Analysis The Cognitive Function And Neuropsychiatric Behavior Of Alzheimer's Disease,Dementia With Lewy Bodies And Frontotemporal Dementia Pafients

Background:Alzheimer's disease(AD),dementia with Lewy bodies(DLB),frontotemporal dementia(FTD)are the three main types of degenerative dementia that cause cognitive impairment.The high incidence of neuropsychiatric behavior symptoms during the process.In the early stage,the performance of cognitive impairments and neuropsychiatric behavior symptoms symptoms often overlaps,which is easily overlooked or misdiagnosed by clinicians.However,the pathological basis of the three is different,and the brain areas involved in the development of the disease are different.At present,there are few comprehensive analyses on the cognitive,mental and behavioral symptoms of AD,DLB,and FTD.Objectives:We used the Neuropsychological assessment to analyze the cognitive impairment,and neuropsychiatric behavior symptoms among AD,DLB,and FTD,as well as analyze the relationship betewwn cognitive function and neuropsychiatric behavior symptoms in patients with AD,DLB,and FTD.Methods:The study was enrolled 98 cases of AD,41 cases of DLB,and 24 cases of FTD in the department of neurology clinic or neurology department hospital of Guangzhou Brain Hospital Affiliated to Guangzhou Medical University that from May 2011 to December 2017.Mini Mental State Examination(MMSE),Clinical Dementia Rating Scale(CDR),Alzheimer's Disease Assessment Scale-cognitive Subscale(ADAS-Cog)and Neuropsychiatric Inventory(NPI)evaluated the cognitive function and the characteristics of neuropsychiatric behavior symptoms in patients.Results:(1)The ADAS-COG total score(P=0.002),memory(P<0.001),and language(p=0.027)scores of mild to moderate AD were significantly higher than those of mild to moderate DLB;mild to moderate AD memory(P=0.001)factor score is significantly higher than the mild to moderate FTD.(2)82.7 %(62/75)of AD,90.9 %(30/33)of DLB,94.7 %(18/19)of FTD patients had at least one type of neuropsychiatric behavior symptoms.The incidence of hallucinations(P=0.046),apathy(P=0.023),and abnormal sleep behavior(P=0.023)were significantly higher in mild to moderate DLB than mild to moderate AD.The incidence of depression(P=0.016)in mild to moderate DLB was significantly higher than that of mild to moderate FTD.The incidence of euphoria in mild to moderate FTD was significantly higher than that mild to moderate AD(P=0.001)and mild to moderate DLB(P=0.028).(3)Severe neuropsychiatric behavior symptoms(NPI ? 4)in AD patients with different degrees of dementia: The incidence of agitation(P = 0.013)and apathy(P = 0.0029)in severe AD patients was significantly higher than that in mild AD patients.The prevalence of exercise behavior(P = 0.001,P = <0.001)and sleep abnormalities(P = 0.001,P = <0.001)was significantly higher than that in patients with mild to moderate AD.(3)In patients with AD,apathy(r=-0.234,P=0.021),abnormal motor behavior(r=-0.287,P=0.004),and abnormal sleep behavior(r=-0.202,P=0.046)significantly correlated with MMSE total score;in DLB patients,agitation(r=-0.408,P=0.008),irritability(r=-0.361,P=0.020),abnormal motor activity(r=-0.319,P=0.042)significantly correlated with MMSE total score.Anxiety(r=-0.506,P=0.012)was associated with a total MMSE score in FTD patients.Conclusions:The impairment of memory in patients with mild-to-moderate AD is more sever than DLB and FTD.The neuropsychiatric behavior symptoms of mild-to-moderate AD mainly include agitation,depression,anxiety,and irritability.The patients with mild-to-moderate DLB have a high incidence of hallucinations,depression,anxiety,apathy,and abnormal sleep behavior.The patients with mild-to-moderate FTD have a high incidence of agitation and apathy irritability.A high proportion of patients with mild to moderate AD,DLB,and FTD have depression and anxiety.Patients with depression and anxiety in the clinical work need to pay more attention to their cognitive functions.In degenerative dementia,there is a close relationship between cognitive function and neuropsychiatric behavior symptoms.When dealing with patients' neuropsychiatric behavior symptoms,it is necessary to consider anti-dementia treatment.