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Neuropsychiatric symptoms in patients with Parkinson's disease and dementia: frequency, profile and associated care giver stress.
J Neurol Neurosurg Psychiatry. 2007 Jan; 78(1):36-42.JN

Abstract

OBJECTIVE

To explore the profile of neuropsychiatric symptoms in patients with dementia associated with Parkinson's disease (PDD).

METHODS

537 patients with PDD drawn from an international multicentre clinical trial of rivastigmine were assessed using the 10-item Neuropsychiatric Inventory (NPI). A cluster analysis was used to investigate the inter-relationship of NPI items. Associations between the clusters and demographic and clinical variables were analysed.

RESULTS

89% of the patients presented at least one symptom on the NPI, 77% had two or more symptoms and 64% had at least one symptom with a score > or = 4. The most common symptoms were depression (58%), apathy (54%), anxiety (49%) and hallucinations (44%). Patients with more severe dementia and advanced Parkinson's disease had more neuropsychiatric symptoms. Nearly 60% of the care givers reported at least one NPI symptom to be of at least moderate severe distress. Five NPI clusters were identified: one group with few and mild symptoms (52%); a mood cluster (11%, high scores on depression, anxiety and apathy); apathy (24%; high apathy and low scores on other items); agitation (5%, high score on agitation and high total NPI score); and a psychosis cluster (8%; high scores on delusions and hallucinations). The psychosis and agitation clusters had the lowest Mini-Mental State Examination score and the highest Unified Parkinson's Disease Rating Scale and care giver distress scores.

CONCLUSION

Neuropsychiatric symptoms are common in patients with PDD. The profile of these symptoms differs from that in other types of dementia. Subgroups with different neuropsychiatric profiles were identified. These subgroups may be associated with distinct neurobiological changes, which should be explored in future studies.

Authors+Show Affiliations

Centre for Clinical Neuroscience Research, Stavanger University Hospital, Stavanger, Norway. daa@sir.noNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16820421

Citation

Aarsland, D, et al. "Neuropsychiatric Symptoms in Patients With Parkinson's Disease and Dementia: Frequency, Profile and Associated Care Giver Stress." Journal of Neurology, Neurosurgery, and Psychiatry, vol. 78, no. 1, 2007, pp. 36-42.
Aarsland D, Brønnick K, Ehrt U, et al. Neuropsychiatric symptoms in patients with Parkinson's disease and dementia: frequency, profile and associated care giver stress. J Neurol Neurosurg Psychiatry. 2007;78(1):36-42.
Aarsland, D., Brønnick, K., Ehrt, U., De Deyn, P. P., Tekin, S., Emre, M., & Cummings, J. L. (2007). Neuropsychiatric symptoms in patients with Parkinson's disease and dementia: frequency, profile and associated care giver stress. Journal of Neurology, Neurosurgery, and Psychiatry, 78(1), 36-42.
Aarsland D, et al. Neuropsychiatric Symptoms in Patients With Parkinson's Disease and Dementia: Frequency, Profile and Associated Care Giver Stress. J Neurol Neurosurg Psychiatry. 2007;78(1):36-42. PubMed PMID: 16820421.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neuropsychiatric symptoms in patients with Parkinson's disease and dementia: frequency, profile and associated care giver stress. AU - Aarsland,D, AU - Brønnick,K, AU - Ehrt,U, AU - De Deyn,P P, AU - Tekin,S, AU - Emre,M, AU - Cummings,J L, Y1 - 2006/07/04/ PY - 2006/7/6/pubmed PY - 2006/12/21/medline PY - 2006/7/6/entrez SP - 36 EP - 42 JF - Journal of neurology, neurosurgery, and psychiatry JO - J Neurol Neurosurg Psychiatry VL - 78 IS - 1 N2 - OBJECTIVE: To explore the profile of neuropsychiatric symptoms in patients with dementia associated with Parkinson's disease (PDD). METHODS: 537 patients with PDD drawn from an international multicentre clinical trial of rivastigmine were assessed using the 10-item Neuropsychiatric Inventory (NPI). A cluster analysis was used to investigate the inter-relationship of NPI items. Associations between the clusters and demographic and clinical variables were analysed. RESULTS: 89% of the patients presented at least one symptom on the NPI, 77% had two or more symptoms and 64% had at least one symptom with a score > or = 4. The most common symptoms were depression (58%), apathy (54%), anxiety (49%) and hallucinations (44%). Patients with more severe dementia and advanced Parkinson's disease had more neuropsychiatric symptoms. Nearly 60% of the care givers reported at least one NPI symptom to be of at least moderate severe distress. Five NPI clusters were identified: one group with few and mild symptoms (52%); a mood cluster (11%, high scores on depression, anxiety and apathy); apathy (24%; high apathy and low scores on other items); agitation (5%, high score on agitation and high total NPI score); and a psychosis cluster (8%; high scores on delusions and hallucinations). The psychosis and agitation clusters had the lowest Mini-Mental State Examination score and the highest Unified Parkinson's Disease Rating Scale and care giver distress scores. CONCLUSION: Neuropsychiatric symptoms are common in patients with PDD. The profile of these symptoms differs from that in other types of dementia. Subgroups with different neuropsychiatric profiles were identified. These subgroups may be associated with distinct neurobiological changes, which should be explored in future studies. SN - 1468-330X UR - https://www.unboundmedicine.com/medline/citation/16820421/Neuropsychiatric_symptoms_in_patients_with_Parkinson's_disease_and_dementia:_frequency_profile_and_associated_care_giver_stress_ L2 - https://jnnp.bmj.com/lookup/pmidlookup?view=long&pmid=16820421 DB - PRIME DP - Unbound Medicine ER -