Clinical Characteristics of Behavioral and Psychological Symptoms in Patients with Drug-naïve Alzheimer’s Disease

Department of Neurology, Hyoja Geriatric Hospital, Yongin; Department of Neurology*, Seoul Veterans Hospital, Seoul; Seoul National University College of Medicine†, Seoul, Korea Background: Behavioral and psychological symptoms of dementia (BPSD) are less well-defined aspects of Alzheimer’s disease (AD). We designed this study to explore the followings: 1) the clinical profiles of BPSD 2) the clustered-groups domains of the Korean-Neuropsychiatric Inventory (K-NPI) assessment of BPSD 3) the clinical characteristics of the clustered-groups of BPSD in patients with drug-naïve probable AD. Methods: Descriptive and cluster analyses of the 12 K-NPI domains were done in 220 patients with drug-naïve probable AD. After clustering these domains, characteristics of these positive symptoms clustered-group of patients were compared with the negative symptoms groups of patients. Results: The mean Korean-Mini Mental Status Examination (K-MMSE), Clinical Dementia Rating (CDR) scale, and K-NPI scores were 15.0, 1.6, and 14.2, respectively. The CDR and K-MMSE scores correlated with total KNPI scores, and depression was the most common symptom. According to cluster analysis, five major clusters were identified. Using the associated neuropsychological dysfunctions, characteristics of each group were defined. Conclusions: This study identified the clustered-domains for K-NPI, and suggested the possible anatomical substrates for these groups in drug-naïve AD patients. These attempts may clarify the complex and bizarre behavioral and psychological symptoms as more neurologically relevant symptoms. Received: May 2, 2012 Revision received: September 14, 2012 Accepted: September 14, 2012