The role of pathological grief reaction in the development of old age dementia

Background: much research has been devoted to investigation of pathological grief reaction (PGR) in late age and its affective disorder outcomes, however the role of PGR in the development of dementia in the elderly and old age patients is studied insufciently. The aim of the study was to investigate the PGR role in the development of dementia in late age and to determine the impact of psyсhogenic experience on the course and specifcities of the clinical picture in Alzheimer’s disease (AD) and vascular dementia (VaD). Material: during continuous examination of 134 patients, frst hospitalized in geriatric departments of MHRC clinic due to dementia, 42 subjects were selected (31,3% from the total number of hospitalized patients), having endured bereavement of emotionally important person in late age. Two groups were formed from among of these patients: the main group, consisting of 20 patients (46,7% from the patients of general sample), having endured bereavement of important person with PGR, and comparison group, including22 patients (53,3%), in whom bereavement was not accompanied with PGR. Two groups of patients with dementia syndrome in AD and VaD were comparable according to various clinical and demographic parameters. Methods were used as follows: psychopathological, clinical, brain MRI, psychometric (MMSE), neuropsychological examination. Results: the study showed, that in patients with PGR in the past medical history terms of development of marked manifestations of dementia syndrome reduced almost twice, and in the structure of the main disease reactive experiences were preserved in the form of PRG symptoms although in an erased state. Residual PRG symptoms in the structure of dementia have defnite specifc character depending on nosological belonging of dementia. In AD psychopathological disorders presented more often the form of delusions and perception illusion, and in VaD the symptoms bear more marked affective character. Conclusion: PGR in aged may be a trigger of manifestation, or quick increase of dementia. The clinical picture of dementia is complicated by residual PGR symptoms. The risk of dementia manifestation following the development of pathological grief reaction makes it necessary to carefully study cognitive functions in individuals, enduring bereavement in old age, and timely beginning of anti dementia treatment.

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