Longitudinal assessment of symptoms of depression, agitation, and psychosis in 181 patients with Alzheimer's disease

Am J Psychiatry. 1996 Nov;153(11):1438-43. doi: 10.1176/ajp.153.11.1438.


Objective: The goal of this study was to define the recurrence or continuation of neuropsychiatric symptoms in patients with Alzheimer's disease who were observed serially for a 1-year period.

Method: One hundred eighty-one patients with probable Alzheimer's disease were assessed five times at 3-month intervals with a standardized neuropsychiatric rating instrument.

Results: Recurrence rates of neuropsychiatric symptoms during the 1-year period were 85% for depression, 93% for agitation, and 95% for psychosis. Symptom frequency at any point in time underestimated the cumulative 1-year frequency. Recurrence rates were significantly greater among patients who had multiple symptoms. Women exhibited more symptoms than men. Patients in the oldest age group (76-87 years) had more psychosis, less depression and agitation, and slower cognitive decline. Psychosis was associated with more rapid cognitive decline, and agitation was associated with more rapid functional deterioration.

Conclusions: These results indicate that once psychiatric symptoms are present in patients with Alzheimer's disease, they frequently recur. These symptoms vary with age, sex, and rate of illness progression.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / diagnosis*
  • Alzheimer Disease / psychology
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / psychology
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / psychology
  • Disease Progression
  • Double-Blind Method
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Placebos
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / psychology
  • Recurrence
  • Severity of Illness Index
  • Sex Factors


  • Placebos