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Stage-Specific Prevalence of Behavioral Symptoms in Alzheimer's Disease in a Multi-Ethnic Community Sample

Received December 11, 1998; revised February 11, 1999; accepted June 17, 1999. From the Alzheimer's Disease Research Satellite Diagnostic Clinic and the Department of Psychiatry and Behavioral Science, University of Washington, Seattle WA. Address correspondence to Dr. Chen, Box 356560, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195-6560.

The authors extended previous studies of the stage-specific prevalence of behavioral pathology to members of ethnic minority groups. Behavioral symptoms and their relationship to severity of Alzheimer's disease (AD) were examined in 125 heterogeneous minority elderly patients interviewed with a modified CERAD protocol, with behavioral symptoms scored on the caregiver-rated BEHAVE-AD Rating Scale. Behavioral disturbances were extremely common, occurring in 98% of the sample; the most common was activity disturbances (89%), followed by paranoid and delusional ideation (72%), aggressivity (64%), anxieties and phobias (61%), depressive symptoms (50%), sleep disturbances (43%), and hallucinations (34%). As in white patients, overall behavioral symptoms were most frequent among patients with moderate and severe dementia. Preliminary evidence supports the possibility of ethnic differences in behavioral profiles; Blacks showed lower affective, anxiety, and sleep symptoms than Asians and Hispanics, and lower total BEHAVE-AD scores than Hispanics. Inquiry in larger, population-based samples will be needed to determine whether the ethnic differences in behavioral symptoms of AD found here are robust and replicable.

Key Words: Alzheimer's Disease • Diagnostic Criteria • Ethnic Differences