A-1 Neuropsychiatric Symptoms over Time in Autopsy-Confirmed Alzheimer’s Disease, Lewy Body Disease, and Mixed Pathology

2021 ◽  
Vol 36 (6) ◽  
pp. 1022-1022
Author(s):  
Jeff Schaffert ◽  
Will Goette ◽  
Anne Carlew ◽  
Allison Parker ◽  
Saranya Patel ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Lewy Body ◽  
Neuropsychiatric Symptoms ◽  
Depression Scale ◽  
Lewy Body Disease ◽  
Cognitive Status ◽  
Future Research ◽  
Final Visit ◽  
Over Time

Abstract Objective Neuropsychiatric symptoms (NPS) are common in neurodegenerative disease, but longitudinal studies using large autopsy-confirmed samples are lacking. Our primary aim was to investigate progression of NPS over time in autopsy-confirmed Alzheimer’s disease (ad), Lewy body disease (LBD), and mixed (ad+LBD) cohorts. Methods Data on individuals (age > =50) with autopsy-confirmed ad (N = 1568), ad+LBD (N = 349), and LBD (N = 142) was obtained from the National Alzheimer’s Coordinating Center (Mean visits = 2.61). Neuropsychiatric Inventory Questionnaire (NPI-Q) and 15-item Geriatric Depression Scale (GDS) scores were used to measure NPS. Multilevel zero-inflated binomial regression models were used to assess if NPI-Q and GDS scores differed among ad, ad+LBD, and LBD groups over time. Covariates included: years from baseline to final visit, cognitive status at baseline (i.e., normal, MCI, or dementia), demographic characteristics, MMSE, Functional Activities Questionnaire, and psychotropic treatment of psychiatric conditions. Results Higher NPI-Q and GDS scores were observed at baseline in the LBD group compared to ad (p’s < 0.001). NPI-Q scores increased over time in the LBD group compared to ad+LBD and ad groups (90% CI). GDS scores differed among all groups at baseline (95% CI), with more rapid increase in the LBD group vs. ad and ad+LBD groups. Conclusions Overall, the course of NPS differs among disease pathologies. Those with pure LBD appear to have more severe NPS over time compared to those with ad and ad+LBD. Depressive symptoms increased more in LBD and ad+LBD compared to ad over time. Future research examining clinical outcomes related to NPS burden (care needs, caregiver burden, and life expectancy) is needed.

scholarly journals Impact of Alzheimer's Disease, Lewy Body and Vascular Co-Pathologies on Clinical Transition to Dementia in a National Autopsy Cohort

2016 ◽  
Vol 42 (1-2) ◽  
pp. 106-116 ◽  
Author(s):  
Jagan A. Pillai ◽  
Robert S. Butler ◽  
Aaron Bonner-Jackson ◽  
James B. Leverenz
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Lewy Body ◽  
Functional Decline ◽  
Lewy Body Disease ◽  
Vascular Pathology ◽  
Final Visit ◽  
Clinical Dementia Rating ◽  
National Cohort

Aims: We examined the effect of vascular or Lewy body co-pathologies in subjects with autopsy-confirmed Alzheimer's disease (AD) on the rate of cognitive and functional decline and transition to dementia. Methods: In an autopsy sample of prospectively characterized subjects from the National Alzheimer's Coordinating Center database, neuropathology diagnosis was used to define the groups of pure AD (pAD, n = 84), mixed vascular and AD (ADV, n = 54), and mixed Lewy body disease and AD (ADLBD, n = 31). Subjects had an initial Clinical Dementia Rating-Global (CDR-G) score <1, Mini-Mental State Examination ≥15, a final visit CDR-G >1, ≥3 evaluations, and Braak tangle stage ≥III. We compared the rate of cognitive and functional decline between the groups. Results: The rate of functional and cognitive decline was lower for ADV, and ADV patients had less severe deficits on CDR-G and the CDR-Sum of Boxes scores at the last visit than pAD and ADLBD patients. No significant differences were noted between ADLBD and pAD patients. After controlling for age at death, the odds of reaching CDR ≥1 at the last visit were lower in the ADV subjects compared to the pAD subjects. Conclusions: The mean rate of functional and cognitive decline among ADV subjects was slower than among either pAD or ADLBD patients. Vascular pathology did not increase the odds of attaining CDR ≥1 when occurring with AD in this national cohort.

