알츠하이머병 (AD)에서 신경정신병학적 증후군의 유병률
Prevalence of neuropsychiatric syndromes in Alzheimer's disease (AD)
Youn, Jong Chul; Lee, Dong Young; Jhoo, Jin Hyeong; Kim, Ki Woong; Choo, Il Han; Woo, Jong Inn
Archives of gerontology and geriatrics 2011 May ; 52 ( 3 ) : 258-63.
PMID : 20537736
저자
Youn, Jong Chul – Kyunggi Provincial Hospital for the Elderly Department of Neuropsychiatry
Lee, Dong Young – Seoul National University College of Medicine Department of Psychiatry
Jhoo, Jin Hyeong – Kangwon National University Hospital Department of Psychiatry
Kim, Ki Woong – Seoul National University Bundang Hospital Department of Psychiatry
Lee, Dong Young – Seoul National University College of Medicine Department of Psychiatry
Jhoo, Jin Hyeong – Kangwon National University Hospital Department of Psychiatry
Kim, Ki Woong – Seoul National University Bundang Hospital Department of Psychiatry
Choo, Il Han – Chosun University College of Medicine Department of Psychiatry
Woo, Jong Inn – Seoul National University College of Medicine Department of Psychiatry
Woo, Jong Inn – Seoul National University College of Medicine Department of Psychiatry
요약
이 연구는 유병률을 추정하고 AD의 신경정신과적 증후군의 다차원적 복합성을 탐구하는 것을 목표로 하였다.
NINCDS-ADRDA 기준에 의해 진단될 가능성이 있고 가능한 AD를 가진 216명의 신경 정신과적 증상 및 증후군은 치매에 대한 행동평가척도 한국판(BRSD-K)에 의해 평가되었다. 6개의 신경정신과학적 증후군 (우울증 증상, 무력, 의욕이 없는 증상, 과민성 / 공격성, 행동조절장애, 정신병적 증상) 및 동반 신경정신증후군의 유병률은 임상 치매 평가 척도에 따라 계산되었다. 신경정신과 증후군의 관계를 조사하기 위해 로지스틱 회귀 분석을 수행하였다.
AD 환자의 약 95 %는 지난 달 동안 하나 이상의 신경정신과적 증상 및 증후군을 가졌다. 신경정신과증후군 중 과민성 / 공격성 (76.2 %)이 가장 빈번했고, 무관심 (72.3 %)과 우울 증상 (68.0 %)이 뒤를 이었다. 대상의 약 90 %가 하나 이상의 동반 신경정신과 증후군을 가졌다. 동시이환 신경정신병 증후군의 평균 수는 질환의 중증도에 따라 유의미하게 변하였다 (p <0.05). 우울 증상은 의욕이 없는 증상 및 과민성 / 공격성과 관련이 있었다 (p <0.05). 관성 및 정신병 증상은 각각 의욕이 없는 증상 및 행동 조절 이상과 유의한 관련이 있었다 (p <0.05). 이 연구는 AD의 신경정신과 증후군이 매우 널리 퍼져 있고 그들 사이의 복잡한 관계들을 보여 주었다.
ABSTRACT
This study aimed to estimate the prevalence and explore the multidimensional complexity of the neuropsychiatric syndromes of AD. Neuropsychiatric symptoms and syndromes of 216 subjects with probable and possible AD diagnosed by NINCDS-ADRDA criteria were evaluated by the Korean version of behavior rating scale for dementia (BRSD-K). The prevalence rate of six neuropsychiatric syndromes (depressive symptoms, inertia, vegetative symptoms, irritability/aggression, behavioral dysregulation, psychotic symptoms) and comorbid neuropsychiatric syndromes were calculated according to the Clinical Dementia Rating scale. To investigate the relationship among neuropsychiatric syndromes, logistic regression analyses were performed. About 95% of patients with AD had one or more neuropsychiatric symptoms and syndromes during the past month. Among the neuropsychiatric syndromes, irritability/aggression (76.2%) was the most frequent, followed by apathy (72.3%) and depressive symptoms (68.0%). About 90% of the subjects had one or more comorbid neuropsychiatric syndromes. The mean numbers of comorbid neuropsychiatric syndromes were significantly varied according to the severity of disease (p<0.05). Depressive symptoms were significantly associated with vegetative symptoms and irritability/aggression (p<0.05). Inertia and psychotic symptoms were significantly associated with vegetative symptoms and behavioral dysregulation, respectively (p<0.05). This study demonstrated that neuropsychiatric syndromes of AD were highly prevalent and involved complex relationships among them. CI – Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.