Prevalence and implications of psychopathological non-cognitive symptoms in dementia

Objective:  Clinical experience and recent population studies suggest that psychopathological, non-cognitive symptoms are both frequent and relevant in dementia. Method:  A representative community sample (n = 4,803 individuals, 55 + years) was interviewed in a two-phase design. The Geriatric Mental Sate (GMS) was used for assessment and cases were diagnosed according to DSM-IV-TR criteria. Results:  The prevalence of non-cognitive symptoms (1 + symptoms) in cases of dementia (n = 223) was 90.1%, and negative-type symptoms were most frequently found. A GMS ‘apathy-related symptom cluster’ (anergia, restriction of activities and anhedonia) was significantly more frequent in the demented (55.6%) than in non-cases (0.7%; specificity = 99.2%). In both dementia of Alzheimer’s type and vascular dementia, number of symptoms tended to be inversely related to severity of dementia, but psychopathological profiles differed. Conclusion:  Non-cognitive, negative-type symptoms are very frequent in cases of dementia living in the community. They have powerful specificity in the distinction with non-cases, and might change current concepts of dementia.