Relationships between neuropsychiatric symptoms and cognitive profiles in Alzheimer's disease and related syndromes

• Published in: International journal of geriatric psychiatry 2023-07, Vol.38 (7), p.e5960-n/a
• Main Authors: Seixas‐Lima, Bruna, Binns, Malcolm, Black, Sandra E., Fischer, Corinne, Freedman, Morris, Kumar, Sanjeev, Lahiri, Durjoy, Roncero, Carlos Tyler, Strother, Stephen, Tang‐Wai, David F., Tartaglia, Maria Carmela, Chertkow, Howard
• Format: Article
• Language: English
• Subjects: Age; Alzheimer Disease - psychology; Alzheimer's disease; Case-Control Studies; Cognition; Cognitive ability; Cognitive Dysfunction - psychology; Dementia; Dementia disorders; Emotional behavior; Executive function; Female; Geriatric psychiatry; Humans; Memory; Mental disorders; mild cognitive impairment; Neurodegenerative Diseases; neuropsychiatric symptoms; Neuropsychological Tests; Retrospective Studies; Short term memory; Spatial memory; subjective cognitive impairment; Syndrome; Vascular dementia; young‐onset AD
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/gps.5960

Objectives To investigate the rate of occurrence of neuropsychiatric symptoms (NPS) and their relationship with age, sex and cognitive performance in subjects with Alzheimer's disease and related dementias (Alzheimer's disease and related dementias [ADRD]). Methods This is a retrospective matched case‐control study. Data from memory clinic patients included demographic information presence of NPS, and cognitive testing of Orientation, Immediate and Delayed Memory, Visuospatial Function, Working Memory, Attention, Executive Control and Language. Participants were Individuals with subjective cognitive impairment (n = 352), mild cognitive impairment (MCI) (n = 369), vascular MCI (n = 80), Alzheimer's disease (n = 147), vascular dementia (n = 41), mixed dementia (n = 33), and healthy controls (n = 305). Logistic regression was used to investigate the relationship between the presence of NPS, age and sex. A generalised additive model was used to investigate the relationship between presence of NPS, age and cognitive impairment. Analysis of variance was used to investigate differences in cognition between younger and older groups with and without NPS. Results We found an increased likelihood of occurrence of NPS in younger individuals and females across cohorts. Anxiety, depression, agitation, and apathy were associated with higher overall rate of NPS. We also found that individuals under 65 years of age with NPS had worse cognitive scores than their counterpart without NPS. Conclusion The younger group with ADRD and NPS had lower cognitive scores, probably reflecting more aggressive neurodegenerative disease. Further work will be needed to elicit the degree to which imaging or mechanistic abnormalities distinguish this group. Key points Younger individuals with Alzheimer's disease and related dementias (ADRD) were more likely to present with neuropsychiatric symptoms (NPS) than older individuals. Younger individuals with ADRD and NPS showed lower cognitive scores than individuals in the same age group without NPS, which was not observed in the older group.