scholarly journals Correlation of Frontal Atrophy and CSF Tau Levels With Neuropsychiatric Symptoms in Patients With Cognitive Impairment: A Memory Clinic Experience

2021 ◽  
Vol 13 ◽  
Author(s):  
Matteo Cotta Ramusino ◽  
Giulia Perini ◽  
Gloria Vaghi ◽  
Beatrice Dal Fabbro ◽  
Marco Capelli ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Lewy Body Disease ◽  
Cortical Atrophy ◽  
Psychotic Symptoms ◽  
Memory Clinic ◽  
Neuropsychiatric Inventory ◽  
Clinic Experience ◽  
Behavioral And Psychological Symptoms

Background: Behavioral and psychological symptoms of dementia (BPSD) are a distressful condition. We aimed to investigate the BPSD distribution in subjects with cognitive impairment, and the potential correlations between BPSD and neurodegeneration in terms of cerebrospinal fluid (CSF) tau and brain atrophy.Methods: One-hundred patients with mild cognitive impairment (MCI) or dementia (Alzheimer’s disease, AD; Lewy-body disease, LBD; frontotemporal dementia, FTD; vascular dementia, VD) underwent a complete diagnostic workup, including 3T-MRI and/or CT and CSF. Cortical atrophy was assessed with medial temporal atrophy (MTA), posterior atrophy (PA), and global cortical atrophy-frontal lobe (GCA-F) scales. BPSD were rated using the Neuropsychiatric Inventory (NPI), and BPSD clusters were defined according to the European Alzheimer Disease Consortium.Results: Delusions, hallucinations, and psychosis cluster were differently distributed among the diagnostic groups (p < 0.05, p < 0.001, and p < 0.05), with LBD patients showing higher scores for hallucinations (vs. MCI, p < 0.001, and AD, p < 0.05) and psychosis cluster (vs. MCI, p < 0.05). In primary dementias, we found a negative correlation between NPI total score and tau levels (p = 0.08), confirmed by beta regression (p < 0.01), while a positive non-significant relationship was observed in MCI. Higher GCA-F scores were associated with delusions and apathy (p < 0.05, on both hemispheres) and hallucinations (left: p < 0.01, right: p < 0.05). GCA-F scores were positively correlated with psychosis cluster (right: p < 0.05), and agitation/aggression (left: p < 0.05). Conversely, nighttime disturbances were positively correlated with both GCA-F and MTA scores (left: p < 0.01; right: p < 0.05).Conclusion: Our results suggest that psychotic symptoms are significantly more represented in LBD patients and that CSF tau and frontal atrophy are associated with the occurrence and severity of BPSD in clinical practice. Longitudinal studies are however required to ascertain their actual predictive value.

scholarly journals Neuropsychiatric symptoms in Vascular Cognitive Impairment: A systematic review

2015 ◽  
Vol 9 (3) ◽  
pp. 230-236 ◽  
Author(s):  
Chan Tiel ◽  
Felipe Kenji Sudo ◽  
Gilberto Sousa Alves ◽  
Letice Ericeira-Valente ◽  
Denise Madeira Moreira ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Vascular Dementia ◽  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Vascular Cognitive Impairment ◽  
Behavioral Symptoms ◽  
Neuropsychiatric Inventory ◽  
Subcortical Vascular Dementia ◽  
Behavioral And Psychological Symptoms ◽  
Cognitive Impairment No Dementia

