Quantitative evaluation of severity of behavioral and psychological symptoms of dementia in patients with vascular dementia

Abstract

To quantitatively evaluate severity of behavioral and psychological symptoms of dementia (BPSD) for vascular dementia (VD). Changes of 51 patients with VD in BPSD between the first and 24th week were assessed using the Neuropsychiatric Inventory (NPI) and the behavioral pathology in Alzheimer's disease (BEHAVE-AD) rating scale, in detrended fluctuation analysis (DFA) represented by diurnal activity (DA), evening activity (EA), and nocturnal activity (NA), and the relationships were analyzed. The subscores of activity disturbances, diurnal rhythm disturbances, and anxieties and phobias in the BEHAVE-AD score, and that of agitation, irritability, and sleep disorder in the NPI score were significantly increased compared with the first week, as was for the changes for EA in the DFA value. A linear correlation was observed between the changes of activity disturbances plus anxieties and phobias, and those of DA, and between the development of diurnal rhythm and those of EA, the vehement and autism scores and those of DA, and the difference in sleep disorder scores and those of EA, respectively. Analysis of DA, NA, and EA may reflect the fluctuational degrees of VD-BPSD, can provide a useful assessment of VD-BPSD accompanied by clinical scores for VD.

Figure 1

The changes of behavioral and psychological symptoms and physical activity parameters of VD patients for patients with vascular dementia. Changes in each subscore for BEHAVE-AD (A) and NPI (B), and changes in diurnal activity (DA), evening activity (EA), and nocturnal activity (NA) (C) in the analysis of actigraph recordings between first week and 24th week in patients with vascular dementia. * p < 0.05, compared with first week. BEHAVE-AD: rating scale of the behavioral pathology in Alzheimer’s disease; NPI: Neuropsychiatric Inventory.

Figure 2

The relationship of the changes between behavioral and psychological symptoms and physical activity parameters of VD patients for patients with vascular dementia. Relationship of the changes in activity disturbances plus anxieties and phobias and diurnal activity (A), diurnal rhythm and evening activity (B) of the subscores for BEHAVE-AD, and relationship of the changes in agitation plus irritability and diurnal activity (C), and sleep disturbances and evening activity (D), respectively. (r = 0.674, 0.721, 0.668, and 0.809, P < 0.05, by Spearman’s rank correlation coefficient).