The Clinical Characteristics Of Non-cognitive Symptoms In Patients With Alzheimer’s Disease And Their Relations To Caregiver’s Burden

ObjectiveTo describe the clinical characteristics of sleep disorders and behavioral and psychiatric symptoms in patients with Alzheimer’s disease and explore their relations to cognitive function and caregiver’s burden.Methods43 AD patients were recruited from the Northern Jiangsu People’s Hospital from November 2015 to November 2017.They had been assessed with thorough inquiry of the medical history.A set of neuropsychological assessments including Mini Mental State Examination(MMSE),Montreal cognitive assessment(MOCA)and Cognition-12(Cog-12)were used for their cognitive function.Pittsburgh sleep quality index(PSQI)was used to assess the sleepy condition.Neuropsychiatric Inventory Questionnaire(NPI-Q)was to evaluate the behavior and psychological symptoms.Caregiver Burden Inventory(CBI)was used for caregiver’s burdens.The control group was from community with the same neuropsychological assessments as AD group and Pittsburgh sleep quality index(PSQI)was used for sleepy condition.Results1.There was no significant difference in gender,age,hypertension,diabetes mellitus and smoking and drinking between two groups;there was significant difference in education years,total scores of MMSE and MOCA and Cog-12.2.In AD group,sleep disturbances had a higher ration than others followed by sleep latency,daytime dysfunction,subjective sleep quality,sleep duration,sleep efficiency,use of sleeping medication.The highest ratio in control group wassleep disturbances.Next came the following daytime dysfunction,sleep latency,subjective sleep quality,sleep duration,habitual sleep efficiency,use of sleeping medication.3.In AD group,the mean total score of PSQI was 8.72±5.444;The mean of seven "component" scores was from 0.12(use of sleeping medication)to 3.33(sleep disturbances).In control group,the mean total score of PSQI was 6.97±5.074;The mean of seven "component" scores was from 0.28(use of sleeping medication)to1.50(sleep disturbances).There was a significant difference in sleep disturbances between two groups.4.In AD group,the highest score of domain in severity was depression followed by euphoria/elation,irritability,anxiety,delusions,agitation/aggression,hallucinations,aberrant motor,apathy,nighttime behavior,disinhibition,appetite/eating.5.The order of caregiver’s burden was time-dependence burden,developmental burden,emotional burden,physical burden,social burden.6.In AD group,the total score of PSQI had a positive correlation to the score of MMSE and MOCA with significant difference and a negative correlation to the score of Cog-12 with no difference.7.In AD group,the total score of NPI-Q severity and caregiver distress had a negative correlation to the score of MMSE and MOCA and a positive correlation to the score of Cog-12 with no difference.8.In AD group,the total score of NPI-Q severity had a positive correlation to the time-dependence burden,emotional burden,social burden and total score of CBI with significant difference;the total score of NPI-Q caregiver distress had a positive correlation to time-dependence burden and total scare of CBI with significant difference.Conclusion1.AD patients have more prominent sleep disturbances,difficulty in falling asleep and daytime dysfunction.2.The emotional symptoms are the main manifestations of AD patients and the most unusual is depression.3.The most common burden of caregivers in the AD patients is time cost.4.Behavioral and psychiatric symptoms increased the time-dependence burden,emotional burden,social burden of the caregivers.