Neuropsychiatric symptoms or Behavioral and Psychological Symptoms of Dementia (BPSD) are common and invariably appear at some point during the course of the disease, mediated both by cerebrovascular disease and neurodegenerative processes. Few studies have compared the profiles of BPSD in Vascular Cognitive Impairment (VCI) of different subtypes (subcortical or cortical) and clinical stages (Vascular Cognitive Impairment No Dementia [VaCIND] and Vascular Dementia [VaD]). Objective: To review the BPSD associated with different subtypes and stages of VCI using the Neuropsychiatric Inventory (NPI). Methods: Medline, Scielo and Lilacs databases were searched for the period January 2000 to December 2014, with the key words: "BPSD AND Vascular Dementia, "NPI AND Vascular Dementia" and "NPI AND VCI. Qualitative analysis was performed on studies evaluating BPSD in VCI, using the Neuropsychiatric Inventory (NPI). Results: A total of 82 studies were retrieved of which 13 were eligible and thus included. Among the articles selected, 4 compared BPSD in Subcortical Vascular Dementia (SVaD) versus Cortical-Subcortical Vascular Dementia (CSVaD), 3 involved comparisons between SVaD and VaCIND, 1 study analyzed differences between CSVaD and VaCIND, while 5 studies assessed BPSD in CSVaD. Subcortical and Cortical-Subcortical VaD were associated predominantly with Apathy and Depression. VaCIND may present fewer behavioral symptoms than VaD. Conclusion: The profile of BPSD differs for different stages of VCI. Determining the most prevalent BPSD in VCI subtypes might be helpful for improving early diagnosis and management of these symptoms.

scholarly journals The impact of lockdown during SARS-CoV-2 outbreak on behavioral and psychological symptoms of dementia

2021 ◽  
Vol 42 (3) ◽  
pp. 825-833
Author(s):  
Arianna Manini ◽  
Michela Brambilla ◽  
Laura Maggiore ◽  
Simone Pomati ◽  
Leonardo Pantoni
Keyword(s):  
Logistic Regression ◽  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Community Dwelling ◽  
Caregiver Distress ◽  
Neuropsychiatric Inventory ◽  
Logistic Regression Models ◽  
The Impact ◽  
Behavioral And Psychological Symptoms

Abstract Background During Covid-19 pandemic, the Italian government adopted restrictive limitations and declared a national lockdown on March 9, which lasted until May 4 and produced dramatic consequences on people’s lives. The aim of our study was to assess the impact of prolonged lockdown on behavioral and psychological symptoms of dementia (BPSD). Methods Between April 30 and June 8, 2020, we interviewed with a telephone-based questionnaire the caregivers of the community-dwelling patients with dementia who had their follow-up visit scheduled from March 9 to May 15 and canceled due to lockdown. Among the information collected, patients’ BPSDs were assessed by the Neuropsychiatric Inventory (NPI). Non-parametric tests to compare differences between NPI scores over time and logistic regression models to explore the impact of different factors on BPSD worsening were performed. Results A total of 109 visits were canceled and 94/109 caregivers completed the interview. Apathy, irritability, agitation and aggression, and depression were the most common neuropsychiatric symptoms experienced by patients both at baseline and during Covid-19 pandemic. Changes in total NPI and caregiver distress scores between baseline and during lockdown, although statistically significant, were overall modest. The logistic regression model failed to determine predictors of BPSD worsening during lockdown. Conclusion This is one of the first studies to investigate the presence of BPSD during SARS-CoV-2 outbreak and related nationwide lockdown, showing only slight, likely not clinically relevant, differences in BPSD burden, concerning mostly agitation and aggression, anxiety, apathy and indifference, and irritability.

Comparison of behavioral and psychological symptoms of dementia and psychotropic drug treatments among old people in geriatric care in 2000 and 2007

