Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dementia patients often present with behavioural and psychological symptoms, with prevalence rates reaching 90%. It is therefore important to know whether an antidementia drug that improves cognitive function can also reduce the burden of behavioural and psychological symptoms of dementia, and whether it can improve cognitive function in patients suffering from such non-cognitive symptoms. Therefore, three types of study with Ginkgo special extract EGb 761 (definition see editorial) were reviewed: 1) studies on patients with impairment of cerebral function or dementia associated with behavioural and psychological symptoms (BPSD); 2) studies on patients suffering from impairment of cerebral function and depression; 3) dementia studies on patient samples with a high prevalence of BPSD. Compared to placebo, EGb 761 improved these symptoms significantly in all studies that used a scale to measure the presence and intensity of BPSD. Moreover, EGb 761 was found to be superior to placebo with respect to improvement in cognitive function, daily living activities and global assessment in dementia patients suffering from BPSD. It may be concluded that EGb 761 is of particular interest to patients with dementia and BPSD since it improves both the patient's cognitive ability and behavioural and psychological symptoms.
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PMID:Behavioural and psychological symptoms of dementia (BPSD): effects of EGb 761. 1313 Mar 90

Clinical expressions of cognition and behaviour in Alzheimer's disease (AD) patients are heterogeneous. Therefore, assessing the entire range of selective cognitive and behavioural characteristics of dementia in minute detail is extremely important. However, considering that groups of different symptoms may respond to the same pharmacological agent, it is also evident that a correct evaluation of the behaviour requires the grouping of symptoms in fewer syndromes. Thus, the authors have analysed various connections between selective cognitive domains and behavioural symptoms (BPSD) in probable AD outpatients. Two hundred and forty four patients with diagnosis of probable AD, according to DSM-IV and NINCDS-ADRDA criteria were enrolled. The evaluation included the Mini Mental State Examination, the Mental Deterioration Battery, and the Neuropsychiatric Inventory. Treatment with low doses of neuroleptic drugs only was allowed. Principal component analysis condensed the 18 cognitive/behavioural variables in 7 factors namely general-cognitive, constructional abilities, hyperactivity, psychosis, anxiety, mood-excitement and mood-depression/apathy. None of the cognitive domains were included in the behavioural factors and vice-versa. Furthermore, the only BPSD which impaired continuously with progression of disease severity was apathy which was also the most severe symptom. In conclusion, many cognitive and behavioural syndromes exist in patients with AD. However, the results of this study suggest that cognition and behaviour are independent dimensions.
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PMID:Cognition and behaviour are independent and heterogeneous dimensions in Alzheimer's disease. 1531 44

Neuropsychiatric symptoms seen in Alzheimer's disease (AD) are not simply a consequence of neurodegeneration, but probably result from differential neurotransmitter alterations, which some patients are more at risk of than others. Therefore, the hypothesis of this study is that an imbalance between the cholinergic and serotonergic systems is related to cognitive symptoms and psychological syndromes of dementia (BPSD) in patients with AD. Cholinergic and serotonergic functions were assessed in post-mortem frontal and temporal cortex from 22 AD patients who had been prospectively assessed with the Mini-Mental State examination (MMSE) for cognitive impairment and with the Present Behavioral Examination (PBE) for BPSD including aggressive behavior, overactivity, depression and psychosis. Not only cholinergic deficits, but also the cholinacetyltransferase/serotonin ratio significantly correlated with final MMSE score both in frontal and temporal cortex. In addition, decreases in cholinergic function correlated with the aggressive behavior factor, supporting a dual role for the cholinergic system in cognitive and non-cognitive disturbances associated to AD. The serotonergic system showed a significant correlation with overactivity and psychosis. The ratio of serotonin to acetylcholinesterase levels was also correlated with the psychotic factor at least in women. It is concluded that an imbalance between cholinergic-serotonergic systems may be responsible for the cognitive impairment associated to AD. Moreover, the major findings of this study are the relationships between neurochemical markers of both cholinergic and serotonergic systems and non-cognitive behavioral disturbances in patients with dementia.
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PMID:Cholinergic-serotonergic imbalance contributes to cognitive and behavioral symptoms in Alzheimer's disease. 1570 19

Behavioral problems produce excess disability, potentially devastating in cognitively impaired patients. These behavioral symptoms can be a major cause of stress, anxiety and concern for caregivers. While psychotropic drugs are frequently used to control these symptoms, they have the potential for significant side effects, which include sedation, disinhibition, depression, falls, incontinence, parkinsonism and akathisia. We followed up (for 12 months) a group of 346 consecutive outpatients, with a diagnosis of subcortical vascular dementia or multi-infarctual dementia. Patients eligible for this open-label study were required to have behavioral problems (BPSD). Patients were divided into two groups, Group A received olanzapine 2.5-7.5 mg/day while Group B received typical antipsychotics. Patients in both groups were allowed to continue any previous therapy. Patients in both groups were significantly improved in their BPSD. Our patients had a host of medical conditions and received numerous concomitant medications. Given the potential complications associated with these therapeutic agents, these patients tolerated olanzapine quite well. On examination of consequences of adverse events, particularly somnolence, postural instability, and postural hypotension, it appeared that cerebrovascular events were not present. Moreover, no anticholinergic effect was recorded. These findings suggest that olanzapine could be a safe and effective treatment even for elderly population in suitable doses and receiving the adequate follow-up.
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PMID:Olanzapine as a possible treatment of behavioral symptoms in vascular dementia: risks of cerebrovascular events. A controlled, open-label study. 1580 22

