Behavioral and Psychological Symptoms of Dementia in Alzheimer's Dementia: The Neuroimaging Correlates
Isha Ahluwalia, G Prasad Rao, P Chytanya Deepak, Monisha Reddy
Alzheimer's dementia, Behavioral and psychological symptoms of dementia, Neuroimaging
Citation Information :
Ahluwalia I, Rao GP, Deepak PC, Reddy M. Behavioral and Psychological Symptoms of Dementia in Alzheimer's Dementia: The Neuroimaging Correlates. Ind J Priv Psychiatry 2019; 13 (2):48-51.
Background: Behavioral and psychological symptoms of dementia (BPSD) is defined as “symptoms of disturbed perception, thought content, mood or behavior that frequently occur in patients with dementia.” Behavioral and psychological symptoms of dementia is associated with significant caregiver burden, early institutionalization, and rapid cognitive decline. The worldwide prevalence of dementia is 5–7%; whereas in India, it is reported to be 0.8–4%. Alzheimer's dementia amounts to 60% of the total prevalence of dementia. We aim to study the neuroimaging correlates of BPSD in Alzheimer's dementia.
Objective: To study the correlation between BPSD with white matter changes on neuroimaging in Alzheimer's dementia.
Materials and methods: It is a cross-sectional study with a sample size of 30 patients. The magnetic resonance imaging (MRI) changes were seen using volumetric analysis and white matter hyperintensity change using Fazekas scale, global cortical atrophy (GCA) score, medial temporal atrophy (MTA) score, and KOEDAM scale.
Results: It was found that clinical dementia rating (CDR) scale has positive correlation with Fazekas, GCA, and KOEDAM. Addenbrooke's cognitive examination (ACE-3) has correlation with GCA. On neuropsychiatric inventory (NPI) questionnaire, depression followed by nighttime behavior were the most common BPSD symptoms. Sociodemographic factors such as age >65 years, middle socioeconomic status (SES) population, and urban population have higher mean neuropsychiatric inventory-frequency and severity (NPI-F*S) scores.
Conclusion: Our study here in concordance with other studies worldwide gives a clue about the role of neuroimaging biomarkers in understanding BPSD in terms of its neuroimaging correlates and builds the scope of future studies in this domain. The study sheds light on the common presentation of BPSD, which adds to our knowledge in clinical assessment of Alzheimer's disease (AD) patients. Finally, it also adds to our understanding of the role of sociodemographic factors in predicting the at risk population.
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