2011 ◽  
Vol 23 (10) ◽  
pp. 1616-1622 ◽  
Author(s):  
Hugo Lövheim ◽  
Yngve Gustafson ◽  
Stig Karlsson ◽  
Per-Olof Sandman
Keyword(s):  
Cognitive Impairment ◽  
Drug Use ◽  
Psychotropic Drug ◽  
Psychological Symptoms ◽  
Antidepressant Drug ◽  
Geriatric Care ◽  
Psychotic Symptoms ◽  
Aggressive Behaviors ◽  
People With Dementia ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground: Behavioral and psychological symptoms, such as verbal or physical aggression, aberrant motor behaviors, psychotic symptoms, anxiety, depressive symptoms and apathy are common among people with dementia. The aim of the present study was to compare the one-week prevalence of behavioral and psychological symptoms and psychotropic drug treatment among people with cognitive impairment living in institutional care, in two large, comparable samples from 2000 and 2007.Methods: A comparison was made between two cross-sectional samples, collected in 2000 and 2007, comprising 4054 participants with cognitive impairment living in geriatric care units in the county of Västerbotten, Sweden. The Multi-Dimensional Dementia Assessment Scale (MDDAS) was used to assess cognitive impairment and behavioral and psychological symptoms. The use of psychotropic drugs was recorded.Results: Between 2000 and 2007, 15 out of 39 behavioral or psychological symptoms had become less common and no symptoms had become more common, after controlling for demographic changes. Four out of six behaviors within the cluster of aggressive behaviors had declined in prevalence. Patients prescribed anti-dementia drugs increased from 5.1% to 18.0% and antidepressant drug use increased from 43.2% to 49.1%, while anxiolytic, hypnotic, sedative and antipsychotic drug use remained largely unchanged.Conclusion: The prevalence of many behavioral symptoms had declined from 2000 to 2007, and among these changes, the decline in aggressive behaviors probably has the greatest clinical impact.

scholarly journals Correlation of frontal atrophy and CSF tau levels with neuropsychiatric symptoms in patients with cognitive impairment: A memory clinic experience

2021 ◽  
Vol 17 (S6) ◽  
Author(s):  
Matteo Cotta Ramusino ◽  
Giulia Perini ◽  
Gloria Vaghi ◽  
Beatrice Dal Fabbro ◽  
Marco Capelli ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Neuropsychiatric Symptoms ◽  
Memory Clinic ◽  
Clinic Experience

Behavioral and psychological symptoms in Lewy body disease: a review

2018 ◽  
Vol 16 (1) ◽  
pp. 87-95
Author(s):  
Lucie Jurek ◽  
Mathieu Herrmann ◽  
Mathilde Bonze ◽  
Sophie Brunet ◽  
Catherine Padovan ◽  
...  
Keyword(s):  
Lewy Body ◽  
Psychological Symptoms ◽  
Lewy Body Disease ◽  
Behavioral And Psychological Symptoms

scholarly journals Association Between Neuropsychiatric Symptoms and Functional Change in Older Non-Demented Adults: Mayo Clinic Study of Aging

2020 ◽  
Vol 78 (3) ◽  
pp. 911-917
Author(s):  
Janina Krell-Roesch ◽  
Jeremy A. Syrjanen ◽  
Michelle M. Mielke ◽  
Teresa J. Christianson ◽  
Walter K. Kremers ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Sex Education ◽  
Functional Performance ◽  
Neuropsychiatric Symptoms ◽  
Functional Decline ◽  
Beck Depression Inventory Score ◽  
Functional Change ◽  
Neuropsychiatric Inventory ◽  
Functional Activities ◽  
Clinic Study

We examined the associations between baseline neuropsychiatric symptoms (NPS) and longitudinal changes in functional performance among 5,394 non-demented individuals aged ≥50 years (2,729 males; median age 74.2 years; 4,716 cognitively unimpaired, 678 mild cognitive impairment). After adjusting for age, sex, education, and medical comorbidities, NPS assessed by the Neuropsychiatric Inventory Questionnaire, clinical depression (Beck Depression Inventory score ≥13) and anxiety (Beck Anxiety Inventory score ≥10) were significantly associated with an increase in the Functional Activities Questionnaire score, indicating functional decline over time. This association may vary depending on the degree of cognitive impairment at baseline.

