[The psychopathological symptoms of the preclinical stages of Alzheimer's disease]

Abstract

The aim of the undertaken studies based on many years' observation of the group of elderly people was to describe psychopoathological pictures typical of preclinical phase of Alzheimer disease (AD) as well as the changes in social functioning. The obtained data were to serve to work out the criteria making initial recognition of preclinical phase of AD possible. Estimation of direct degree--in the perspective of next few years--of the danger of dementia of Alzheimer type should simplify making a decision about including therapeutic activities. 204 persons have completed the five-year-observation (70% of the qualified). During the observation AD has developed at 19 persons, five of the examined at the beginning of the observation were described as "no disturbances of cognitive functions"--I according to the GDS scale and 14 were qualified as "slight impairment of cognitive functions"--GDS II. The basis for further conclusions was the comparison of the results obtained in the groups of people at whom, during the five-year-observation, in the examination with the GDS scale, no changes regarding cognitive functions have been observed, with those examined in whom dementia has been recognised. Statistic analysis has been done mostly for the results obtained before the appearance of the dementia. The conducted studies made it possible to verify the stated hypotheses and draw the following conclusions: preclinical period of AD is connected with intensification of psychopathological disturbances, especially depression; in the period preceding the development of AD usually slight disturbances of cognitive functions appear which are most often revealed during the particular examination of cognitive functions; clear decrease in social activity is typical of the preclinical phase of AD; people in premorbid period showed various disturbances but no symptom has been observed that would be pathognomic for the preclinical phase of AD; it is possible, on the basis of the examination by means of proper clinical scales, to predict the danger of dementia but it is necessary to take into account various elements of psychic state and social functioning.