Noncognitive or behavioral and psychological symptoms (BPSD) are common in vascular dementia. Many occur with the same frequency as in Alzheimer's disease, though depression, emotional lability, and apathy may be more common and psychosis less so. There is a particularly strong relationship between cerebrovascular disease and depression.
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PMID:Behavioral symptoms in vascular cognitive impairment and vascular dementia. 1619 Dec 30

With increasing understanding of BPSD, the question of whether there are differences between BPSD of AD and VaD may be raised. The available evidence from the Cache County Study, the role of vascular risk factors in late-life depression, and vascular pathology in AD and VaD all converge to explore the impact of vascular burden on cerebral function and BPSD. This article argues that there may be domain differences in BPSD between AD and VaD and suggests that BPSVaD may be a concept to be pursued with possible useful clinical implications.
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PMID:Vascular burden and BPSD: a reconceptualization. 1619 Dec 38

We assessed the effects of music therapy (MT) on behavioral and psychological symptoms (BPSD) in dementia associated with changes in physiological parameters, as heart rate (HR) and heart rate variability (HRV). Twenty subjects were randomly assigned to MT treatment or standard care; all patients underwent neuropsychological assessment and ECG Holter recordings before and after the 15-week treatment. The treatment included 30 MT sessions. Depression significantly decreased (p=0.021) in the MT group. PNN50 improved in 50% patients of the MT group, but in none of the control group (p=0.013). MT may improve symptoms of depression and increase HRV in demented patients.
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PMID:Effects of music therapy on psychological symptoms and heart rate variability in patients with dementia. A pilot study. 2073 42

The purpose of this study was to investigate caregiver burden associated with BPSD in Taiwanese people. The study had a cross-sectional design. Eighty-eight patients with dementia and 88 caregivers who visited the memory clinic of a medical center from January 2007 to December 2007 were recruited. The BPSD were assessed using the neuropsychiatric inventory (NPI); caregiver burden was evaluated using the NPI caregiver distress scale (NPI-D). Demographic data on the patients and caregivers along with patients' cognitive functions and clinical dementia ratings were collected. In addition to descriptive statistics, we analyzed the relationship between each parameter and caregiver burden using binary correlation. The results showed a statistically significant positive correlation between the total NPI-D score and the total NPI score (r=0.898, p<0.001). For individual BPSD, delusions had the highest mean NPI-D score, followed by agitation/aggression, anxiety, irritability/lability, and dysphoria/depression. The symptom frequency of anxiety, delusions, and agitation/aggression showed a statistically significant positive correlation with caregiver's NPI-D score. These findings suggest that improvement of treatments for delusions, agitation/aggression, anxiety, irritability/lability, and dysphoria/depression among dementia patients may reduce caregiver burden.
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PMID:Caregiver burden associated with behavioral and psychological symptoms of dementia (BPSD) in Taiwanese elderly. 2160 31

It was suggested that the gene encoding for sorLa, (SORL1) may affect Alzheimer's disease (LOAD) through a female-specific mechanism. The aims of this study were to confirm the role of gender in modulating the association between SORL1 and LOAD and to ascertain the influence of SORL1 on cognitive impairment, neuropsychiatric symptoms (BPSD) and secretion of pro-inflammatory cytokines. Ninety six outpatients with LOAD and 120 unrelated controls were genotyped for APOE and three SNPs at the 5' end of SORL1(intron 6): SNP 8 (rs668387); SNP 9 (rs68902); SNP 10 (rs641120). Clinical evaluation was made with the MMSE, Neuropsychiatric Inventory (NPI) and Cornell Scale for Depression in Dementia (CDDS). ELISPOT assays were used to measure pro-inflammatory cytokine (TNF-alpha; IL-6; IL-1beta; IFN-gamma) production in peripheral blood mononuclear cell (PBMC) supernatant from AD patients. SORL1 SNPs were not associated with LOAD in overall sample. Instead the G-alleles at SNPs 9 (p=0.015) and 10 (p=0.015) and the CGG haplotype (p=0.02) were associated with LOAD in the women subgroup. The TAA haplotype was marginally protective in AD patients being associated with lower BPSD scores (p=0.01). The same haplotype was also associated with higher IL-1beta (p=0.01) production. These genetic effects were not modified by APOE4 allele and controlled for illness duration and treatment. In conclusion, SORL1 does not appear to be a major risk factor for LOAD. Its contribution could be underestimated in our small sample. Sex-specific factors could modulate the association between SORL1 and AD. The influence of SORL1 variants on production of inflammatory cytokines warrants further investigation.
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PMID:Effects of SORL1 gene on Alzheimer's disease. Focus on gender, neuropsychiatric symptoms and pro-inflammatory cytokines. 2346 34

Disaster preparedness in geriatric psychiatry was proposed on the basis of experience of the Great East Japan Earthquake. 1) Frail or demented elderly should be considered as a special population at risk for disaster victims and addressed in local disaster prevention programs. 2) To response to various psychiatric symptoms(delirium, BPSD, depression, anxiety, insomnia, and posttraumatic stress disorder) caused by medical conditions and rapid environmental changes due to disaster, linkage and coordination systems between psychiatric and medical sections should be established. 3) As a medium- and long-term support for the elderly who lost the community familiar to them, creation of a new community should be promoted in order to prevent depression, alcohol dependence, BPSD, and suicide.
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PMID:[Disaster psychiatry in late life]. 2426 Dec 21


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