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From the Departments of Neurology (Drs. Mega and Cummings, and T. Fiorello) and Psychiatry and Biobehavioral Science (Dr. Cummings), UCLA School of Medicine; Behavioral Neuroscience Section (Dr. Cummings), Psychiatry Service, West Los Angeles Veterans Affairs Medical Center; and the Biomathematical Consulting Unit, Department of Biomathematics (Dr. Gornbein), UCLA School of Medicine, Los Angeles, CA.
Supported by the Department of Veteran's Affairs, a National Institute on Aging Alzheimer's Disease Center (AG 10123), and the Helga and Irving Cooper Award of the UCLA Center on Aging.
Received January 12, 1995. Accepted in final form April 26, 1995.
Address correspondence and reprint requests to Dr. Jeffrey L. Cummings, Neurobehavior Unit (Bldg 256b; 116AF), West LA VAMC, 11301 Wilshire Blvd, Los Angeles, CA 90073.
Article abstract-We investigated the range of behavioral abnormalities in patients with Alzheimer's disease (AD) compared with normal age-matched control subjects. The range of behavioral disturbances manifested and the relationship between specific abnormalities with the level of cognitive impairment have not been established. Fifty consecutive outpatients with mild (n = 17), moderate (n = 20), and severe (n = 13) AD and 40 age-matched normal controls were evaluated for behavioral abnormalities occurring in the month preceding the interview. The caregivers of the patients and the spouses of the control subjects were interviewed with the Neuropsychiatric Inventory (NPI). The frequency and severity of the following 10 behaviors were assessed: delusions, hallucinations, agitation, dysphoria, anxiety, euphoria, apathy, disinhibition, irritability, and aberrant motor behavior. Correlations among these 10 behaviors and their relationship with cognitive impairment were also investigated. Eighty-eight percent of AD patients had measurable behavioral changes. All 10 behaviors were significantly increased in the AD patients compared with normal subjects. The most common behavior was apathy, which was exhibited by 72% of patients, followed by agitation (60%), anxiety (48%), irritability (42%), dysphoria and aberrant motor behavior (both 38%), disinhibition (36%), delusions (22%), and hallucinations (10%). Agitation, dysphoria, apathy, and aberrant motor behavior were significantly correlated with cognitive impairment.
NEUROLOGY 1996;46: 130-135
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D. Aarsland, J. P Larsen, N. G. Lim, C. Janvin, K. Karlsen, E. Tandberg, and J. L Cummings Range of neuropsychiatric disturbances in patients with Parkinson's disease J. Neurol. Neurosurg. Psychiatry, October 1, 1999; 67(4): 492 - 496. [Abstract] [Full Text] [PDF]
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J. L. Cummings and D. V. Jeste Alzheimer's Disease and Its Management in the Year 2010 Psychiatr Serv, September 1, 1999; 50(9): 1173 - 1177. [Abstract] [Full Text] [PDF]
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J. L. Cummings and D. Knopman Advances in the treatment of behavioral disturbances in Alzheimer's disease Neurology, September 1, 1999; 53(5): 899 - 899. [Full Text]
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M. C. Irizarry, S. N. Ghaemi, E. R. Lee-Cherry, T. Gomez-Isla, G. Binetti, B. T. Hyman, and J. H. Growdon Risperidone Treatment of Behavioral Disturbances in Outpatients With Dementia J Neuropsychiatry Clin Neurosci, August 1, 1999; 11(3): 336 - 342. [Abstract] [Full Text]
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D. Aarsland, J. P. Larsen, J. L. Cummings, and K. Laake Prevalence and Clinical Correlates of Psychotic Symptoms in Parkinson Disease: A Community-Based Study Arch Neurol, May 1, 1999; 56(5): 595 - 601. [Abstract] [Full Text] [PDF]
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 L. A. O'Tuama, D. P. Dickstein, R. Neeper, and G. G. Gascon Topical Review: Functional Brain Imaging in Neuropsychiatric Disorders of Childhood J Child Neurol, April 1, 1999; 14(4): 207 - 221. [Abstract] [PDF]
