scholarly journals RACIAL DIFFERENCES IN NON-COGNITIVE SYMPTOMS IN ALZHEIMER’S DISEASE AND CAREGIVER DEPRESSION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S857-S857
Author(s):  
Weizhou Tang
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
African American ◽  
African Americans ◽  
Ethnic Groups ◽  
Racial Differences ◽  
Neuropsychiatric Symptoms ◽  
Cognitive Symptoms ◽  
Significant Group ◽  
Caregiver Depression

Abstract Behavioral and psychological symptoms (BPS) represent a heterogeneous group of non-cognitive symptoms occurring in persons with Alzheimer’s disease (PwAD), and they are often associated with negative outcomes for AD caregivers. Evidence indicates differences in caregivers’ mental health across race/ethnic groups. However, there is a lack of research that compares racial differences in BPS in PwAD. This study aims to compare racial differences in BPS in PwAD and caregiver depression. The study analyzed data collected from the South Carolina AD Registry in 2010. The survey used in the interview included measures of caregiver depression, caregiver burden, PwAD’s non-cognitive symptoms, caregiving competence, caregiver distress, and demographics. The final analysis focused on 635 African-American (n=313) and white (n=322) caregivers. Mann-Whitney U-tests, Chi-square tests, and multiple linear regression were conducted. Among all PwAD, higher percentage of whites than African Americans exhibited apathy/indifference (67.52% vs 52.44%, p=.0001), depression/dysphoria (61.54% vs 44.59%, p<.0001), and anxiety (45.08% vs 29.64%, p<.0001). In terms of both frequency and severity of BPS, whites had significantly higher BPS score (Mean=35.49, SD=24.75) than African Americans (Mean=28.13, SD=23.97; p<.0001). Mean comparisons indicated significant group differences in caregiver depressive symptoms between white caregivers (mean=11.89, SD=6.90) and African-American caregivers (mean=9.41, SD=5.77). However, there were no racial differences in the relationship between BPS in PwAD and caregiver depression. The findings of this study highlight the importance of developing more effective and targeted treatment options and therapies for neuropsychiatric symptoms and delivering cultural relevant education programs/interventions to ethnic groups.

Perceived Stress is Associated with Alzheimer’s Disease Cerebrospinal Fluid Biomarkers in African Americans with Mild Cognitive Impairment

2020 ◽  
Vol 77 (2) ◽  
pp. 843-853
Author(s):  
Antoine R. Trammell ◽  
Darius J. McDaniel ◽  
Malik Obideen ◽  
Maureen Okafor ◽  
Tiffany L. Thomas ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cerebrospinal Fluid ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
African Americans ◽  
Racial Differences ◽  
Perceived Stress ◽  
Cross Sectional Study ◽  
Cross Sectional

Background: African Americans (AA) have a higher Alzheimer’s disease (AD) prevalence and report more perceived stress than White Americans. The biological basis of the stress-AD link is unclear. This study investigates the connection between stress and AD biomarkers in a biracial cohort. Objective: Establish biomarker evidence for the observed association between stress and AD, especially in AA. Methods: A cross-sectional study (n = 364, 41.8% AA) administering cognitive tests and the perceived stress scale (PSS) questionnaire. A subset (n = 309) provided cerebrospinal fluid for measurement of Aβ42, Tau, Ptau, Tau/Aβ42 (TAR), and Ptau/Aβ42 (PTAR). Multivariate linear regression, including factors that confound racial differences in AD, was performed. Results: Higher PSS scores were associated with higher Ptau (β= 0.43, p = 0.01) and PTAR (β= 0.005, p = 0.03) in AA with impaired cognition (mild cognitive impairment). Conclusion: Higher PSS scores were associated with Tau-related AD biomarker indices in AA/MCI, suggesting a potential biological connection for stress with AD and its racial disparity.

