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The Neuropsychiatric Inventory Scores Change Across the Mini Mental State Examination Ranges in Patients With Alzheimer's Disease: A Multicenter Study in Turkey

Yener, Görsev G. MD, PhD; and Turkuaz Alzheimer Working (TAÇ) Group

Cognitive & Behavioral Neurology:
doi: 10.1097/WNN.0b013e3181c14737
Original Studies

Objective: To investigate neuropsychiatric manifestations in patients at various stages of Alzheimer's disease (AD).

Background: Several earlier studies reported high prevalence of neuropsychiatric symptoms in patients with AD; to date, no such study has been conducted in Turkey.

Method: We evaluated 217 patients with AD from 18 referral centers across Turkey using a web-based dementia data registry. The Mini Mental State Examination and the Neuropsychiatric Inventory (NPI) were used to evaluate the global cognitive function, and assessment of neuropsychiatric symptoms, respectively. We classified the patients into mild, moderate, and severe stages on the basis of their Mini Mental State Examination scores. We assessed group differences and correlations between the degree of AD severity and NPI values.

Results: The highest NPI scores were seen in patients with severe AD. The mean composite scores for apathy, anxiety, and depression were the highest. The prevalence of any behavioral symptom was 86%. There was no difference in the behavioral domain between the groups or between the referral centers. Moderate correlation was found between the severity of AD and the total NPI score. The caregivers' NPI distress scores varied among referral centers.

Conclusions: The prevalence of behavioral disturbance in AD is high and similar to earlier studies, yet regional differences are seen in caregivers' reactions to behavioral symptoms.

Author Information

Department of Neurology and Neurosciences, Brain Dynamics Multidisciplinary Research and Application Center, Dokuz Eylul University, Izmir Turkey

Financial Support: the TAÇ web-based dementia registry was supported by the Sanovel Drug Company, Turkey.

Reprints: Görsev G. Yener, MD, PhD, Departments of Neurology and Neurosciences, Dokuz Eylul University, Izmir, 35340, Turkey (e-mail:

Received for publication December 15, 2008

accepted September 13, 2009

Disclosure: none declared.

© 2009 Lippincott Williams & Wilkins, Inc.