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Psychic distress common with Parkinson's dementia
Wed Jan 24, 1:54 PM ET
NEW YORK (Reuters Health) - People with dementia associated with Parkinson's
disease often suffer from a range of psychiatric and neurological symptoms
such as anxiety, agitation and hallucinations, researchers report.
Dr. D. Aarsland, of Stavanger University Hospital, Norway, and colleagues
examined the pattern of neuropsychiatric symptoms in 537 patients with
Parkinson's disease-related dementia, assessed using the 10-item
Neuropsychiatric Inventory.
The subjects were an average of 73 years old, had had Parkinson's disease
for some 10 years, and had been demented for about 2 years.
Overall, 89 percent of them had at least one neuropsychiatric symptom, and
77 percent had two or more, the team reports in the Journal of Neurology,
Neurosurgery, and Psychiatry.
The most common symptoms were depression, apathy, anxiety, and
hallucinations. In general, patients with more severe dementia and advanced
Parkinson's disease exhibited more neuropsychiatric symptoms.
The investigators noted five distinct patterns or clusters of symptoms.
These included a "mild" cluster with few symptoms; a "mood" cluster with
high scores on depression and anxiety; an "apathy" cluster with high scores
on apathy and low scores on other items; an "agitation" cluster with high
scores on agitation and high total scores; and a "psychosis" cluster with
high scores for delusions and hallucinations.
Patients in the psychosis and agitation clusters had the most advanced
disease, and these two groups were also associated with the highest distress
scores among caregivers.
Classifying patients into these subgroups has "potential treatment
implications," Aarsland's team concludes. They also suggest that there may
be "specific neurobiological changes underlying the different
neuropsychiatric clusters."
SOURCE: Journal of Neurology, Neurosurgery, and Psychiatry, January 2007.

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