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Neuropsychiatric symptom burden across neurodegenerative disorders and its association with function
Author(s) -
Kapustin Daniel,
Zarei Shadi,
Wang Wei,
Black Sandra E.,
Finger Elizabeth,
Freedman Morris,
Hink Heather,
Kwan Donna,
Lang Anthony,
Masellis Mario,
McLaughlin Paula,
Pollock Bruce G.,
Saposnik Gustavo,
Strother Stephen C,
Sunderland Kelly M,
Swartz Richard H.,
Tan Brian,
TangWai David F.,
Tartaglia Carmela,
Turnbull John,
Zinman Lorne,
Rajji Tarek K.,
Fischer Corinne E.,
Kumar Sanjeev
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.047279
Subject(s) - montreal cognitive assessment , activities of daily living , amyotrophic lateral sclerosis , cognition , dementia , medicine , frontotemporal dementia , alzheimer's disease , disease , cognitive impairment , psychology , psychiatry
Background Neuropsychiatric symptoms (NPS) are common in neurodegenerative disorders such as Alzheimer’s disease/Mild Cognitive Impairment (AD/MCI), Parkinson’s disease (PD), Frontotemporal Dementia (FTD), Amyotrophic Lateral Sclerosis (ALS) and in those with Cerebrovascular disease (CVD). The relationship between symptoms, cognition, and function in these cohorts is unclear. Method Data was obtained from the Ontario Neurodegenerative Disease Research Initiative study. We used the Neuropsychiatric Inventory Questionnaire‐ severity scale (NPIQ) to measure NPS, Montreal Cognitive Assessment (MoCA) for cognition, and Lawton’s informant based questionnaires to measure basic and instrumental activities of daily living (ADLs/iADLs). Linear regression was performed to investigate the effects of NPS on ADL and iADL function while controlling for age, education and cognition. Results were bootstrapped by resampling residuals (n=1,000) to control for non‐normal sample distribution. Result 520 participants were enrolled: AD/MCI (n=126), VCD (n=161), PD (n=140), FTD (n=53), and ALS (n=40). There were significant differences between these cohorts on NPIQ scores (AD/MCI=16.77±0.18, VCD=16.94±0.12, PD=16.34±0.17, FTD=21.44±0.15, ALS=14.19±0.22, p < .001). Across combined cohorts, NPIQ was inversely correlated with MoCA (rs=‐0.15, p =.001), iADLs (rs=‐0.32, p <.001), and ADLs (rs=‐0.34, p <.001). NPIQ (alone) predicted iADLs in FTD, and (together with MoCA) in MCI/AD and PD (Corrected p values < .05) but not in CVD or ALS. Further, NPIQ alone predicted ADLs in AD/MCI, FTD and PD (Corrected p values < .05) but not in VCD or ALS. Conclusion NPS burden was different across neurodegenerative disease cohorts. NPS were the main determinants of function in FTD, and in AD/MCI and PD when combined with cognition. However, NPS did not determine function in VCD or ALS. These findings indicate the need for further research into biomarkers of NPS and function, and targets of clinical interventions in neurodegenerative disorders.