Racial Differences in Neuropsychiatric Symptoms Among Dementia Patients: A Comparison of African Americans and Whites

2000 ◽  
Vol 12 (S1) ◽  
pp. 395-402 ◽  
Author(s):  
Carl I. Cohen
Keyword(s):  
African American ◽  
Nursing Home ◽  
African Americans ◽  
Racial Differences ◽  
Neuropsychiatric Symptoms ◽  
Psychotic Symptoms ◽  
Sociodemographic Variable ◽  
Behavioral Disturbances ◽  
Dementia Patients ◽  
Nursing Home Patients

Race is a critical sociodemographic variable that may serve as a marker for genetic, clinical, cultural, and socioeconomic factors. There have been several studies that found differences between African Americans and Whites in the neuropsychiatric symptoms of dementia. There have been fairly consistent findings that psychotic symptoms—hallucinations and delusions—are more prevalent among African American patients with dementia (Cohen & Carlin, 1993; Cooper et al., 1991, Deutsch et al., 1991; Fabrega et al., 1988), and that depression is higher among Whites than among African Americans (Fabrega et al., 1988; Walker et al., 1995). One study by Class and colleagues (1996) also suggested that behavioral disturbances might be higher among White than among African American nursing home patients, a majority of whom had dementia.

scholarly journals Disparities Research at the Deep South Alzheimer’s Disease Center of the University of Alabama at Birmingham

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 100-100
Author(s):  
Maria Pisu ◽  
David Geldmacher
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
South Carolina ◽  
African American ◽  
African Americans ◽  
Deep South ◽  
Medicare Beneficiaries ◽  
University Of Alabama ◽  
The Us ◽  
The University

Abstract Residents of the US Deep South (Alabama, Georgia, Louisiana, Mississippi, and South Carolina) have a 20–30% higher risk of developing Alzheimer’s disease or related dementia (ADRD). Moreover, >20% of African Americans, who are at higher ADRD risk than whites, live in this region. Therefore, one important goals of the Deep South Alzheimer’s Disease Center (DS-ADC) of the University of Alabama at Birmingham is to spearhead research to address these disparities. This panel presents current DS-ADC research, with two presentations focusing on the local patient population and the last two on the Deep South population compared to the rest of the nation. Addressing the challenge of recruiting representative samples in clinical research, the first paper is part of a research program to understand difference that may exist between African American and white research participants. The second paper examines patients with multiple conditions, in particular dementia and cancer, showing a marked disadvantage in cognition outcomes for African Americans. The next two papers take a broader perspective to better understand the population of older adults with ADRD in the Deep South and in the rest of the US. The third paper examines socioeconomic and medical contexts of African American and white older Medicare beneficiaries with ADRD, and the fourth paper examines differences in utilization of specialists, ADRD drugs, and hospitalizations in the two regions taking these contexts into account. The discussant will close the session by placing these studies in the larger context of the disparities research at the DS-ADC.

scholarly journals Neuropsychiatric Symptoms in Patients With Alzheimer’s Disease During SARS-COV-2 Pandemic in Peru

2021 ◽  
Vol 36 ◽  
pp. 153331752110390
Author(s):  
Nilton Custodio ◽  
Sheila Castro-Suárez ◽  
Rosa Montesinos ◽  
Virgilio E. Failoc-Rojas ◽  
Rossana Cruz del Castillo ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Motor Activity ◽  
Sleep Disorders ◽  
Odds Ratio ◽  
Neuropsychiatric Symptoms ◽  
Cognitive Symptoms ◽  
Memory Clinic

To evaluate neuropsychiatric symptoms in patients with Alzheimer’s disease (AD) and their association with cognition and functionality during lockdown of the COVID-19’s first wave. We included 91 patients and caregivers of people with AD from a memory clinic. The RUDAS, M@T, and CDR were administered to patients and NPI/ADCS-ADL to caregivers. Baseline and lockdown measurements scales were analyzed to compare the frequencies at baseline versus lockdown and conditional Odds Ratio (ORc) was calculated for the neuropsychiatric symptoms. During the pandemic, significant increase in the number of cases was observed in depression (23%), agitation (36.8%), aberrant motor activity (12%), sleep disorders (26.3%), and appetite change (12.1%). In worsening of pre-existing symptoms, the most frequent were delusions (75%), followed by sleep disorders (71.7%). Lockdown induces a rapid increase of neuropsychiatric symptoms affecting cognitive symptoms and functionality of Peruvian patients with AD.

