Behavioral differences between white matter lacunar dementia and Alzheimer's disease: A comparison on the neuropsychiatric inventory

Background and Purpose: Behavioral abnormalities account for much of the mo rbidity of vascular dementia (VaD) and Alzheimer's disease (AD). The goals of the study were to compare the behavioral changes in patients with VaD as sociated with ischemic white matter subcortical changes and lacunar infarct ions (VaD-WSI) to those in patients with AD. Methods: Thirty outpatients wi th VaD and multiple lacunar infarctions in the periventricular white matter and 30 AD patients, matched for age and severity of dementia, were enrolle d in this prospective study. The behavioral abnormalities of these patients were assessed by interviewing their caregivers with the Neuropsychiatric I nventory. Results: A similar spectrum of noncognitive behavioral changes wa s found in AD and WSI patients. In VaD-WSI, the severity of delusions, hall ucinations, aggression, irritability, aberrant motor behavior, nighttime be havior and appetite changes was correlated with cognitive decline, whereas depression, apathy, anxiety and euphoria were unrelated to the severity of dementia. In AD, none of the behavioral changes correlated with the severit y of dementia. Conclusion: Behavioral changes are frequent in VaD-WSI and a re present regardless of the severity of the cognitive decline. It is there fore important to assess behavioral as well as cognitive changes at early s tages of the illness, to ensure appropriate treatment. Copyright (C) 2000 S . Karger AG, Basel.