Neuropsychiatric Symptoms and Global Functional Impairment along the Alzheimer's Continuum

Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass., USA.
Dementia and Geriatric Cognitive Disorders (Impact Factor: 2.81). 08/2012; 34(2):96-111. DOI: 10.1159/000342119
Source: PubMed

ABSTRACT Background/Aims: Neuropsychiatric symptoms in Alzheimer's disease (AD) are highly prevalent. We sought to determine whether neuropsychiatric symptoms were related to global functional impairment at baseline and over a 3-year period in older normal control (NC), mild cognitive impairment (MCI) and mild AD dementia subjects. Methods: Eight hundred and twelve subjects (229 NC, 395 MCI, 188 AD) from the Alzheimer's Disease Neuroimaging Initiative study underwent cognitive and behavioral assessments over 3 years. Results: Greater hallucinations, anxiety and apathy were associated with greater global functional impairment at baseline, while the presence of hallucinations and apathy at baseline was associated with greater global functional impairment over time across all subjects. The following neuropsychiatric symptoms were not significantly associated with global functioning: delusions, agitation, depression, euphoria, disinhibition, irritability, aberrant motor behaviors, sleep and appetite. Conclusions: These results suggest that increased baseline hallucinations, apathy and anxiety are associated with current and future disease progression in AD.

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    • "A possible confound that may affect the interpretation of the findings is that many of these biomarkers can be viewed as non-specific measures of disease rather than specific, as a number of studies have shown the levels of inflammatory processes change as the disease progresses [49] and the impact may be different at different points in the disease. This may be reflected by the fact that the prevalence of the various NPS changes over the course of the disease [50]. An additional limitation relates to the use of informant data. "
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