Psychic distress common with Parkinson's dementia

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http://news.yahoo.com/s/nm/20070124/..._dementia_dc_1

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.