Psychiatric symptoms, cognitive function and instrumental activity of daily life in mild, moderate Alzheimer’s disease

• Main Authors: Yu San Chang, 張鈺姍
• Other Authors: Ching Kuan Liu
• Format: Others
• Language: zh-TW
• Published: 2002
• Online Access: http://ndltd.ncl.edu.tw/handle/05251454354312540166

碩士 === 高雄醫學大學 === 行為科學研究所 === 90 === Objects－The primary purpose of this study was to examine the differences between Alzheimer’s disease（AD） patients with and without psychotic symptoms（delusions and hallucinations）and to investigate factors associated with either one or both of the two psychotic symptoms. The other main objective was to investigate the correlations between instrumental activities of daily living（IADL）and cognitive function. Methods－This study collected information about 61 AD patients. The diagnosis of AD was made according to DSM-IV and NINCD-ADRDA. Comparisons between with and without psychotic symptoms（delusions and hallucinations）were made for sex, age, education, cognitive function, stage of dementia, and IADL, and to investigate factors associated with each or the combination of the two psychotic symptoms. We further explored the correlations between IADL and cognitive function. Results－Patients with psychotic symptoms were significantly more impaired than those without psychotic symptoms on the IADL, were in more advanced stages of dementia, and performed poorly in cognitive function, especially in orientation, abstract thinking, and judgment, all of which is related to the prefrontal/temporal lobe. Patients with both delusions and hallucinations had greater IADL impairment, were in more advanced stages of dementia and had poorer performance in abstract thinking and judgment, all of which is related to the prefrontal lobe. Delusions however were not related to cognitive function. There were also different correlations between cognitive function and IADL in AD patients with and without psychotic symptoms or differing stages of dementia. A mildly demented stage with psychotic symptoms was related to the prefrontal/parietal lobe, where a mildly demented stage without psychotic symptoms was related to age-degenerative factors. A moderately demented stage with psychotic symptoms was related to the prefrontal lobe, but the moderately demented stage without psychotic symptoms requires further evaluation. Conclusion and suggestions－The results of this study indicate that the prefrontal lobe may be associated with both psychotic symptoms and poor IADL performance in AD patients. Attention to the prefrontal lobe may guide clinical management and lead to cognitive rehabilitation.