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Ann Geriatr Med Res  <  Volume 14(3); 2010 <  Articles

J Korean Geriatr Soc 2010; 14(3): 131-138  https://doi.org/10.4235/jkgs.2010.14.3.131
Relationship between Neuropsychiatric Symptoms and Activities of Daily
Living in Alzheimer’s Disease
Seon-Young Ryu, MD1, Sang-Bong Lee, MD1, Tae-Woo Kim, MD1, In-Uk Song, MD2,
Eun-Young Oh, MS1, Hye-Yeoung Choi3
Department of Neurology, 1Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Daejeon,
2Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon,
3Department of Clinical Psychology, Chungnam National University Graduate School, Daejeon, Korea
Published online: September 1, 2010.
© The Korea Geriatrics Society. All rights reserved.

Abstract
Background: In Alzheimer’s disease (AD), cognitive impairment is associated with functional impairment; and neuropsychiatric
symptoms are common in AD patients. However, there have been few studies about the relationship between
neuropsychiatric symptoms and functional state in AD. The objective of this study is to investigate the effects of neuropsychiatric
symptoms on activities of daily living in AD.
Methods: We reviewed the medical records of 60 AD patients meeting the criteria of the Neurological and Communicative
Disorders and Stroke-Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) for probable AD (mean
age, 75.4±7.0 years; 13 men, 47 women). The relationships between the Neuropsychiatric Inventory (NPI) and two functional
measures, instrumental activities of daily living (IADL) and the Barthel Index, were analysed.
Results: The total NPI score was significantly associated with both functional measures (IADL: r=0.543; Barthel Index: r=
-0.515), as were the NPI subscale scores of delusion, hallucination, agitation, depression, anxiety, and irritability. Multivariate
regression analyses showed that total NPI score and duration of dementia were significant predictive factors for
both IADL and the Barthel Index. In addition, the total NPI score still significantly influenced the two functional measures after
controlling for age, duration of dementia, and Mini-Mental State Examination.
Conclusion: The total NPI score was a significant predictive factor for functional status beyond the contribution of cognitive
impairment in AD. Neuropsychiatric symptoms are associated with increased functional impairments in AD. Screening
and management of neuropsychiatric symptoms during the course of AD would be helpful in improving functional status.
Keywords: Neuropsychiatric symptoms, Activities of daily living, Alzheimer’s disease


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