THE SPECTRUM OF BEHAVIORAL-CHANGES IN ALZHEIMERS-DISEASE

We investigated the range of behavioral abnormalities in patients with Alzheimer's disease (AD) compared with normal age-matched control sub jects. The range of behavioral disturbances manifested and the relatio nship between specific abnormalities with the level of cognitive impai rment have not been established. Fifty consecutive outpatients with mi ld (n = 17), moderate (n = 20), and severe (n = 13) AD and 40 age-matc hed nor mal controls were evaluated for behavioral abnormalities occur ring in the month preceding the interview. The caregivers of the patie nts and the spouses of the control subjects were interviewed with the Neuropsychiatric Inventory (NPI). The frequency and severity of the fo llowing 10 behaviors were assessed: delusions, hallucinations, agitati on, dysphoria, anxiety, euphoria, apathy, disinhibition, irritability, and aberrant motor behavior. Correlations among these 10 behaviors an d their relationship with cognitive impairment were also investigated. Eighty-eight percent of AD patients had measurable behavioral changes . All 10 behaviors were significantly increased in the AD patients com pared with normal subjects. The most common behavior was apathy, which was exhibited by 72% of patients, followed by agitation (60%), anxiet y (48%), irritability (42%), dysphoria and aberrant motor behavior (bo th 38%), disinhibition (36%), delusions (22%), and hallucinations (10% ). Agitation, dysphoria, apathy, and aberrant motor behavior were sign ificantly correlated with cognitive impairment.