scholarly journals Neuropsychiatric and cognitive symptoms across the Alzheimer’s disease clinical spectrum: Cross-sectional and longitudinal associations

2021 ◽  
Author(s):  
Willem S. Eikelboom ◽  
Esther van den Berg ◽  
Ellen Singleton ◽  
Sara J. Baart ◽  
Michiel Coesmans ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Functioning ◽  
Neuropsychiatric Symptoms ◽  
Clinical Stage ◽  
Clinical Spectrum ◽  
Subjective Cognitive Decline ◽  
Cognitive Symptoms ◽  
Cross Sectional ◽  
Over Time

ABSTRACTObjectiveTo investigate the prevalence and trajectories of neuropsychiatric symptoms (NPS) in relation to cognitive functioning in a cohort of amyloid-β positive individuals across the Alzheimer’s disease (AD) clinical spectrum.MethodsWe included 1,524 amyloid-β positive individuals from the Amsterdam Dementia Cohort with subjective cognitive decline (SCD, n=113), mild cognitive impairment (MCI, n=321), or dementia (n=1,090). We measured NPS with the neuropsychiatric inventory (NPI), examining total scores and the presence of specific NPI-items. Cognition was assessed across five cognitive domains and with the MMSE. We examined trajectories including model based trends for NPS and cognitive functioning over time. We used linear mixed models to relate baseline NPI scores to cognitive functioning at baseline (whole-sample) and longitudinal time-points (subsample n=520, Mean=1.8 [SD=0.7] years follow-up).ResultsNPS were prevalent across all clinical AD stages (NPI total score ≥1 81.4% in SCD, 81.2% in MCI, 88.7% in dementia). Cognitive functioning showed an uniform gradual decline; while in contrast, large intra-individual heterogeneity of NPS was observed over time across all groups. At baseline, we found associations between NPS and cognition in dementia that were most pronounced for NPI total scores and MMSE (range β:-0.18–0.11, FDR-adjusted p<0.05), while there were no cross-sectional relationships in SCD and MCI (β:-0.32– 0.36, FDR-adjusted p>0.05). There were no associations between baseline NPS and cognitive functioning over time in any clinical stage (β:-0.13–0.44, FDR-adjusted p>0.05).ConclusionNPS and cognitive symptoms are both prevalent across the AD continuum, but show a different evolution during the course of the disease.

scholarly journals Racial Differences in Alzheimer’s Disease Specialist Encounters are Associated with Usage of Molecular Imaging and Dementia Medications: An Enterprise-Wide Analysis Using i2b2

2020 ◽  
pp. 1-15
Author(s):  
Charles F. Murchison ◽  
Richard E. Kennedy ◽  
Jonathan E. McConathy ◽  
Erik D. Roberson
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
African Americans ◽  
Racial Differences ◽  
Medical Center ◽  
Academic Medical Center ◽  
Primary Care Clinics ◽  
Academic Medical ◽  
Increased Risk

