ABSTRACT
UNLABELLED: Behavioral and psychological symptoms in dementia (BPSD) are very common, with 90% of patients experiencing at least one during the course of the disease. One-third of persons with dementia have depressive symptoms, and concomitant BPSD are very likely. OBJECTIVE: This study aimed to characterize the psychological and behavioral manifestations of depression in patients with dementia. METHODS: We recruited patients with dementia from several nursing homes in the Limousin region of France. Depression was as diagnosed by the Cornell Scale for Depression in Dementia (CSDD) with a cut-off of 7, and BPSD were assessed using the Neuropsychiatric Inventory (NPI). RESULTS: Of 319 patients with dementia, 42.9% (n =137) were depressed and 75.9% (n = 242) had BPSD. All BPSD were significantly (p < 0.0001) more prevalent among depressed patients, but no significant differences were observed according to sex and age. The NPI showed that the most common additional symptoms in depressed patients were agitation (43.2%), anxiety (42.3%) and irritability (40.1%). Four NPI-based factors were indentified (63.9% of the common variance): factor 1 (disinhibition, irritability, agitation, anxiety), factor 2 (sleep disturbance, aberrant motor behavior, apathy), factor 3 (elation, hallucination, delirium) and the last with eating disorders. Depression in dementia patients was significantly associated with disinhibition, irritability, agitation, and anxiety. CONCLUSION: BPSD are common and a major problem. Before addressing them as isolated symptoms, it is important to consider comorbidity with depression in order to optimize the therapeutic approach.
Subject(s)
Behavioral Symptoms/epidemiology , Dementia/psychology , Depressive Disorder/psychology , Mental Disorders/epidemiology , Aged , Aged, 80 and over , Behavioral Symptoms/diagnosis , Female , France/epidemiology , Humans , Male , Mental Disorders/diagnosis , Neuropsychological Tests , Nursing Homes , Psychiatric Status Rating ScalesABSTRACT
Two patients presenting with predominantly dorsal posterior cortical atrophy were evaluated using the Visual Object and Space Perception (VOSP) test. The objective was to determine whether the VOSP was useful to discriminate damage to the ventral and the dorsal visual pathways. Both patients failed almost all the VOSP subtests, and the battery did not permit confirmation of the integrity of the ventral pathway. In addition, certain subtests evaluating dorsal function were nearly completed, probably due to a compensation strategy. Thus, evaluation using VOSP does not discriminate between predominantly ventral and predominantly dorsal clinical forms of posterior cortical atrophy.
