| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Departments of Neurology (Drs. Stern, Mayeux, Sano, and Hauser), Psychiatry (Drs. Stern and Mayeux), and Epidemiology (Drs. Hauser and Bush), and the Sergievsky Center (Dr. Hauser), Columbia University College of Physicians and Surgeons, New York, NY.
The presence of extrapyramidal signs or psychosis may indicate greater disability in patients with probable Alzheimer's disease. We evaluated the ability of these signs, noted at a patient's first visit, to predict one of two specific clinical endpoints: (1) a preselected score on the modified Mini-Mental State examination (cognitive endpoint), and (2) a preselected score on the Blessed Dementia Rating Scale (functional endpoint). Sixty-five patients were followed either until they reached the endpoints or to the end of the study period. Survivorship curves were drawn to predict the distribution of time to onset of an endpoint in patients with and without the clinical signs. Time to reach the cognitive endpoint was shorter for patients with extrapyramidal signs or psychosis compared with those without these signs and symptoms. These clinical signs did not predict the functional endpoint. We conclude that extrapyramidal signs and psychosis may be useful predictors of intellectual decline in Alzheimer's disease.
Address correspondence and reprint requests to Dr. Stem, Neurological Institute, 710 West 168th Street, New York, NY 10032.
Supported by the Charles S. Robertson Memorial Gift for Alzheimer's Disease Research, the Marble Fund, and federal grants AGO2802 and AG05433. Patients were seen in the outpatient clinics of the General Clinical Research Center and data were stored and analyzed on a CLINFO system (both RR00645).
Received August 5, 1986. Accepted for publication in final form January 20, 1987.
This article has been cited by other articles:
|
|
 |
|
  S. Kinkingnehun, M. Sarazin, S. Lehericy, E. Guichart-Gomez, T. Hergueta, and B. Dubois VBM anticipates the rate of progression of Alzheimer disease: A 3-year longitudinal study Neurology, June 3, 2008; 70(23): 2201 - 2211. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Scarmeas, J. Brandt, D. Blacker, M. Albert, G. Hadjigeorgiou, B. Dubois, D. Devanand, L. Honig, and Y. Stern Disruptive Behavior as a Predictor in Alzheimer Disease Arch Neurol, December 1, 2007; 64(12): 1755 - 1761. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Stavitsky, A. M. Brickman, N. Scarmeas, R. L. Torgan, M.-X. Tang, M. Albert, J. Brandt, D. Blacker, and Y. Stern The progression of cognition, psychiatric symptoms, and functional abilities in dementia with lewy bodies and Alzheimer disease. Arch Neurol, October 1, 2006; 63(10): 1450 - 1456. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Borroni, M. Grassi, C. Agosti, S. Archetti, C. Costanzi, C. Cornali, C. Caltagirone, L. Caimi, M. Di Luca, and A. Padovani Cumulative Effect of COMT and 5-HTTLPR Polymorphisms and Their Interaction With Disease Severity and Comorbidities on the Risk of Psychosis in Alzheimer Disease Am J Geriatr Psychiatry, April 1, 2006; 14(4): 343 - 351. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Wilkosz, S. Miyahara, O. L. Lopez, S. T. DeKosky, and R. A. Sweet Prediction of Psychosis Onset in Alzheimer Disease: The Role of Cognitive Impairment, Depressive Symptoms, and Further Evidence for Psychosis Subtypes Am J Geriatr Psychiatry, April 1, 2006; 14(4): 352 - 360. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. S. Schneider, K. S. Dagerman, and P. Insel Risk of Death With Atypical Antipsychotic Drug Treatment for Dementia: Meta-analysis of Randomized Placebo-Controlled Trials JAMA, October 19, 2005; 294(15): 1934 - 1943. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Scarmeas, J. Brandt, M. Albert, G. Hadjigeorgiou, A. Papadimitriou, B. Dubois, M. Sarazin, D. Devanand, L. Honig, K. Marder, et al. Delusions and Hallucinations Are Associated With Worse Outcome in Alzheimer Disease Arch Neurol, October 1, 2005; 62(10): 1601 - 1608. