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Objectives: To assess the prevalence of neuropsychiatric symptoms (NPS) in mild-to-moderate Alzheimer disease (AD) and their association with caregiver burden.Methods: Secondary analyses of baseline data from the Trial of Vitamin E and Memantine in Alzheimer's Disease (TEAM-AD) (N=613). Neuropsychiatric Inventory were used to measure severity of NPS and caregiver activity survey to measure caregiver burden.Results: A total of 87% of patients displayed at least 1 NPS; 70% displayed clinically meaningful NPS. The most common symptoms were apathy (47%), irritability (44%), agitation (42%), and depression (40%). Those with moderate AD had more severe NPS than those with mild AD ( P = .03). Neuropsychiatric symptoms were significantly associated with caregiver time after adjusting for age, education, cognitive function, and comorbidity ( P-value < .0001) with every point increase in NPS associated with a 10-minute increase in caregiver time.Conclusion: Neuropsychiatric symptoms were prevalent in both mild and moderate AD, even in patients receiving treatment with an acetylcholinesterase inhibitors, and were more severe in moderate AD and associated with greater caregiver time. [ABSTRACT FROM AUTHOR]

To examine the utility of the dexamethasone suppression test (DST) in the differential diagnosis of depression in elderly demented patients, we reviewed the literature and focused on four components of this question: (1) cortisol nonsuppression rates in dementia; (2) cortisol nonsuppression and dementia severity; (3) cortisol nonsuppression in demented versus depressed patients; and (4) cortisol nonsuppression following antidepressant treatment. A combined analysis of 27 articles showed cortisol nonsuppression in 60% of patients with concurrent dementia and depression, in 47% of patients with depression only, in 41% of patients with dementia only, in 46% of patients with multi-infarct dementia, in 36% of patients with primary degenerative dementia, and in 10% of controls. The abnormal DST rate in demented patients was not significantly different from the abnormal DST rate in depressed patients. Eight of 12 studies (67%) did not find a significant relationship between DST results and dementia severity in dementia patients without depression. Twelve of 13 studies (92%) did not find a relationship between age and DST outcome. The data we reviewed do not support the use of the DST in discriminating between depression and dementia or between dementia subtypes. (J Geriatr Psychiatry Neurol 1990;3:124-138) . [ABSTRACT FROM PUBLISHER]

Changes in smooth pursuit eye movements and the P300 component of the auditory evoked potential were studied in patients with primary degenerative dementia during a double-blind, placebo-controlled study of ergoloid mesylates (Hydergine). After 18 weeks of treatment, P300 latency and amplitude, recorded at three scalp electrode sites, had not changed significantly. Smooth pursuit gain was elevated for the drug group under some stimulus conditions, suggesting a normalization of pursuit eye movement functioning. However, the results of several other measures of the quality of pursuit eye movements failed to corroborate this finding. (J Geriatr Psychiatry Neurol 1990; 3:41-47). [ABSTRACT FROM PUBLISHER]