Components of behavioral pathology in dementia

• Published in: International journal of geriatric psychiatry Vol. 20; no. 2; pp. 137 - 145
• Main Authors: Schreinzer, Daniel, Ballaban, Thomas, Brannath, Werner, Lang, Thomas, Hilger, Eva, Fasching, Peter, Fischer, Peter
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01-02-2005; Wiley; Wiley Subscription Services, Inc
• Subjects: Affective Symptoms; Aged; Aged, 80 and over; Aggression; agitation; Alzheimer's disease; Behavior; Biological and medical sciences; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; delusions; Dementia; Dementia - classification; Dementia - psychology; factor analysis; Factor Analysis, Statistical; Female; Fundamental and applied biological sciences. Psychology; Geriatric psychiatry; Geriatrics; Hallucinations; Humans; Lewy Body dementia; Male; Medical sciences; Neurology; Psychoanalysis; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; psychotic symptoms; vascular dementia; Agitation; Alzheimer disease; Hallucination; Delusion; Psychosis; Degenerative disease; Behavior; Alzheimer's disease; hallucinations; Human; Nervous system diseases; psychotic symptoms; Factor analysis; Vascular dementia; Aggression; Cerebral disorder; Senile dementia; Symptomatology; Anatomic pathology; Gerontology; delusions; Central nervous system disease; Lewy body dementia; dementia; Elderly; Geriatrics
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/gps.1263

Objective
The purpose of this study was to examine the occurence of the noncognitive behavioral and psychological symptoms and signs of dementia in a geriatric chronic‐care hospital and to separate agitated and affective components of behavioral pathology using factor analysis.
Methods
The frequency and severity of Alzheimer's disease, vascular dementia, mixed dementia and Lewy Body dementia was assessed in 145 consecutive residents of a chronic‐care hospital. The presence of noncognitive behavioral symptoms was evaluated with the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE‐AD) and the Cohen‐Mansfield Agitation Inventory (CMAI). A Factor analysis on the BEHAVE‐AD subscores was performed to create symptom clusters. Analysis of covariance and post hoc tests were used to compare means of factor variables between different types of dementia.
Results
Statistical analysis showed a significant correlation between severity of dementia and BEHAVE‐AD total score and between severity of dementia and CMAI total score. Factor analysis with Varimax rotation revealed the presence of three behavioral subsyndromes: agitation, affectivity and day/night disturbances.
Conclusions
The finding of three factors of behavioral pathology in demented patients reflects the possibility that different etiological mechanisms could explain the expression of the symptoms and signs of psychosis in demented patients. Copyright © 2005 John Wiley & Sons, Ltd.