Prevalence and management of non-cognitive symptoms of Alzheimer's disease.

Selective studies demonstrate that non-cognitive symptoms such as affective instability. psychotic symptoms and behavioral disorders have an extremely variable incidence ranging form 0 - 90% in Alzheimer's disease. We monitored 126 Alzheimer patients for four years for the non-cognitive symptoms. Affective lability was the most frequent finding, followed by inability to cope with day-to-day activities (52,4% and 50;0% respectively). Symptoms of anxiety and depression were apparent in 37,7%. Female patients met criteria of major depression much more frequently and their depressive symptoms increased in severity until the fourth year from the onset of Alzheimer's disease. Caregivers found excessive agitation (37,3%) wandering (31,7%), non-compliance (34,9%), and nocturnal agitation (28,6%) to be the most demending challenges. Together with delusions and hallucinations these symptoms were the most frequent reasons for transferral to a psychiatric facility. One of the challenges of therapy management in Alzheimer's disease is that it has to be multi-dimensional. It is supposed to reduce disease symptoms and to limit care-related stress for the caregivers. It's scope encompasses psychosocial interventions such as organized assistance with daily life of group activities, cognitive training, as well as psychotropic drug therapy with antidepressants, MAO-B-inhibitors, anticonvulsants and acetylcholinesterase inhibitors.