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C. Diaz-Olavarrieta, J. L. Cummings, J. Velazquez, and C. Garcia de al Cadena Neuropsychiatric Manifestations of Multiple Sclerosis J Neuropsychiatry Clin Neurosci, February 1, 1999; 11(1): 51 - 57. [Abstract] [Full Text]
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N. Hirono, E. Mori, M. Yasuda, T. Imamura, T. Shimomura, M. Hashimoto, S. Tanimukai, H. Kazui, and H. Yamashita Lack of Effect of Apolipoprotein E E4 Allele on Neuropsychiatric Manifestations in Alzheimer's Disease J Neuropsychiatry Clin Neurosci, February 1, 1999; 11(1): 66 - 70. [Abstract] [Full Text]
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L. J. Fitten, F. Ortiz, D. W. Siembieda, J. O'Neill, E. Halgren, and A. Fisher Reduction of Motoric Agitation and Restlessness by AF102B and Tacrine in the Macaque J Neuropsychiatry Clin Neurosci, February 1, 1999; 11(1): 79 - 85. [Abstract] [Full Text]
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C. G. Lyketsos, C. Steele, E. Galik, A. Rosenblatt, M. Steinberg, A. Warren, and J.-M. Sheppard Physical Aggression in Dementia Patients and Its Relationship to Depression Am J Psychiatry, January 1, 1999; 156(1): 66 - 71. [Abstract] [Full Text]
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M. L. Levy, J. L. Cummings, L. A. Fairbanks, D. Masterman, B. L. Miller, A. H. Craig, J. S. Paulsen, and I. Litvan Apathy Is Not Depression J Neuropsychiatry Clin Neurosci, August 1, 1998; 10(3): 314 - 319. [Abstract] [Full Text]
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G. Binetti, M. S. Mega, E. Magni, A. Padovani, L. Rozzini, A. Bianchetti, M. Trabucchi, and J. L. Cummings Behavioral Disorders in Alzheimer Disease: A Transcultural Perspective Arch Neurol, April 1, 1998; 55(4): 539 - 544. [Abstract] [Full Text] [PDF]
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D. Kaufer, J. L. Cummings, and D. Christine Differential Neuropsychiatric Symptom Responses to Tacrine in Alzheimer's Disease: Relationship to Dementia Severity J Neuropsychiatry Clin Neurosci, February 1, 1998; 10(1): 55 - 63. [Abstract] [Full Text]
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G. W. Small, P. V. Rabins, P. P. Barry, N. S. Buckholtz, S. T. DeKosky, S. H. Ferris, S. I. Finkel, L. P. Gwyther, Z. S. Khachaturian, B. D. Lebowitz, et al. Diagnosis and Treatment of Alzheimer Disease and Related Disorders: Consensus Statement of the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society JAMA, October 22, 1997; 278(16): 1363 - 1371. [Abstract] [PDF]
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 A. Russo-Neustadt and C. W. Cotman Adrenergic Receptors in Alzheimer's Disease Brain: Selective Increases in the Cerebella of Aggressive Patients J. Neurosci., July 15, 1997; 17(14): 5573 - 5580. [Abstract] [Full Text] [PDF]
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N. C. Bodick, W. W. Offen, A. I. Levey, N. R. Cutler, S. G. Gauthier, A. Satlin, H. E. Shannon, G. D. Tollefson, K. Rasmussen, F. P. Bymaster, et al. Effects of Xanomeline, a Selective Muscarinic Receptor Agonist, on Cognitive Function and Behavioral Symptoms in Alzheimer Disease Arch Neurol, April 1, 1997; 54(4): 465 - 473. [Abstract] [PDF]
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F. Lopera, A. Ardilla, A. Martinez, L. Madrigal, J. C. Arango-Viana, C. A. Lemere, J. C. Arango-Lasprilla, L. Hincapie, M. Arcos-Burgos, J. E. Ossa, et al. Clinical Features of Early-Onset Alzheimer Disease in a Large Kindred With an E280A Presenilin-1 Mutation JAMA, March 12, 1997; 277(10): 793 - 799. [Abstract] [PDF]
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M. L. Levy, B. L. Miller, J. L. Cummings, L. A. Fairbanks, and A. Craig Alzheimer Disease and Frontotemporal Dementias: Behavioral Distinctions Arch Neurol, July 1, 1996; 53(7): 687 - 690. [Abstract] [PDF]
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 Behavior Changes in Alzheimer's Disease Journal Watch Psychiatry, April 1, 1996; 1996(401): 8 - 8. [Full Text]
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