Background: African Americans are at increased risk for Alzheimer’s disease (AD) but barriers to optimal clinical care are unclear. Objective: To comprehensively evaluate potential racial differences in the diagnosis and treatment of AD in an academic medical center. Methods: We used the clinical informatics tool, i2b2, to analyze all patient encounters for AD or mild cognitive impairment (MCI) in the University of Alabama at Birmingham Health System over a three-year period, examining neuroimaging rates and dementia-related medication use by race and clinic site using ratio tests on contingency tables of stratified patient counts. Results: Enterprise-wide, African Americans were not underrepresented among outpatients seen for AD/MCI. However, there were differences in the clinic setting where visits occurred, with African Americans overrepresented in Geriatrics and primary care clinics and underrepresented in Memory Disorders specialty clinics. There were no racial differences in the rates at which any clinic ordered PET neuroimaging tests or dementia-related medications. However, unsurprisingly, specialty clinics ordered both PET neuroimaging and dementia-related medications at a higher rate than primary care clinics, and overall across the medical enterprise, African Americans were statistically less likely to have PET neuroimaging or dementia-related medications ordered. Conclusion: African Americans with AD/MCI were not underrepresented at this academic medical center but were somewhat less likely to have PET neuroimaging or to be on dementia-related medications, potentially in part from underrepresentation in the specialty clinics where these orders are more likely. The reasons for this underrepresentation in specialty clinics are likely multifactorial and important to better understand.

scholarly journals Are neuropsychiatric symptoms modifiable risk factors for cognitive decline in Alzheimer's disease and vascular dementia?

2019 ◽  
Vol 216 (1) ◽  
pp. 1-3 ◽  
Author(s):  
George Savulich ◽  
John T. O'Brien ◽  
Barbara J. Sahakian
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Vascular Dementia ◽  
Early Identification ◽  
Neuropsychiatric Symptoms ◽  
Anxiety And Depression ◽  
Modifiable Risk Factors ◽  
Cognitive Symptoms

SummaryAlzheimer's disease and vascular dementia are associated with overlapping symptoms of anxiety and depression. More accurate discrimination between emerging neuropsychiatric and cognitive symptoms would better assist illness detection. The potential for protection against cognitive decline and dementia following early identification and intervention of neuropsychiatric symptoms warrants investigation.

scholarly journals Racial Differences in the Effect of APOE-ε4 Genotypes on Trail Making Test Part B in Alzheimer’s disease

2021 ◽  
Author(s):  
Chun Xu ◽  
Priscila Acevedo ◽  
Yongke Lu ◽  
Brenda Bin Su ◽  
Victoria Padilla ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
African American ◽  
Racial Differences ◽  
Trail Making Test ◽  
Racial Groups ◽  
Test Part ◽  
Apoe Ε4 ◽  
Trail Making

Abstract The trail making test part B (TMT-B) evaluates "executive" functions, memory, and sensorimotor functions. No previous studies were found to examine the longitudinal effect of apolipoprotein E epsilon 4 (APOE-ε4) genotypes on the TMT-B scores in Alzheimer’s disease (AD), and/or mild cognitive impairment (MCI) participants. This study used data from the Alzheimer's Disease Neuroimaging Initiative (ADNI): 482 participants with AD, 503 with cognitive normal (CN), 1,293 with MCI at baseline and follow-up of four years. The multivariable linear mixed model was used to determine the longitudinal changes in the TMT-B scores. The individuals with 1 or 2 APOE-ε4 alleles revealed significantly higher TMT-B scores (poor cognitive function) compared with individuals without APOE-ε4 allele at baseline and four follow-up visits (all p values < 0.0001). Compared with Whites, non-Hispanic African American and Hispanic populations had higher TMT-B scores (p = 0.0007 and 0.0044, respectively). Furthermore, stratified by diagnosis, the African American CN group had the highest TMT-B scores (p < 0.0001) and the Hispanic AD group had higher TMT-B scores (p = 0.0123) compared with Whites, while both African American and Hispanic MCI groups had higher TMT-B scores compared with Whites (p = 0.162 and 0.0274, respectively). In addition, stratified by racial groups, the subjects with APOE-ε4-homozgous and APOE-ε4-heterozgous showed higher TMT-B scores compared with subjects who carry zero APOE-ε4 allele just in Whites (p = 0.0023 and 0.0003, respectively); whereas there was no difference among APOE-ε4 genotypes in AA and Hispanics. In conclusion, the APOE-ε4 allele was associated with increased TMT-B scores but such associations varied by racial groups.

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