To assess the onset and subsequent course of cognitive, behavioural and neuropsychiatric symptoms of Alzheimer's dementia (AD) we considered the clinical course of these groups of symptoms in 100 patients with NINCDS-ADRDA AD, > 65 years from onset to exitus during the phases t0 (early), t1 (state), t2 (neurological) and t3 (medical). Memory, depressive (40%), anxious (30%), sexual (15%) disturbances are frequent during t0. During t1, memory disturbances worsen in 90% of patients, and attention deficit (46%) and difficulty in abstract thinking appear. During t2, eating disorders (80%), stereotypy (38%), and delusions (23%) appear; anxiety and attention deficit (74%) worsen. During t3, eating disorders (95%) and delusions (46%) increase; higher brain functions can no more be assessed through neuropsychological tests. We showed progressive deterioration of cognitive function and behaviour, and abrupt onset and rapid progress of neuropsychiatric and medical disturbances during AD.
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