Caregiver-Reported Sleep Disturbances Are Associated With Behavioral and Psychological Symptoms in an Asian Elderly Cohort With Cognitive Impairment-No Dementia

2018 ◽  
Vol 31 (2) ◽  
pp. 70-75
Author(s):  
Xin Xu ◽  
Cheuk Ni Kan ◽  
Tien Yin Wong ◽  
Ching-Yu Cheng ◽  
M. Kamran Ikram ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Sleep Disturbances ◽  
Motor Behavior ◽  
Psychological Symptoms ◽  
Risk Of Progression ◽  
Elderly Cohort ◽  
Anxiety Depression ◽  
Behavioral And Psychological Symptoms ◽  
Asian Sample ◽  
Cognitive Impairment No Dementia

Objective: Sleep disturbances were found to be associated with more behavioral and psychological symptoms (BPS) in early patients with Alzheimer's disease (AD). However, data on preclinical stages of dementia are lacking. Hence, the present study sought to investigate the association between sleep disturbances and BPS in dementia-free elderly with varying severity of cognitive impairment in an Asian sample. Methods: Community-living elderly were recruited and administered a comprehensive cognitive battery (vascular dementia battery [VDB]) and the Neuropsychiatric Inventory to assess symptoms of sleep disturbances and BPS. Severity of cognitive impairment was diagnosed and classified as no cognitive impairment (NCI), cognitive impairment-no dementia (CIND) -mild (1-2 impaired domains on the VDB), and CIND-moderate (≥3 impaired domains on the VDB). Analysis of variance was conducted to assess the associations between the presence of sleep disturbances and BPS scores in each diagnostic group. Logistic regression was used to examine whether the coexistence of sleep disturbances and other BPS was associated with CIND-moderate, which is known to carry a higher risk of progression to AD. Results: Among 839 elderly, 79 (9.4%) reported sleep disturbances. Participants with sleep disturbances had higher total BPS burden than those without among CIND participants but not in NCIs. Furthermore, CIND-moderate participants with sleep disturbances had more delusions, hallucinations, anxiety, depression, irritability, aberrant motor behavior, and appetite change ( P < .05). The presence of both sleep disturbances and other BPS was associated with CIND-moderate (odds ratio: 2.5, 95% confidence interval: 1.1-5.5). Conclusions: Sleep disturbances are associated with higher total BPS burden and specific BPS among elderly patients with cognitive impairment, particularly those with CIND moderate, which carries higher risk of developing dementia.

Discussion 3

2000 ◽  
Vol 12 (S1) ◽  
pp. 171-174
Keyword(s):  
Alzheimer’S Disease ◽  
Cognitive Impairment ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Psychological Symptoms ◽  
Cognitively Impaired ◽  
Visual Hallucinations ◽  
Close Relationship ◽  
State Examination ◽  
Behavioral And Psychological Symptoms

Dr. Förstl was impressed by Dr. Reisberg's data showing a close relationship between cognitive impairment and behavioral and psychological symptoms of dementia (BPSD). Yet he questioned Dr. Reisberg's conclusion that cognitive impairment is necessary for developing hallucinations or delusions. Dr. Reisberg responded that although there is no correlation between scores on the Mini-Mental State Examination (MMSE) and BPSD, it does not mean that cognition is not involved in these symptoms. By definition, BPSD are behavioral and psychological. There is a psychological, or cognitive, element to all BPSD, said Dr. Reisberg. As an example, he noted that a patient with cataracts is more likely to experience visual hallucinations. A person who is not cognitively impaired will be able to censor those experiences and not discuss them with others. Patients with dementia do not censor this information, and tell others about their visual hallucinations. Dr. Reisberg noted, however, that visual hallucinations among patients with Alzheimer's disease (AD) are not common, occurring in about 20% of patients, with a peak occurrence just before the final stages of the disease. Dr. Shah commented that BPSD in patients in the final stages of AD may be difficult to detect because techniques for identifying these symptoms in severely cognitively impaired patients are lacking.

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