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K Alagiakrishnan, D Lim, A Brahim, A Wong, A Wood, A Senthilselvan, W T Chimich, and L Kagan Sexually inappropriate behaviour in demented elderly people Postgrad. Med. J., July 1, 2005; 81(957): 463 - 466. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Scarmeas, M. Albert, J. Brandt, D. Blacker, G. Hadjigeorgiou, A. Papadimitriou, B. Dubois, M. Sarazin, D. Wegesin, K. Marder, et al. Motor signs predict poor outcomes in Alzheimer disease Neurology, May 24, 2005; 64(10): 1696 - 1703. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Sarazin, Y. Stern, C. Berr, A. Riba, M. Albert, J. Brandt, and B. Dubois Neuropsychological predictors of dependency in patients with Alzheimer disease Neurology, March 22, 2005; 64(6): 1027 - 1031. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Perez-Madrinan, S. E. Cook, J. A. Saxton, S. Miyahara, O. L. Lopez, D. I. Kaufer, H. J. Aizenstein, S. T. DeKosky, and R. A. Sweet Alzheimer Disease With Psychosis: Excess Cognitive Impairment Is Restricted to the Misidentification Subtype Am J Geriatr Psychiatry, October 1, 2004; 12(5): 449 - 456. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Aarsland, C. G. Ballard, and G. Halliday Are Parkinson's Disease with dementia and Dementia with lewy Bodies the Same Entity? J Geriatr Psychiatry Neurol, September 1, 2004; 17(3): 137 - 145. [Abstract] [PDF]
|
|
|
|
|
|
S. J. Kang, S. H. Choi, B. H. Lee, Y. Jeong, D. S. Hahm, I. W. Han, J. L. Cummings, and D. L. Na Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI) J Geriatr Psychiatry Neurol, March 1, 2004; 17(1): 32 - 35. [Abstract] [PDF]
|
|
|
|
|
|
M. P. Caligiuri, G. Peavy, D. P. Salmon, D. R. Galasko, and L. J. Thal Neuromotor abnormalities and risk for psychosis in Alzheimer's disease Neurology, October 14, 2003; 61(7): 954 - 958. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N.-H. Trinh, J. Hoblyn, S. Mohanty, and K. Yaffe Efficacy of Cholinesterase Inhibitors in the Treatment of Neuropsychiatric Symptoms and Functional Impairment in Alzheimer Disease: A Meta-analysis JAMA, January 8, 2003; 289(2): 210 - 216. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Scarmeas, J. Brandt, M. Albert, D. P. Devanand, K. Marder, K. Bell, A. Ciappa, B. Tycko, and Y. Stern Association between the APOE genotype and psychopathologic symptoms in Alzheimer's disease Neurology, April 23, 2002; 58(8): 1182 - 1188. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Sweet, M. I. Kamboh, S. R. Wisniewski, O. L. Lopez, W. E. Klunk, D. I. Kaufer, and S. T. DeKosky Apolipoprotein E and Alpha-1-Antichymotrypsin Genotypes Do Not Predict Time to Psychosis in Alzheimer's Disease J Geriatr Psychiatry Neurol, April 1, 2002; 15(1): 24 - 30. [Abstract] [PDF]
|
|
|
|
|
|
M. N. Haan, W. J. Jagust, D. Galasko, and J. Kaye Effect of Extrapyramidal Signs and Lewy Bodies on Survival in Patients With Alzheimer Disease Arch Neurol, April 1, 2002; 59(4): 588 - 593. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Sweet, V. L. Nimgaonkar, B. Devlin, O. L. Lopez, and S. T. DeKosky Increased familial risk of the psychotic phenotype of Alzheimer disease Neurology, March 26, 2002; 58(6): 907 - 911. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Tsolaki, K. Kokarida, V. Iakovidou, E. Stilopoulos, J. Meimaris, and A. Kazis Extrapyramidal symptoms and signs in Alzheimer's disease: Pravalence and correlation with the first symptom American Journal of Alzheimer's Disease and Other Dementias, September 1, 2001; 16(5): 268 - 278. [Abstract] [PDF]
|
|
|
|
 |
|
