Document Detail

The neurobiology of neuropsychiatric syndromes in dementia.
MedLine Citation:
PMID:  17012935     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: Neuropsychiatric disturbances in dementia are prevalent, and research is uncovering their neurobiological correlates. RECENT FINDINGS: Late-onset depression appears to be associated with Alzheimer's disease pathology at autopsy, and lifetime depression episodes may worsen Alzheimer's disease pathology in the hippocampus. Vascular disease and elevated homocysteine increase risk for both late-onset depression and Alzheimer's disease and may partly mediate their relationship. Monoamine changes are robust finding in Alzheimer's disease and may account for many observed depression symptoms. Risk of psychosis of Alzheimer's disease appears to be increased by several genes also implicated in schizophrenia (e.g., catechol-O-methyltransferase, neuregulin-1). Psychosis in dementia with Lewy bodies appears to be related to cholinergic deficits. Alzheimer's disease is associated with changes in the circadian sleep-wake cycles, including decreased night-time melatonin. Sleep apnea may be related to apolipoprotein E genotype and impact cognition in Alzheimer's disease. Rapid eye movement sleep behavior disorder is intricately related to synucleinopathies, such as dementia with Lewy bodies, but synuclein changes may not totally explain this relationship. SUMMARY: Neuropsychiatric disturbances are a core feature of dementia and worsen many clinical outcomes. Among the most validated syndromes are depression, psychosis, and sleep disturbance of Alzheimer's disease. Neuropathology, neuroimaging, and genetic studies increasingly provide insight into the origins of these psychiatric symptoms in dementia.
Thomas W Meeks; Susan A Ropacki; Dilip V Jeste
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.; Review    
Journal Detail:
Title:  Current opinion in psychiatry     Volume:  19     ISSN:  0951-7367     ISO Abbreviation:  Curr Opin Psychiatry     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-02     Completed Date:  2007-03-01     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8809880     Medline TA:  Curr Opin Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  581-6     Citation Subset:  IM    
Division of Geriatric Psychiatry, Department of Psychiatry, University of California, San Diego, and Veterans Affairs San Diego Healthcare System, San Diego, California 92161, USA.
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MeSH Terms
Alzheimer Disease / complications,  psychology*
Dementia / complications,  psychology*
Depressive Disorder / complications,  psychology*
Neurobiology / methods*
Neuropsychology / methods
Psychotic Disorders / complications,  psychology*
Sleep Disorders / complications,  psychology*
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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