Journal List > J Korean Neuropsychiatr Assoc > v.52(1) > 1017658

Yoon, Myung, Song, Choi, Kang, Na, Kim, Lee, Han, Choi, Kim, and Kim: Association between Insight and Neuropsychiatric Symptoms in Alzheimer's Dementia : A Clinical Research Center for Dementia of South Korea Study (CREDOS)



The aim of this study was to identify the association between insight and neuropsychiatric symptoms in patients with Alzheimer's dementia (AD).


We examined 2607 patients with AD in the Clinical Research Center for Dementia of South Korea study and designed a cross-sectional study. Each patient underwent psychiatric, neurological, and medical examination, interview for caregivers, laboratory tests, neuropsychological tests, and brain MRI. Cognitive function was measured using the Korean version of the Mini-Mental State Examination, Global Deterioration Scale, and Clinical Dementia Rating. Behavioral and psychological symptoms were measured using the Korean version of the Neuropsychiatric Inventory. Daily Living was measured using the Barthel Index for daily living activities and Seoul-Instrumental Activities of Daily Living. Insight was classified according to 'with insight', 'partial insight', and 'without insight' by interview with caregivers.


Among the 2607 patients, 990 were included in the 'with insight' group, 1191 were included in the 'Partial insight' group, and the 'without insight' group included 426 patients. The 'without insight' group had a significantly higher aggression level than the 'with insight' group, but not the 'partial insight' group [odds ratio (OR)=1.46, 95% confidence interval (CI) : 1,14-1.88]. A significantly lower prevalence of depression was observed in the 'Partial insight' group and the 'without insight' group, compared to the 'with insight' group (OR=0.51, 95% CI : 0.43-0.61/OR=0.61, 95% CI : 0.48-0.78). The 'partial insight' group showed a lower anxiety level than the 'with insight' group (OR=0.63, 95% CI : 0.53-0.75).


Findings of this study confirmed that insight level was associated with aggression, depression, and anxiety in patients with Alzheimer' dementia.

Figures and Tables

Table 1
Clinical and demographic characteristics (n=2607)

*: Chi-square test was used, : Kruskal-Wallis test was used. K-MMSE score : Korean Mini Mental State Examination score, CDR-SB : Clinical Dementia Rating Sum of Box, GDS : Global Deterioration Scale, ADL : Barthel Index daily living actives, S-IADL : Seoul-Instrumental Activities of Daily Living, NPI : Neuropsychiatric Inventory

Table 2
Association between prevalence of each NPI item and insight

*: Fisher's exact test was used ; p-value was corrected using False Discovery Rate method for testing 12 individual NPI items, : Logistic regression was used for controlling for age, sex, education and Clinical Dementia Rating Sum of Box, : p-value was corrected using False Discovery Rate (FDR) method for testing 12 individual NPI items. NPI : Neuropsychiatric Inventory, OR : Odds ratio, CI : Confidence Interval


This study was supported by grants of the Korea Healthcare technology R&D Project, the Ministry of Health and Welfare, Republic of Korea (A102065) and Eisai Korea Inc.


The authors have no financial conflicts of interest.


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