The influences of psychotic symptoms on the activities of daily living of individuals with Alzheimer disease: a longitudinal analysis

The importance of behavioural and pyschological symptoms in Alzheimer's disease

INTRODUCTION

Behavioral and psychological symptoms of dementia (BPSD), present in the vast majority of patients with Alzheimer's disease (AD), cause extensive impairment in all areas, including functionality. Early diagnosis and management are critical, especially since these symptoms are not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) as a diagnostic criterion of AD, but only as specific features of some patients. The main purpose of this review is to highlight the importance of these behavioural and psychological symptoms of dementia, particularly in AD. In addition, we discuss why these symptoms have not been included in the latest DSM-V.

DEVELOPMENT

We conducted a literature search through various databases to gather data about BPSD in AD, and found a total of 12 articles.

CONCLUSIONS

BPSD are present in almost all patients and result in cognitive and functional impairment. The prevalence of these symptoms varies depending on the study and the symptom in question. In our view, BPSD should be included among the DSM diagnostic criteria for AD.

Reaching forward: effects of a preceding task and aging

Forward reaching is an integral part of many essential daily activities. It is often performed while standing quietly or after standing up from a seated position. This study sought to determine how a preceding balance task and aging would affect the task performance and movement strategy. Twenty-two healthy young and 20 older adults participated in this study and performed forward reaching under two task conditions. In forward reach (FR), reaching was performed during quiet standing. In up-and-reach (UR), subjects stood up from a seated position and then reached forward. A motion analysis system was used to calculate the location of the center of mass (COM) and joint angles at the initial and final positions, and the finger, COM, and joint angular displacements during the reaching task. For both groups, UR was initiated in a more flexed posture and had a significantly shorter reach distance and greater ankle dorsiflexion angle, compared to FR. The location of the COM, however, did not differ between the two task conditions. Older adults were found to significantly slow down their downward and forward COM motions in UR but not young adults. These findings showed that a preceding balance task increased the task demand and required modifications in the movement strategy. For older adults, the impact of increased task demand was greater, and adopting a cautious strategy could help to complete the task safely.