P790
Poster Presentations: P4
body parts, plants, means of transport, food and musical instruments. First we eliminated those pictures whose naming agreement with the intended name was less than 90 % in the Czech healthy elderly. Then we asked 140 cognitively normal elderly controls (NC) and 75 patients with AD (Mini-Mental State Examination 2365 points) fulfilling NINCDS-ADRDA criteria to write down the names of the 35 pictures in either test version (some examples in the figure). All pictures were categorized into three groups according to the difference in the naming agreement between NC and AD patients. Results: We ranked 13 pictures as difficult (the difference more than 20 %, e.g. hippopotamus, pretzel, walrus), 14 ones as moderate (the difference 10 - 20 %, e.g. swan, cactus, lion) and 40 ones as easy (the difference less than 10 %, e.g. tree, sweater, hedgehog). AD patients made significantly more mistakes (unnamed or wrongly named pictures) than HC [median (min-max): the first version 5 (0-15) vs 0 (0-4); the second version 4 (0-20) vs 0 (0-2)]. To differentiate NC from AD patients we found following areas under the curves (AUC) and optimal cut-off scores using ROC analyses with corresponding sensitivities and specificities: the first version - AUC 0,88; > 1, 78 % and 85 %, the second version - AUC 0,90; > 2, 71 % and 99 %. Naming mistakes were independent of age or gender. Conclusions: Graded naming difficulty of the unambiguously named pictures by one Czech word could serve as an additional feature of AD. We invite collaborators from other countries to select universal pictures across the world according to the same principles.
P4-231
RELIABILITY AND VALIDITY OF THE KOREAN VERSION OF THE FRONTAL BEHAVIORAL INVENTORY IN PEOPLE WITH DEMENTIA
Eun Joo Kim1, Yeo-Jo Yoon1, Ji-Hyang Oh1, Min-Kyung Jo1, Go Woon Kim2, Ju Hee Chin3, Byoung Hwa Lee3, Duk L. Na3, 1Pusan National University Hospital, Busan, South Korea;
[email protected], Busan, South Korea; 3SMC, Seoul, South Korea. Contact e-mail:
[email protected] Background: Frontal behavioral inventory (FBI), a semistructured interview with caregiversfor 24-item abnormal behaviors, was specifically designed for the quantification of the personality and behavioral changes in frontotemporal dementia (FTD). The aim of this study was to examine the reliability and validity of the Korean version of FBI (K-FBI). Methods: K-FBI was developed after the translation of the FBI into Korean and backtranslation of the translated version into English. K-FBI was modifiedas a caregiver-adminstered questionarie, in which caregivers completed the K-FBI worksheet by scoring on a 4-point scale (0¼none, 1¼ mild, 2 ¼ moderate, 3 ¼ severe) for each item after a brief instruction. It wasadministered to the caregiviers of 278 patients(mean age: 70.12 6 8.40years, mean K-MMSE: 19.56 6 6.40, sex: 116 for male)with mild cognitive impairment (MCI) and dementia (94 patients with alzheimer’s dementia, 27 patients with FTD, 14 patients with vascular dementia, 106 patients with MCI, 37 patients with other dementia and congitive deficits). The cognitive and daily living functions, and other behavioral scales of all patients had been assessed at the same time. Results: The K-FBI showed good internal consistency (Cronbach’s alpha¼0.95) and test-retest reliability (r¼0.92). K-FBI was correlated with caregiver-administered neuropsychiatric inventory(CGA-NPI) (p¼ 0.74), FTD-specific NPI score which was
created from the sum of scores for five behaviros most typically associated with FTD including elation/euphoria, apathy, disinhibition, aberrant motor behavior and eating disordrs. K-FBI was also moderately correlated with K-MMSE (p¼ -0.55) and SNSB-D score (p¼-0.57). The K-FBI total cutoff score was 24.5 when the sensitivity and the specificity for differentitiating behavioral variant FTD(bvFTD) from non-bv FTDwere 65% and 63%, respectively. Conclusions: The K-FBI is a reliable and valid behavioral questionare to detect FTD like behavioral symptoms among patients with cognitive deficits and dementia.
