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P2‐095: Neuropsychiatric manifestations in dementia: Differences between young‐onset and late‐onset presentation
Author(s) -
Ebner Laura L.,
Rosenberg Paul B.,
Appleby Brian S.
Publication year - 2010
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 - 10.1016/j.jalz.2010.05.1141
Subject(s) - dementia , irritability , depression (economics) , medicine , pediatrics , age of onset , geriatric depression scale , psychiatry , depressive symptoms , cognition , disease , economics , macroeconomics
Background: Young onset dementia is less researched than late onset dementia; accordingly, the specific presentations of young onset dementia are not as well known. Neuropsychiatric symptoms across dementias of all ages are well documented; yet, there is no known study comparing neuropsychiatric symptoms of young onset dementia versus late onset dementia. Methods: The National Alzheimer’s Coordination Center database was used for the current study. Patients that were diagnosed with a dementia syndrome and had a documented cognitive decline within two years of the initial evaluation were selected for the study. Geriatric Depression Scale (GDS) and Neuropsychiatric Inventory (NPI) scores were compared by age at the time of initial evaluation. Results: 792 subjects were included in the study. Mean GDS scores were highest in those 50 years of age and declined by age, with the exception of those who were 91-100 years of age. GDS severity (score 1⁄4 12-15) was associated with younger age (HR 1⁄4 2.19, 95% CI 1⁄4 2.19-4.66, p 1⁄4 0.042). NPI symptoms of agitation (HR 1⁄4 1.27, 95% CI 1⁄4 1.06-1.53, p 1⁄4 0.011), depression (HR 1⁄4 1.27, 95% CI 1⁄4 1.04-1.56, p 1⁄4 0.017), elation (HR 1⁄4 1.82, 95% CI 1⁄4 1.25-2.67, p 1⁄4 0.002), and irritability (HR 1⁄4 1.27, 95% CI 1⁄4 1.07-1.52, p 1⁄4 0.007) were associated with younger age at dementia diagnosis. Depression within 2 years of the initial evaluation was also associated with a younger age at dementia diagnosis (HR 1⁄4 1.2, 95% CI 1⁄4 1.02-1.41, p 1⁄4 0.027). Conclusions: The results suggest depression, agitation, elation, and irritability may be early signs of cognitive decline in patients with a young age at dementia onset. The identification of symptoms specific to young onset may enable clinicians to identify cognitive decline earlier; thereby, enacting treatment earlier.