Behavioral symptoms in alzheimer's patients and its relationship with clinical findings

Alzheimer's Disease (AD) is one of the leading causes of dementia in elderly population. Behavioral symptoms are as important as cognitive symptoms in demantia patients because they negatively affect the quality of life of patients and their relatives. In this study, behavioral symptoms in AD, especially agitation as the most frequent and troublesome behavioral symptom, were examined in detail. Thirty diagnosed AD patients, according to DSM-IV and NINCDS-DRDA, and 24 cognitively healthy individual were included to the study. In patient group, Mini-Mental State Examination MMSE, Neuropsychiatric Inventory (NPI), Cohen - Mansfield Agitation Inventory (CMAI), Clinical Dementia Rating Scale (CDR) and Functional Activities Questionnarie (FAQ) were performed. Both in control and patient group, electroencephalography (EEG) and metabolic parameters as haemoglobin (Hb), thyroid function tests (TFT), vitamin B12, folic acid (FA), ferritin, urea, creatinine, sodium (Na), potassium (K) and were evaluated. According to NPI, apathy was found to be the most frequent behavioral symptom, followed by agitation. According to NPI and CMAI, patients were divided into 2 groups as high and low level of agitation group, and these groups were compared. According to NPI agitation subscale and CMAI, the group which had high level of agitation were found to be more advenced stage according to CDR. Furthermore, the group which had high level of agitation according to both agitation rating scales, were found to have lower levels of haemoglobin. There were no significant differences on EEG findings between patient and control groups and high agitation and low agitation groups. As a result, behavioral symptoms were found to be seen more and more as the disease progresses and agitation, which has a negative effect on patients and their caregivers, was found to be related with metabolic disorders such as low hemoglobin levels. It is recommended to control these parameters in patients with agitation.