ABSTRACT
Behavioral symptoms are common in Alzheimer’s disease (AD) and represent a major source of the
disease morbidity. Neuropsychiatric disturbances have been associated with more rapid cognitive
decline (1), increased caregiver burden (2,3), increases in patient care costs due to earlier
institutionalization of the AD patient, greater medication use and more adverse side effects and
more extensive institutional staffing needs (4,5). Kaufer and colleagues (6) reported a strong
correlation between the amount of neuropsychiatric disturbance as measured by the
Neuropsychiatric Inventory (NPI) and the degree of caregiver distress with little relationship
between the degree of impairment on the Mini-Mental State Exam (MMSE) (7) and the degree of
caregiver distress. In addition, a recent cost analysis showed that AD patients with higher NPI
scores (worse psychopathology) had formal costs between $3,162 and $5,919 higher than those
with low NPI scores and the total direct costs between $10, 670, and $16,141 higher, depending on
the severity of cognitive impairments (8).