Psychiatric and cognitive disorders were evaluated on an all-inclusive basis in 64 patients with dementia of Alzheimer type and related to regional cerebral blood flow (CBF) measured by SPECT. Isolated affective troubles were found in 22 patients and isolated behavioral changes in 24 cases, whereas only 5 patients presented with both type of disorders. Delirious reactions and hallucinations never occurred alone and were present in only 4 patients. The occurrence and severity of psychiatric disorders were related to the overall severity of dementia and to the magnitude of the instrumental (cortical functions) deficit for most patients, with no difference according to affective versus behavioral disorders. Later onset and higher prevalence of females characterized the group of 14 patients with preponderant psychiatric over instrumental disorders. Left parietotemporal hyperperfusion was associated with prominently decreased instrumental capacities, whereas no peculiar flow defect was associated with either type of psychiatric disorder, while in the 14 patients with preponderant psychiatric impairment, mean CBF was only slightly reduced compared to controls.

Keywords:
Dementia of Alzheimer type, Psychiatric disorders, Cognitive impairment, Cerebral blood flow, Single-photon emission tomography
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© 1990 S. Karger AG, Basel
1991
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