Relationship between Eating Disturbance and Dementia Severity in Patients with Alzheimer’s Disease

<div><p>Background</p><p>Eating is one of the most important daily activities in managing patients with dementia. Although various eating disturbance occur as dementia progresses, to our knowledge, most of the studies focused on a part of eating disturbance such as swallowing and appetite. There have been few comprehensive studies including eating habits and food preference in patients with Alzheimer’s disease (AD). The aims of this study were to investigate almost all eating disturbance and to examine the relationship of eating disturbance to dementia stage in AD.</p><p>Methods</p><p>A total of 220 patients with AD and 30 normal elderly (NE) subjects were recruited. Eating disturbance was assessed by a comprehensive questionnaire that had been previously validated. Potential relationships between the characteristics of eating disturbance and dementia stage as classified by the Clinical Dementia Rating (CDR) were assessed.</p><p>Results</p><p>Overall, 81.4% of patients with AD showed some eating and swallowing disturbance, whereas only 26.7% of the NE subjects had such a disturbance. Even in an early stage, patients with AD had many types of eating disturbance; “Appetite change” was shown in nearly half of the mild AD patients (49.5%). In the moderate stage, the scores of “change of eating habits and food preference” were highest, and in the severe stage “swallowing disturbance” became critical.</p><p>Conclusion</p><p>In AD, the relationship of dementia stage to eating disturbance differs according to the type of eating disturbance. The relationships between various eating disturbance and the severity of dementia should be considered.</p></div

Results of logistic regression analysis for the relationship between saving appearance responses and AD in people with AD and MCI.

<p>Results of logistic regression analysis for the relationship between saving appearance responses and AD in people with AD and MCI.</p

Results of logistic regression analysis for the relationship between saving appearance responses and AD in people with AD and DLB.

<p>Results of logistic regression analysis for the relationship between saving appearance responses and AD in people with AD and DLB.</p

Demographics of participants.

<p>Demographics of participants.</p

The percentages of people who had the saving appearance responses (SARs).

<p>MCI: mild cognitive impairment; AD: Alzheimer’s disease; DLB: dementia with Lewy bodies; *: <i>P</i> < 0.05 with Bonfferoni correction.</p

Prevalence of abnormal blood marker values (%).

<p>Prevalence of abnormal blood marker values (%).</p

Odds ratio of abnormal levels of biochemical blood markers (reference = AD).

<p>Odds ratio of abnormal levels of biochemical blood markers (reference = AD).</p

The Pareidolia Test: A Simple Neuropsychological Test Measuring Visual Hallucination-Like Illusions

<div><p>Background</p><p>Visual hallucinations are a core clinical feature of dementia with Lewy bodies (DLB), and this symptom is important in the differential diagnosis and prediction of treatment response. The pareidolia test is a tool that evokes visual hallucination-like illusions, and these illusions may be a surrogate marker of visual hallucinations in DLB. We created a simplified version of the pareidolia test and examined its validity and reliability to establish the clinical utility of this test.</p><p>Methods</p><p>The pareidolia test was administered to 52 patients with DLB, 52 patients with Alzheimer’s disease (AD) and 20 healthy controls (HCs). We assessed the test-retest/inter-rater reliability using the intra-class correlation coefficient (ICC) and the concurrent validity using the Neuropsychiatric Inventory (NPI) hallucinations score as a reference. A receiver operating characteristic (ROC) analysis was used to evaluate the sensitivity and specificity of the pareidolia test to differentiate DLB from AD and HCs.</p><p>Results</p><p>The pareidolia test required approximately 15 minutes to administer, exhibited good test-retest/inter-rater reliability (ICC of 0.82), and moderately correlated with the NPI hallucinations score (r_s = 0.42). Using an optimal cut-off score set according to the ROC analysis, and the pareidolia test differentiated DLB from AD with a sensitivity of 81% and a specificity of 92%.</p><p>Conclusions</p><p>Our study suggests that the simplified version of the pareidolia test is a valid and reliable surrogate marker of visual hallucinations in DLB.</p></div

Demographic and clinical profiles of the participants.

<p>Demographic and clinical profiles of the participants.</p

Numbers of patients who scored above or below the cut-off scores on the noise and scene pareidolia tests.

<p>Numbers of patients who scored above or below the cut-off scores on the noise and scene pareidolia tests.</p