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Am J Psychiatry 1993; 150:639-642
Copyright © 1993 by American Psychiatric Association
Psychopathology in younger versus older persons with very mild and mild dementia of the Alzheimer type
EH Rubin, DA Kinscherf and JC Morris
Departments of Psychiatry and Neurology, Washington University School of Medicine, St. Louis, MO 63110.
OBJECTIVE: The psychopathology associated with early-onset dementia of the
Alzheimer type was investigated by comparing the prevalence of psychiatric
symptoms in younger subjects (mean age = 59 years) who had very mild or
mild dementia with that in older adults (mean age = 72) whose dementia was
of equivalent severity. METHOD: Nondemented comparison subjects and persons
with very mild or mild dementia of the Alzheimer type were recruited to
participate in longitudinal studies. All subjects met strict inclusion and
exclusion criteria. Information pertaining to personality changes,
affective symptoms, and psychotic symptoms was included in the 90-minute
semistructured, physician- administered interview, which was used to assign
a clinical dementia rating according to published guidelines. The younger
group were age 64 or younger and consisted of 20 nondemented subjects, 11
subjects with very mild dementia, and 18 subjects with mild dementia. The
older group, described previously, were 64-83 years old and consisted of 83
nondemented subjects, 41 persons with very mild dementia, and 68 subjects
with mild dementia. RESULTS: The psychopathology in the younger subjects
was similar to that in the older group. Personality changes occurred in
over 80% of the younger persons with very mild illness. Psychotic symptoms
were present in over 40% of the younger persons with mild illness but were
rare in the group with very mild dementia. CONCLUSIONS: Similar patterns of
psychopathology in younger and more elderly persons with dementia of the
Alzheimer type support the suggestion that these changes are direct effects
of the illness on the CNS. Increased attention to documenting these
noncognitive symptoms and studying various treatments is urgently needed.
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