P4-232
THE RELATIONSHIP BETWEEN PSYCHOTIC SYMPTOMS OF PEOPLE WITH ALZHEIMER’S DISEASE AND THEORY OF MIND SKILLS AND FUNCTIONALITY
Evrim Gode Oguten1, Isin Baral kulaksizoglu2, 1Istanbul University, Istanbul, Turkey; 2Istanbul University, Istanbul, Turkey. Contact e-mail:
[email protected] Background: Research on Alzheimer’s Disease (AD) has mostly focused on cognitive sypmtoms, however behavioral and neuropsychiatric symptoms are equally important as cognitive sypmtoms in the clinical profile of the disease. Especially psychotic sypmtoms are found to be associated with increase in caregiver burden, more institualisation necessity rapid cognitif decline. Theory of Mind (ToM), ability to attribute others mental states, thoughts and feelings, recently has become popular and been studied in AD. In this study, we have evaluated ToM skills which are thought to be responsible for social problems, decline in daily living activities and loss of insight among patients with and without psychosis in AD and investigated the relationship between psychotic symptoms and ToM skills and functionality. Methods: We have included 14 psychotic and 25 nonpsychotic, in total 39 AD patients. Psychotic and nonpsychotic patient groups were matched for age, gender and duration of illness. Patients were applied Minimental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Geriatric Depression Scale (GDS), Insight Scale (IS), Basic and Instrumental Activities of Daily Living (ADL & IADL) and Reading Mind in the Eyes Test (RMET) as an evaluating material for ToM. Results: The results have shown that there was no significant difference in ToM skills between psychotic and nonpsychotic patient groups. On the other hand, psychotic patients were worse at Activities of Daily Living, Insight and MMSE scores; and experience behavioral disturbances as Anormal Motor Behavior (AMB) more common than nonpsychotic ones. For whole group; RMET was found to be correlated with ADL & IADL, insight and MMSE scores according to Pearson Correlation Analysis. Conclusions: Functionality, insight and cognitive skills are found to be worse in patient group with psychotic signs. On the other hand, through whole group ToM skills are found to be correlated with functionality, insight and cognitive functions. In conclusion, evaluation of ToM skills and a better definition of psychotic symptoms and characteristics of this psychotic patient group who experience lack of insight, disability to preserve social status and performing activities of daily living more common, may lead to a better understanding of causes underlying these symptoms and develop novel treatment and therapy modalities.
P4-233
ANXIETY BUT NOT DEPRESSION AFFECTS SELFREPORTED SPATIAL NAVIGATION DIFFICULTIES IRRESPECTIVE OF THE REAL-SPACE NAVIGATION PERFORMANCE IN INDIVIDUALS AT RISK OF ALZHEIMER’S DISEASE
Katerina Sheardova1, Jan Laczo2, Martin Vyhnalek3, Ivana Mokrisova4, Zuzana Nedelska5, Ivana Gazova6, Petr Telensky7, Ross Andel8, Jakub Hort9, 1ICRC, St.Anne’s University Hospital Brno, Czech Republic, Brno, Czech Republic; 2Charles University in Prague 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic; 3Dpt. of Neurology, Motol University Hospital, Prague, Czech Republic; 4Charles University in Prague 2nd Medical School, Prague, Czech Republic;
Poster Presentations: P4 5 Charles University in Prague, Czech Republic and Mayo Clinic Rochester, MN, United States; 6Memory Clinic, Charles University in Prague 2nd Medical School, Prague, Czech Republic; 7Mayo Clinic Arizona, Scottsdale, Arizona, United States; 8School of Aging Studies, University of South Florida, Tampa, Florida, United States; 9International Research Center, Brno, Czech Republic, Prague, Czech Republic. Contact e-mail:
[email protected]
Background: Subjects with Mild Cognitive Impairment (MCI) have cognitive and spatial navigation (SN) impairment. Individuals without cognitive function or SN impairment yet reporting subjective memory complaints (SMC) are at higher risk of MCI or dementia. Subjects with depression or anxiety report SMC more frequently than those without depression or anxiety. Both, subjects with MCI and SMC suffer more frequently from depression and/or anxiety than their healthy peers.We investigated whether 1.) Depression or anxiety influences subjective perception of SN in SMC and in MCI 2.) Self-reported daily-life SN difficulties reflect the real-space navigation performance. Methods: A total of 76 subjects including patients with amnestic (aMCI; n¼29), nonamnestic (naMCI; n¼23) MCI and SMC (n¼24) underwent real-space navigation testing in the human analogue of the Morris Water Maze (hMWM). A multiple choice 15 item subjective SN complaints (SSNC) questionnaire assessing SN performance in one’s daily life was administered. Depression and anxiety was assessed by Geriatric Depression Scale (GDS) and Beck Anxiety Inventory (BAI) together with neuropsychological battery. Mann-Whitney U test was used. Results: There were no differences in GDS and BAI scores among aMCI, naMCI, and SMC subjects. MCI groups together did not report more SN complaints than SMC group regardless of differences in the real-space navigation performance between these two groups. However, when all subjects were divided according to their median BAI score (10) to anxious vs. non-anxious groups, there was a difference in total SSNC score (p¼0.037), specifically in items "worse orientation outside the neighborhood" (p
