APOE-RELATED FREQUENCY OF COGNITIVE AND NONCOGNITIVE SYMPTOMS IN DEMENTIA

Although memory disorders and the aphaso-apraxo-agnosic syndrome are t he most relevant clinical symptoms in dementia, behavioral changes, mo od-related disturbances and sleep disorders are the major cause of ins titutionalization and caregiver concern. In the present study we have investigated the frequency and progression of cognitive and noncogniti ve symptoms in Alzheimer's disease (AD) as well as the APOE-related fr equency of clinical symptoms in dementia. Memory decline (100%), aphas ia (94%), apraxia (99%), agnosia (94%) and motor dysfunction (90%) app eared in practically all cases with mild (GDS-3), moderate (GDS 3-4) a nd seven (GDS 6-7) dementia. The most frequent noncognitive symptoms i nclude anxiety (76%), depression (68%), behavioral changes (67%), psyc hotic symptoms (43%), sleep disorders (43%), incontinence (23%) and ce rebrovascular symptoms (75%). Anxiety, depression, behavioral changes, psychotic symptoms, motor dysfunction and cognitive deterioration par alleled the severity of dementia, increasing their frequency from mild to severe dementia. The most important sleep disorders were irregular sleep-wake pattern (67%) and insomnia (47%). Disorientation (90%) and drug administration (88%) appeared to be the most important factors i n causing sleep disorders in dementia. Disorientation, agitation and m otor disorders were slightly more frequent in patients with APOE-4/4, while anxiety and sleep disorders appeared more frequently in APOE-3/4 . Behavioral changes and psychotic symptoms did not show any clear ass ociation with specific APOE subtypes. In conclusion, our results sugge st that noncognitive symptoms are very important clinical events in th e disease progression and in decision making for therapeutic intervent ion and institutionalization. Furthermore, it is likely that some brai n dysfunctions leading to particular clinical symptoms might be associ ated with specific AD genotypes.