Open AccessMisidentification Subtype of Alzheimer's Disease Psychosis Predicts a Faster Cognitive Decline
Author(s) -
D'Antonio Fabrizia,
Reeves Suzanne,
Sheng Yucheng,
McLachlan Emma,
Lena Carlo,
Howard Robert,
Bertrand Julie
Publication year - 2019
Publication title -
cpt: pharmacometrics and systems pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 37
ISSN - 2163-8306
DOI - 10.1002/psp4.12389
Subject(s) - psychosis , cognitive decline , disease , cognition , psychology , delusion , apolipoprotein e , schizophrenia (object oriented programming) , alzheimer's disease , psychiatry , pathological , neuroimaging , dementia , clinical psychology , logistic regression , medicine
The presence of psychosis is associated with a more rapid decline in Alzheimer's disease ( AD ), but the impact of paranoid (persecutory delusions) and misidentification (misperceptions and/or hallucinations) subtypes of psychosis on the speed of decline in AD is still unclear. We analyzed data on Alzheimer's Disease Neuroimaging Initiative 2 participants with late mild cognitive impairment or AD, and we described individual trajectories of Alzheimer's Disease Assessment Scale–Cognitive Subscale scores using a semimechanistic logistic model with a mixed effects–based approach, which accounted for dropout and adjusted for baseline Mini Mental State Examination scores. The covariate model included psychosis subtypes, age, gender, education, medications, and Apolipoprotein E epsilon 4 (Apo‐e ε4 genotype). We found that the Alzheimer's Disease Assessment Scale–Cognitive Subscale rate of increase was doubled in misidentification ( β r,misid_subtype = 0.63, P = 0.031) and mixed (both subtypes; β r,mixed_subtype = 0.70, P = 0.003) when compared with nonpsychotic (or paranoid) patients, suggesting that the misidentification subtype may represent a distinct AD sub‐phenotype associated with an accelerated pathological process.