A-3 History of Traumatic Brain Injury and the Course of Neuropsychiatric Symptoms among those with Autopsy-Confirmed Alzheimer’s Disease

2021 ◽  
Vol 36 (6) ◽  
pp. 1042-1042
Author(s):  
Jeff Schaffert ◽  
Will Goette ◽  
Christian LoBue ◽  
Nyaz Didehbani ◽  
John Hart ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Neuropsychiatric Symptoms ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Lewy Pathology ◽  
Functional Activities ◽  
Binomial Regression ◽  
History Of ◽  
Over Time

Abstract Objective We explored the course of neuropsychiatric symptoms (NPS) in autopsy-confirmed Alzheimer’s disease (ad) subjects with and without a history of TBI (TBI+ vs. TBI-), expecting that TBI history may be associated with NPS severity over time. Method Data from 1532 individuals (age 50+) with autopsy-confirmed ad were obtained from the National Alzheimer’s Coordinating Center (Mean visits = 3.69). Those with other tau pathology and significant Lewy pathology were removed. Neuropsychiatric Inventory Questionnaire (NPI-Q) and the 15-item Geriatric Depression Scale (GDS) scores were used to examine NPS. Multilevel zero-inflated binomial regression models assessed if NPS severity differed between TBI+ (N = 154) and TBI- (N = 1378) groups over time. Covariates included: years from baseline visit, demographics, MMSE, Functional Activities Questionnaire score, and psychotropic treatment. Results The groups did not differ at baseline in NPI-Q (p = 0.36) or GDS (p = 0.07) scores. NPI-Q scores mildly decreased in the TBI+ group (trend = −0.03), whereas the TBI- group remained stable over time (trend = 0.001), 95% CI for the trend [0.01, 0.07]. GDS scores increased more rapidly in the TBI+ group (trend = 0.08) than the TBI- group (trend = 0.02), 95% CI for the trend [0.02, 0.10]. Conclusions This preliminary study suggests that NPS course in ad may differ depending on TBI history, though effect sizes were small. Over the course of ad, individuals with a history of TBI may experience less NPS overall (as measured by NPI-Q scores) but may experience marginally more depressive symptoms (as measured by GDS scores). Future investigations evaluating the relationship between TBI and the course of neurodegenerative disease are needed.

scholarly journals Structural connectivity networks in Alzheimer’s disease and Lewy body disease

2021 ◽  
Author(s):  
Kyoungwon Baik ◽  
Jin‐Ju Yang ◽  
Jin Ho Jung ◽  
Yang Hyun Lee ◽  
Seok Jong Chung ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Lewy Body ◽  
Structural Connectivity ◽  
Lewy Body Disease

scholarly journals RESTING HEART RATE MODERATES THE RELATIONSHIP BETWEEN NEUROPSYCHIATRIC SYMPTOMS, MCI, AND ALZHEIMER’S DISEASE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S641-S641
Author(s):  
Shanna L Burke
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Heart Rate ◽  
Relative Risk ◽  
Neuropsychiatric Symptoms ◽  
Cognitive Status ◽  
Resting Heart Rate ◽  
Data Set ◽  
Increased Risk ◽  
The Relationship

Abstract Little is known about how resting heart rate moderates the relationship between neuropsychiatric symptoms and cognitive status. This study examined the relative risk of NPS on increasingly severe cognitive statuses and examined the extent to which resting heart rate moderates this relationship. A secondary analysis of the National Alzheimer’s Coordinating Center Uniform Data Set was undertaken, using observations from participants with normal cognition at baseline (13,470). The relative risk of diagnosis with a more severe cognitive status at a future visit was examined using log-binomial regression for each neuropsychiatric symptom. The moderating effect of resting heart rate among those who are later diagnosed with mild cognitive impairment (MCI) or Alzheimer’s disease (AD) was assessed. Delusions, hallucinations, agitation, depression, anxiety, elation, apathy, disinhibition, irritability, motor disturbance, nighttime behaviors, and appetite disturbance were all significantly associated (p&lt;.001) with an increased risk of AD, and a reduced risk of MCI. Resting heart rate increased the risk of AD but reduced the relative risk of MCI. Depression significantly interacted with resting heart rate to increase the relative risk of MCI (RR: 1.07 (95% CI: 1.00-1.01), p&lt;.001), but not AD. Neuropsychiatric symptoms increase the relative risk of AD but not MCI, which may mean that the deleterious effect of NPS is delayed until later and more severe stages of the disease course. Resting heart rate increases the relative risk of MCI among those with depression. Practitioners considering early intervention in neuropsychiatric symptomology may consider the downstream benefits of treatment considering the long-term effects of NPS.

