Emotional distress and disruptive behaviors were assessed for 26 persons with Alzheimer's disease (AD) at admission to a research registry and again three years later. Average prevalence of disruptive behaviors increased, as did the variability among patients in these characteristics. Individual differences in disruptive symptoms at initial assessment were unrelated to symptom status three years later. Emotional symptoms decreased on average and the patient group became more homogeneous in this symptom dimension. Nonetheless, individual differences in prevalence showed significant stability over three years. These differences in pattern of average change and predictability of changes suggest the importance of studying behavioral change in Alzheimer's disease in terms of individual differences as well as group trends within specific symptom clusters.
References
1.
Teri L , Wagner A: Alzheimer's disease and depression. Journal of Consulting and Clinical Psychology. 1992; 60: 379-391.
2.
Gilley D : Behavioral and affective disturbances in Alzheimer's disease. In RW Parks, RF Zec, RF Wilson, (Eds.), Neuropsychology of Alzheimer's disease and other dementias. New York: Oxford University Press, 1993: 112-137.
3.
Bolger J , Carpenter B, Strauss M: Behavior and affect in Alzheimer's disease. Clinics in Geriatric Medicine. 1994; 10: 315-337.
4.
Patterson M , Mack J, Mackell J, et al: A longitudinal study of behavioral pathology across five levels of dementia severity in Alzheimer's disease: The CERAD behavior rating scale for dementia. Alzheimer Disease and Associated Disorders. 1997; 11: S40-S44.
5.
Levy M , Cummings J, Fairbanks L, et al: Longitudinal assessment of symptoms of depression, agitation, and psychosis in 181 patients with Alzheimer's disease. American Journal of Psychiatry. 1996; 153: 1438-1443.
6.
Devanand D , Jacobs D, Tang M, et al: The course of psychopathologic features in mild to moderate Alzheimer disease. Archives of General Psychiatry. 1997; 54: 257-263.
7.
Marin D , Green C, Schmeidler J, et al: Noncognitive disturbances in Alzheimer's disease: Frequency, longitudinal course, and relationship to cognitive symptoms. Journal of the American Geriatrics Society. 1997; 45: 1331-1338.
8.
Rubin E , Morris J, Berg L: The progression of personality changes in senile dementia of the Alzheimer's type. Journal of the American Geriatrics Society. 1987; 35: 721-725.
9.
Martinson I , Muwaswes M, Gilliss C, et al: The frequency and troublesomeness of symptoms associated with Alzheimer's disease. Journal of Community Health Nursing. 1995; 12: 47-57.
10.
Wagner A , Teri L, Orr-Rainey N: Behavioral problems among dementia residents in special care units change over time. Journal of the American Geriatrics Society. 1995; 43: 784-787.
11.
Rosen W , Mohs R, Davis K: Longitudinal changes: Cognitive, behavioral, and affective patterns in Alzheimer's disease. In LW Poon, T Crook, et al(Eds.), Handbook of clinical memory assessment of older adults. Washington DC: American Psychological Association,1986: 294-301.
12.
Rosen W , Mohs R, Davis, K: A new rating scale for Alzheimer's disease. American Journal of Psychiatry. 1984; 141: 1356-1364.
13.
Weiner M , Koss E, Patterson M, et al: A comparison of the Cohen-Mansfield agitation inventory with the CERAD behavioral rating scale for dementia in community-dwelling persons with Alzheimer's disease. Journal of Psychiatric Research. 1998; 32: 347-351.
14.
Koss E , Weiner M, Ernesto C, et al: Assessing patterns of agitation in Alzheimer's disease patients with the Cohen-Mansfield Agitation Inventory. Alzheimer Disease and Associated Disorders. 1997; 11(Supp2): S45-S50.
15.
Weyer G , Erzigkeit H, Kanowski S, et al: Alzheimer's disease assessment scale: Reliability and validity in a multicenter clinical trial. International Psychogeriatrics. 1997; 9: 123-138.
16.
Cummings J , Mega M, Gray K, et al: The neuropsychiatric inventory: Comprehensive assessment of psychopathology in dementia. Neurology. 1994; 44: 2308-2314.
17.
Logsdon R , Teri L, Weiner M, et al: The agitated behavior in dementia scale. Journal of the American Geriatrics Society. 1999; 47: 1354-1358.
18.
Anastasi A : Psychological Testing, Sixth Edition. Upper Saddle River, NJ: Simon & Schuster, 1997.
19.
Patterson M , Schnell A, Martin R, et al: Assessment of behavioral and affective symptoms in Alzheimer's disease. Journal of Geriatric Psychiatry and Neurology. 1990; 3: 21-30.
20.
Folstein M , Folstein S, McHugh P: Mini Mental State. Journal of Psychiatric Research. 1975; 12: 189-198.
21.
Hughes C , Berg L, Danziger W, et al: A new clinical scale for the staging of dementia. British Journal of Psychiatry. 1982; 140: 566-572.
22.
Blessed G , Tomlison B, Roth M: The association between quantitative measures of dementia and of senile change in the cerebral gray matter of elderly subjects. British Journal of Psychiatry. 1968; 114: 797-811.
23.
Alexopoulous G , Abrams R, Young R, Shamoian C: Cornell scale for depression in dementia. Biological Psychiatry. 1988; 23: 271-284.
24.
Reisberg B , Borenstein J, Salob S, et al: Behavioral symptoms in Alzheimer's disease: Phenomenology and treatment. Journal of Clinical Psychiatry. 1987; 48 (Suppl 5): 9-15.
25.
Chatterjee A , Strauss M, Smyth K, Whitehouse P: Personality change in Alzheimer's disease. Archives of Neurology. 1992; 49: 486-491.
26.
Malloy P , Richardson E: Assessment of frontal lobe functions. Journal of Neuropsychiatry and Clinical Neurosciences. 1994; 6: 399-410.
