Neuropsychiatric symptoms in patients with vascular dementia in mainland China

Abstract

Background: Neuropsychiatric deficits can induce marked disability in patients with dementia and increasecaregiver distress. Several studies have found that neuropsychiatric symptoms are common both in patientswith Alzheimer’s disease (AD) and patients with vascular dementia (VaD). However, there are few studies of theneuropsychiatric disturbances in large clinical samples of patients with mixed (cortical - subcortical) VaD frommainland China. This study aimed to investigate the neuropsychiatric symptoms in VaD patients in mainlandChina. Methods: Eighty patients with mixed VaD for over 6 months duration, and their caregivers (VaD group),were recruited for interview in Zhongnan Hospital of Wuhan University, from June 2010 to June 2012. Eightyage- and sex-matched normal volunteers (control group) were interviewed at the same time. The Mini MentalState Examination (MMSE) and the Neuropsychiatric Inventory (NPI) were administered to the VaD patients, theircaregivers, and normal volunteers. Group differences were analyzed using the unpaired t-test. Results: The totalmean scores of the NPI in the VaD group were higher than in the control group (P < 0.01). The subscale scores ofNPI, including delusions, hallucinations, depression, apathy, irritability, agitation, aberrant motor behavior, andchange in appetite were significantly higher in the VaD group than in the control group (P < 0.05-0.01). Comparedwith the mild VaD subgroup, the NPI subscale scores of apathy, irritability and total scores were significantlyhigher in the moderate VaD subgroup (P < 0.05-0.01); the NPI subscale scores of anxiety, apathy, irritability, andtotal scores were significantly higher in the severe VaD subgroup (P < 0.01). Compared with the moderate VaDsubgroup, the NPI subscale scores of anxiety and apathy were significantly higher in the severe VaD subgroup(P < 0.05-0.01). Conclusions: Neuropsychiatric symptoms, such as hallucination, anxiety, apathy, irritability andaberrant action behavior, are common in patients with mixed VaD from mainland China; anxiety and apathy weremore pronounced in the subgroup of severe VaD patients.