scholarly journals Cognitive anosognosia and behavioral changes in probable Alzheimer's disease patients

2013 ◽  
Vol 7 (2) ◽  
pp. 197-205 ◽  
Author(s):  
Corina Satler ◽  
Carlos Tomaz
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Neuropsychiatric Symptoms ◽  
Cognitive Status ◽  
Behavioral Changes ◽  
Self Awareness ◽  
Functional Abilities ◽  
Neuropsychological Battery ◽  
Subjective Memory ◽  
Study Objective

ABSTRACT Anosognosia, impairment insight and unawareness of deficits are used as equivalent terms in this study. Objective: To investigate the relationship between the presence of anosognosia symptoms and cognitive domains, functional abilities, and neuropsychiatric symptoms in patients with probable Alzheimer's disease (pAD) and elderly controls (EC). Methods: Twenty-one pAD (14 women) and twenty-two EC (16 women) were submitted to a neuropsychological battery of tests assessing global cognitive status, and specific cognitive functions: memory, executive and attention functions, verbal fluency and visuoconstructive abilities. Additionally, functional abilities (FAQ) and neuropsychiatric symptoms (NPI) were measured. Results: The linear regression statistical test found general anosognosia to be associated with subjective memory complaints, age and Arithmetic-DRS in the EC group. On the other hand, cognitive and functional abilities scores (Arithmetic- DRS, IQCODE and FAQ) were the best predictors in pAD patients, particularly for behavioral awareness. Conclusion: These results indicated that different variables are associated with self-awareness for pAD patients and EC, but for both groups executive functions appear to play an important role, contributing particularly to awareness of behavioral changes.

scholarly journals Neuropathological characterization of Lemur tyrosine kinase 2 (LMTK2) in Alzheimer’s disease and neocortical Lewy body disease

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
János Bencze ◽  
Máté Szarka ◽  
Viktor Bencs ◽  
Renáta Nóra Szabó ◽  
Máté Smajda ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Tyrosine Kinase ◽  
Lewy Body ◽  
Lewy Body Disease ◽  
Cortical Layer ◽  
Cellular Processes ◽  
Tyrosine Kinase 2 ◽  
Post Mortem Brain ◽  
Significant Difference

AbstractAlzheimer’s disease (AD) and neocortical Lewy body disease (LBD) are the most common neurodegenerative dementias, with no available curative treatment. Elucidating pathomechanism and identifying novel therapeutic targets are of paramount importance. Lemur tyrosine kinase 2 (LMTK2) is involved in several physiological and pathological cellular processes. Herewith a neuropathological characterization is presented in AD and neocortical LBD samples using chromogenic and fluorescent LMTK2 immunohistochemistry on post-mortem brain tissues and compared them to age-matched controls (CNTs). LMTK2 immunopositivity was limited to the neuronal cytoplasm. Neurons, including tau-positive tangle-bearing ones, showed decreased chromogenic and immunofluorescent labelling in AD in every cortical layer compared to CNT and neocortical LBD. Digital image analysis was performed to measure the average immunopositivity of groups. Mean grey values were calculated for each group after measuring the grey scale LMTK2 signal intensity of each individual neuron. There was significant difference between the mean grey values of CNT vs. AD and neocortical LBD vs. AD. The moderate decrease in neocortical LBD suggests the effect of coexisting AD pathology. We provide neuropathological evidence on decreased neuronal LMTK2 immunolabelling in AD, with implications for pathogenesis.

scholarly journals Effects of Alzheimer's disease and Lewy body disease on subcortical atrophy

2019 ◽  
Vol 27 (2) ◽  
pp. 318-326 ◽  
Author(s):  
H. S. Yoo ◽  
E. C. Lee ◽  
S. J. Chung ◽  
Y. H. Lee ◽  
S. G. Lee ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Lewy Body ◽  
Lewy Body Disease
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