[Non-cognitive symptom profiles in dementia--experience from psychiatric services and memory clinics]

To assess the non-cognitive symptoms in 153 consecutive dementia patients admitted to our psychiatric ward or seen at the gerontopsychiatric ambulance and Memory Clinic.

We used the Global Deterioration Scale, the Hachinski Ischaemia Score, the Hamilton Psychiatric Rating Scale for Depression, and the Mini-Mental State Exam as staging tools in a cross-sectional design. A semi-quantitative 34-item questionnaire based on the Columbia University Scale for Psychopathology was employed to assess non-cognitive symptoms as reported by caregivers.

All patients had disturbances of affect, 95% of behavior and 71% of motivation, while 52% and 29% had delusions and hallucinations, respectively. Delusions, but not hallucinations, were correlated with verbal and physical aggressiveness. Factor analysis extracted three complex variables which accounted for 40.6 percent of the observed total variance, and which were subsequently interpreted as manifestations of agitation, burdensome behavior, and depression. Using these variables, we then identified three categories of patients: Agitated, debilitated, and depressive-anxious. Depression and anxiety were most common 3-4 years after diagnosis. Patients with Alzheimer's disease had less severe behavioral and psychotic symptoms than those with other types of dementia. Agitation, depression, and loss of competence in daily living had a greater impact on caregivers than aggression and psychotic symptoms.

The non-cognitive symptom profile is related to the type of dementia, and shifts dynamically with disease progression.