chapter  24
16 Pages

Treatment of the Neuropsychiatric Symptoms in Alzheimer’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Importance of Treating Behavioral Disturbances

ByDonna Masterman

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).