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P4‐047: Behavioral correlates of cognitive decline in normal aging and prodromal Alzheimer's disease
Author(s) -
Goukasian Naira,
LeClair Holly,
Hwang Kristy S.,
Ringman John M.,
Cummings Jeffrey L.,
Apostolova Liana G.
Publication year - 2015
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.2015.06.1751
Subject(s) - irritability , dementia , logistic regression , medicine , alzheimer's disease , cognitive impairment , cognitive decline , disease , odds ratio , psychiatry , psychology , cognition
Background: Neuropsychiatric behaviors are often seen in mild cognitive impairment (MCI). The frequency rates might be influenced by presence or absence of amyloid pathology. Methods: 669 elderly ADNI participants (213 NC and 429 MCI) were followed longitudinally for an average of 0.5(±1.5) years. NC and MCI subjects received [18F]-Florbetapir PET 0.8(±1.8) and 0.4(±1.3) years into the study, respectively. 27[percnt] of NC and 50[percnt] of MCI were amyloid positive. Yearly neuropsychiatric inventory (NPI) data was collected from the study partners at each visit. NPI symptoms were coded as present or absent. Fisher-exact or Wicoxon rank test was used as appropriate. Results: Amyloid positive NC were older (76.4 vs. 71.7 yrs, p<0.001) and more likely to be APOE4 positive (38[percnt] vs. 23[percnt], p=0.025) yet had a lower mean total NPI score (0.6 vs. 0.9, p=0.001) and significantly lower frequency of depression at baseline (2[percnt] vs. 10[percnt], p=0.046). They were, however, significantly more likely to develop depression (26[percnt] vs. 10[percnt], p=0.008) and sleep abnormalities (28[percnt] vs. 12[percnt], p=0.007) in follow-up.Amyloid positive MCI were older (73.9 vs. 69.6 yrs, p<0.001), more likely to be APOE4 positive (70[percnt] vs. 25[percnt], p<0.001) and had a higher mean total NPI score (4.5 vs. 3.1, p<0.001). Amyloid positive MCI had significantly greater frequency of anxiety (21[percnt] vs. 10[percnt], p=0.002) and agitation (21[percnt] vs. 14[percnt], p=0.042) at baseline and were significantly more likely to develop delusions (9[percnt] vs. 1[percnt], p<0.001), hallucinations (8[percnt] vs. 2[percnt], p=0.006), apathy (28[percnt] vs. 15[percnt], p=0.002), disinhibition (20 [percnt] vs. 12[percnt], p=0.024), aberrant motor behavior (15[percnt] vs. 7[percnt], p=0.005) and appetite disturbances (27[percnt] vs. 16[percnt], p=0.007) in follow-up. Conclusions: Amyloid positive MCI subjects have higher prevalence and incidence of neuropsychiatric behaviors. Although amyloid positive NC were significantly less depressed at baseline they developed higher rates of depression over time. Disclosure: Dr. Goukasian has nothing to disclose. Dr. Do has nothing to disclose. Dr. Grotts has nothing to disclose. Dr. Ringman has received research support from Janssen, Pfizer, Accera, Bristol Myers Squibb, and Wyeth Pharmaceuticals. Dr. Elashoff has nothing to disclose. Dr. Apostolova has received personal compensation from Eli Lilly for speaker and advisory services. Dr. Apostolova received research support from General Electric Healthcare.