of Сurrеnt Specific Treatments on Behavioral and Psychological Symptoms in Patients with Alzheimer's Disease: АI2-month, randomized, open-label trial. JоumаI of Alzheimer's Disease. 2014;39:417-85.

57. Li P, Quan W, Zhou Y. et al. Efficacy of memantine on neuropsychiatric symptoms associated with the severity of behavioral variant frontotemporal dementia: A six-month, open-label, self-controlled clinical trial. Exp Ther Med. 2016 Jul;12(1):492-498. Epub 2016 Apr 20.

58. Gauthier S, Cummings J, Ballard C, et al. Management of behavioral problems in Alzheimer’s disease. Int Psychogeriatr. 2010 May; 22(3):346-72. doi: 10.1017/S1041610209991505. Epub 2010 Jan 25.

59. Wang J, Yu J, Wang H, et al. Pharmacological treatment of neuropsychiatric symptoms in Alzheimer's disease: a systematic review and metaanalysis. J Neurol Neurosurg Psychiatry. 2015 Jan; 86(1):101-9. doi: 10.1136/jnnp-2014-308112. Epub 2014 May 29.

60. Miller LJ. The use of cognitive enhancers in behavioral disturbances of Alzheimer’s disease. Consult Pharm. 2007 Sep;22(9):754-62.


Review

For citations:


Mendelevich E.G. Cognitive and non-cognitive neuropsychiatric disorders in dementia and methods of their correction. Neurology, Neuropsychiatry, Psychosomatics. 2017;9(2):65-70. (In Russ.) https://doi.org/10.14412/2074-2711-2017-2-65-70

Views: 1173


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)