Biomedical subjects
Publications and source records attributed to M Haupt.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
BACKGROUND: The aim was to examine the longitudinal occurrence and persistence of behavioural and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD). METHODS: Following 60 patients with mild to severe AD over a period of 2 years with annual evaluations, the prospective occurrence and persistence of BPSD in AD were determined by using the Behavioural Abnormalities in AD Rating scale (BEHAVE-AD). Clinical and demographic features of the AD patients were analysed for their association with course features of these symptoms. RESULTS: All of the 60 AD patients experienced BPSD at some point during the 2-year period, particularly agitation was present in every patient within this period. 2-year persistence of BPSD in AD was frequently observed in patients with agitation and with depressiveness, with less frequency in patients with anxiety and aggressiveness, but not in patients with delusions or hallucinations. 2-year persistent aggressiveness was associated with older age and more functional impairment. More functional impairment was also related to 2-year non-persistent hallucinations. CONCLUSIONS: Counselling AD patients and their families and tailoring therapeutic strategies should take into account the different modi of BPSD in AD occurring and persisting longitudinally and interacting with functional disturbances.
Cognitive deficits are the most important symptoms in the diagnosis of dementia. Changes in noncognitive behavioural areas often go unrecognised at examination or are considered insignificant. These abnormalities, however, contribute most to the caregiver's burden, interfere with the individual well-being of the patient, and are predictors of early institutionalization. Psychotherapeutic interventions in dementia complete the treatment effects achieved by psychopharmacology, cognitive enhancers, and cognitive training of target functions. Psychotherapy in dementia should be based on an interacting form of therapy, i.e. a contingency management in the natural environments of the dementia sufferer where the primary caregiver, as a mediator, takes over the main therapeutic tasks.
In a longitudinal study of 90 patients with mild to moderate dementia of the Alzheimer type (DAT) we investigated the relative severity of impairment in a confrontation naming, a categorical word fluency and a word list recall task. Severity of impairment was assessed in comparison to a healthy age-matched control group. At baseline, confrontation naming and fluency deficits were about equally often the most severe deficit. The number of patients with most severe naming deficits increased from mild to moderate dementia and from baseline to 1-year follow-up. Word recall was the most severe deficit only in a minority of patients. An addition of lexical-semantic and visual-perceptive dysfunctions is discussed as a possible cause for the shift towards naming deficits in the course of the disease.
Eighty-eight patients with mild to moderate dementia of the Alzheimer type were tested in a word list and a spatial pattern recall task. With increasing degree of dementia severity we found a decline in the initial recall scores while learning curves over five consecutive trials remained normal in the mildly demented patients. Furthermore, there was a loss of the primacy effect in the word list task in our moderately demented patients. These findings are consistent with the pattern that have been reported after medial temporal lobe dysfunction. The data are discussed in the framework of cognitive dual process theories of memory as indicators of a contextual retrieval deficit.
Clinical research into Alzheimer's disease has predominantly focused on standardized assessment of cognitive impairment and behavioral changes. The description of feelings and attempts of adaptation of patients with Alzheimer's disease is a neglected area. Here we present five statements, each given by a patient with Alzheimer's disease, and investigate perception and attempts of adaptation contained in these statements. Important consequences for the care of patients with Alzheimer's disease are discussed.
The relevance of the apolipoprotein E epsilon 4 allele as risk factor for Alzheimer's disease is independent of age. This was demonstrated in 126 patients and 72 healthy controls. The age in both groups varied between 44 and 95 years. An earlier onset of symptoms among carriers of the epsilon 4 allele, however, was observed only in the oldest patients. This may reflect a selection bias which is due to the association of the epsilon 4 allele with two competitive age-dependent risks: for Alzheimer's disease and for coronary heart disease. In a subsample of 64 patients who had participated in a longitudinal study no relationship was found between the apolipoprotein E genotype and clinical symptoms or symptom progression.
A register of the families of 60 patients with Alzheimer's disease was established with two questionnaires (the Family History Questionnaire and the Patient History Questionnaire). These questionnaires, instruments of the MIRAGE study, were translated into German. 35% of the families had more than one family member affected with dementia. The frequencies of the risk factors that were studied were surprisingly high. The responses of the family members to the study were very positive and encourage further investigation in the field of genetic epidemiology in Alzheimer's disease.