博士 / 中山醫學大學 / 醫學研究所 / 104 / Objective：Previous studies on the clinical and pathological manifestations of Parkinson’s disease dementia (PDD) have reported findings more similar to dementia with Lewy bodies (DLB) than to Alzheimer’s disease (AD). The first aim of this study was to investigate the neuropsychiatric symptoms of PDD compared to DLB and AD. The second was to provide the evidence of whether PDD and DLB belong to the same disease entity.
Methods and Materials： First, we conducted a case-control study on 125 newly diagnosed consecutive PDD patients and age- and dementia stage-matched controls with either DLB (N = 250) or AD (N = 500) who visited the same hospital over the same period. For each case and control, neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory (NPI). Second, we selected 282 patients with PDD (N = 41), DLB (N = 59) or AD (N = 182) who were given a complete assessment of frequency and severity of depression using multiple criteria and scales. After the data collection, valid samples were processed and analyzed by descriptive statistics, Chi-square tests and ANOVA by SPSS for windows 19.0.
Results：Overall, 513 (58.6%) patients were female and 362 (41.4%) were male. Comparisons of clinical data revealed that the PDD group, similar to the AD group, had a lower NPI total score, NPI caregiver burden score, and rate of antipsychotic use (all p < 0.001) than the DLB group. One or more psychiatric symptoms were reported in 95.2% of the PDD, 99.2% of the DLB, and 96.8% of the AD patients. The PDD group had lower subscores in the items of delusions, hallucinations, agitation, anxiety, irritation, aberrant motor behavior compared to the DLB group. Severe neuropsychiatric symptoms among all dementia patients were associated with younger age, more advanced stage, and a diagnosis of DLB. Depression in DLB was more severe and more frequent than PDD or AD. Association of depression with PDD was more like that of AD than DLB. Pervasive anhedonia has high diagnostic value for the differentiation of DLB with AD.
Conclusion and Suggestion：Neuropsychiatric symptoms in PDD were more like those in AD than in DLB. Our findings provided an evidence that PDD and DLB might not be the same disease entity. Severe neuropsychiatric symptoms in degenerative dementia were associated with younger age, more advanced stage of dementia, and a diagnosis of DLB.
| Identifer | oai:union.ndltd.org:TW/104CSMU5534033 |
| Date | January 2016 |
| Creators | Pai-Yi Chiu, 邱百誼 |
| Contributors | Ten-Je Lai, 賴德仁 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 144 |
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