First episodes of behavioral symptoms in Alzheimer's disease patients at age 90 and over, and early‐onset Alzheimer's disease: Comparison with senile dementia of Alzheimer's type

• Published in: Psychiatry and clinical neurosciences 2005-12, Vol.59 (6), p.730-735
• Main Authors: HORI, KOJI, ODA, TATSURO, ASAOKA, TOSHIYASU, YOSHIDA, MASAHIRO, WATANABE, SHOICHI, OYAMADA, REIKO, TOMINAGA, ITARU, INADA, TOSHIYA
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Age of Onset; Aged; Aged, 80 and over - psychology; Alzheimer Disease - psychology; Alzheimer's disease; Behavior; behavioral and psychological symptoms of dementia; Biological and medical sciences; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia; Early onset; Elderly people; Female; Humans; Male; Medical sciences; Memory - physiology; Middle Aged; Neurology; nonagenarian; oldest old; Organic mental disorders. Neuropsychology; Orientation; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Scales; Symptoms; Wakefulness - physiology
• ISSN: 1323-1316; 1440-1819
• DOI: 10.1111/j.1440-1819.2005.01444.x

We evaluated dementia symptoms to clarify the character of dementia with Alzheimer's disease (AD) observed in the oldest old patients and that of dementia with early‐onset AD. Subjects were consecutive AD inpatients admitted for the first time at age of 90 years and over because of behavioral symptoms (demented nonagenarian group: D90G; n = 18) and those with 24 consecutive inpatients with AD with early‐onset (EOG). The Gottfries, Brane and Steen's scale and the Dementia Behavior Disturbance scale were used to evaluate the symptoms and troublesome behaviors. The scores of these scales in D90G and in EOG were compared with those of 26 sex distribution‐, severity of dementia‐, and disease duration‐matched inpatients with AD with late‐onset (LOG). Compared with LOG, wakefulness was more impaired and waking up at night was more frequent in D90G, while memory, orientation and inappropriate behaviors were more severe in EOG. These results suggest that the clinical features of dementia in EOG were quantitatively different from those of LOG. In contrast, the clinical feature of dementia of D90G were sleep–wake pattern disturbance and were qualitatively different from those of LOG.