Objectives-To investigate affective change in Alzheimer's disease and ischa
emic vascular disease and examine the contribution of white matter disease
to psychopathology in these dementias. Based on earlier studies, it was pre
dicted that: (1) depression would be more prevalent and severe in ischaemic
vascular disease; (2) psychomotor slowing would be more prevalent in ischa
emic vascular disease; (3) apathy would be more prevalent in ischaemic vasc
ular disease; and (4) The degree of white matter disease would be positivel
y correlated with the severity of psychomotor slowing.
Methods-Ratings of affective/behavioural states and white matter disease we
re compared in 256 patients with Alzheimer's disease and 36 patients with i
schaemic vascular disease or mixed dementia with an ischaemic vascular comp
onent using analysis of variance (ANOVA) and linear regression models.
Results-The findings were: (1) decreased affect/withdrawal was more prevale
nt and severe in patients with ischaemic vascular disease and patients with
white matter disease; (2) psychomotor slowing was more severe in patients
with ischaemic vascular disease and patients with white matter disease; and
(3) differences between Alzheimer's disease and ischaemic vascular dementi
a groups in the degree of psychomotor slowing were independent of the sever
ity of white matter disease.
Conclusions-Future studies using structural and functional neuroimaging tec
hniques would be helpful for examining the relation between neurobiological
factors and affective/behavioural disturbances in dementia.