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Agitation/aggression and Irritability/lability in Alzheimer's Disease: A study using Neuropsychiatric Inventory(NPI) Chihiro HONMA 1 , Takuya SATO 2 , Toru IMAMURA 1,3 1Department of Speech Therapy, School of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan 2Division of Speech Therapy, Department of Rehabilitation, Niigata Rehabilitation Hospital 3Department of Neurology, Niigata Rehabilitation Hospital Keyword: Neuropsychiatric Inventory(NPI) , Agitation/aggression , Irritability/lability , Alzheimer's disease , ApoE4 pp.661-669
Published Date 2017/7/15
DOI https://doi.org/10.11477/mf.1405205423
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 Objective:To investigate the factors that relate to the presence of agitation/aggression and irritability/lability assessed on the Neuropsychiatric Inventory(NPI)in patients with Alzheimer's disease(AD). Subjects:442 patients who had a diagnosis of AD and whose reliable informants underwent the NPI at the first visit of our hospital. Methods:We examined all subjects on digit spans, the Mini-Mental State Examination(MMSE), and Alzheimer's Disease Assessment Scale(ADAS). In some subjects, we assessed their overall dementia severity on the Clinical Dementia Rating(CDR), and determined their apolipoprotein E(ApoE)phenotypes. We evaluated the relationships between various characteristics of subjects and the presence of agitation and irritability assessed on the NPI. Results:Subjects with agitation had significantly higher CDR severity, a higher ratio of men, and higher frequencies of delusions, anxiety, elation/euphoria, disinhibition, and irritability/lability. Subjects with irritability had significantly higher educational attainment, a longer duration of disease, a higher rate of patients with ApoE4, and higher frequencies of delusions, agitation/aggression, depression/dysphoria, anxiety, apathy/indifference, and disinhibition. Discussion:In subjects with agitation, the higher ratio of men may be attributed to the psychosocial factor that elderly men are not accustomed to being directed or led. In subjects with irritability, higher educational attainment may be related to the tendency that patients with a higher premorbid level of intelligence feel more struggle over their disability. The higher frequency of ApoE4 in subjects with irritability indicates the possibility that there are some biological factors related to the occurrence of irritability.


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電子版ISSN 1882-126X 印刷版ISSN 0488-1281 医学書院

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