 M. C. Carlson, J. Brandt, C. Steele, A. Baker, Y. Stern, and C. G. Lyketsos Predictor Index of Mortality in Dementia Patients Upon Entry Into Long-term Care J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2001; 56(9): M567 - 570. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Mungas, B. R. Reed, W. G. Ellis, and W. J. Jagust The Effects of Age on Rate of Progression of Alzheimer Disease and Dementia With Associated Cerebrovascular Disease Arch Neurol, August 1, 2001; 58(8): 1243 - 1247. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. B. Farber, E. H. Rubin, J. W. Newcomer, D. A. Kinscherf, J. P. Miller, J. C. Morris, J. W. Olney, and D. W. McKeel Jr Increased Neocortical Neurofibrillary Tangle Density in Subjects With Alzheimer Disease and Psychosis Arch Gen Psychiatry, December 1, 2000; 57(12): 1165 - 1173. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. S Wilson, D. W Gilley, D. A Bennett, L. A Beckett, and D. A Evans Hallucinations, delusions, and cognitive decline in Alzheimer's disease J. Neurol. Neurosurg. Psychiatry, August 1, 2000; 69(2): 172 - 177. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Wilson, D. A. Bennett, D. W. Gilley, L. A. Beckett, J. A. Schneider, and D. A. Evans Progression of Parkinsonism and Loss of Cognitive Function in Alzheimer Disease Arch Neurol, June 1, 2000; 57(6): 855 - 860. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Paulsen, D. P. Salmon, L. J. Thal, R. Romero, C. Weisstein-Jenkins, D. Galasko, C. R. Hofstetter, R. Thomas, I. Grant, and D. V. Jeste Incidence of and risk factors for hallucinations and delusions in patients with probable AD Neurology, May 23, 2000; 54(10): 1965 - 1971. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Wilson, D. A. Bennett, D. W. Gilley, L. A. Beckett, J. A. Schneider, and D. A. Evans Progression of parkinsonian signs in Alzheimer's disease Neurology, March 28, 2000; 54(6): 1284 - 1289. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D.P. Devanand, K. Marder, K. S. Michaels, H. A. Sackeim, K. Bell, M. A. Sullivan, T. B. Cooper, G. H. Pelton, and R. Mayeux A Randomized, Placebo-Controlled Dose-Comparison Trial of Haloperidol for Psychosis and Disruptive Behaviors in Alzheimer's Disease Am J Psychiatry, November 1, 1998; 155(11): 1512 - 1520. [Abstract] [Full Text]
|
|
|
|
 |
|
 V. Rao and C. G. Lyketsos Delusions in Alzheimer's Disease: A Review J Neuropsychiatry Clin Neurosci, November 1, 1998; 10(4): 373 - 382. [Abstract] [Full Text]
|
|
|
|
|
|
S. T. Chen, D. L. Sultzer, C. H. Hinkin, M. E. Mahler, and J. L. Cummings Executive Dysfunction in Alzheimer's Disease: Association With Neuropsychiatric Symptoms and Functional Impairment J Neuropsychiatry Clin Neurosci, November 1, 1998; 10(4): 426 - 432. [Abstract] [Full Text]
|
|
|
|
|
|
N. Hirono, E. Mori, M. Yasuda, Y. Ikejiri, T. Imamura, T. Shimomura, M. Ikeda, M. Hashimoto, and H. Yamashita Factors associated with psychotic symptoms in Alzheimer's disease J. Neurol. Neurosurg. Psychiatry, May 1, 1998; 64(5): 648 - 652. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. P. Caligiuri, E. Rockwell, and D. V. Jeste Extrapyramidal Side Effects in Patients With Alzheimer's Disease Treated With Low-Dose Neuroleptic Medication Am J Geriatr Psychiatry, February 1, 1998; 6(1): 75 - 82. [Abstract] [Full Text]
|
|
|
|
|
|
R. A. Sweet, M. Akil, B. H. Mulsant, R. Ulrich, R. E. Pasternak, and G. S. Zubenko Determinants of SPontaneous Extrapyramidal Symptoms in Elderly Psychiatric Inpatients Diagnosed With Alzheimer's Disease, Major Depressive Disorder, or Psychotic Disorders J Neuropsychiatry Clin Neurosci, February 1, 1998; 10(1): 68 - 77. [Abstract] [Full Text]
|
|
|
|
|
|
M. Kirby and B. A. Lawlor Biologic Markers and Neurochemical Correlates of Agitation and Psychosis in Dementia J Geriatr Psychiatry Neurol, October 1, 1995; 8(1): S2 - S7. [Abstract] [PDF]
|
|
|
|
|
|
D.P. Devanand and S. R. Levy Neuroleptic Treatment of Agitation and Psychosis in Dementia J Geriatr Psychiatry Neurol, October 1, 1995; 8(1): S18 - S27. [Abstract] [PDF]
|
|
|
|
|
|
A. J. Flint Delusions, hallucinations and depression in Alzheimer's disease: A biological perspective American Journal of Alzheimer's Disease and Other Dementias, May 1, 1991; 6(3): 21 - 28. [Abstract] [PDF]
|
|
|
|
|
|
M. B. Patterson, A. H. Schnell, R. J. Martin, M. F. Mendez, K. A. Smyth, and P. J. Whitehouse Assessment of Behavioral and Affective Symptoms in Alzheimer's Disease J Geriatr Psychiatry Neurol, January 1, 1990; 3(1): 21 - 30. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
