Neuropsychiatric features in a multi‐ethnic population with Alzheimer disease and mild cognitive impairment
Year: 2023
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Alzheimer disease (AD) is more prevalent in African American (AA) and Hispanic White (HIW) compared to Non-Hispanic White (NHW) individuals. Similarly, neuropsychiatric symptoms (NPS) vary by population in AD. This is likely the result of both sociocultural and genetic ancestral differences. However, the impact of these NPS on AD in different groups is not well understood. METHODS: Self-declared AA, HIW, and NHW individuals were ascertained as part of ongoing AD genetics studies. Participants who scored higher than 0.5 on the Clinical Dementia Rating (CDR) Scale (CDR) were included. Group similarities and differences on Neuropsychiatric Inventory Questionnaire (NPI-Q) outcomes (NPI-Q total score, NPI-Q items) were evaluated using univariate ANOVAs and post hoc comparisons after controlling for sex and CDR stage. RESULTS: Our sample consisted of 498 participants (26% AA; 30% HIW; 44% NHW). Overall, NPI-Q total scores differed significantly between our groups, with HIW having the highest NPI-Q total scores, and by AD stage as measured by CDR. We found no significant difference in NPI-Q total score by sex. There were six NPI-Q items with comparable prevalence in all groups and six items that significantly differed between the groups (Anxiety, Apathy, Depression, Disinhibition, Elation, and Irritability). Further, within the HIW group, differences were found between Puerto Rican and Cuban American Hispanics across several NPI-Q items. Finally, Six NPI-Q items were more prevalent in the later stages of AD including Agitation, Appetite, Hallucinations, Irritability, Motor Disturbance, and Nighttime Behavior. CONCLUSIONS: We identified differences in NPS among HIW, AA, and NHW individuals. Most striking was the high burden of NPS in HIW, particularly for mood and anxiety symptoms. We suggest that NPS differences may represent the impact of sociocultural influences on symptom presentation as well as potential genetic factors rooted in ancestral background. Given the complex relationship between AD and NPS it is crucial to discern the presence of NPS to ensure appropriate interventions.
DOI: 10.1002/gps.5992
Authors: Katrina Celis, Andrew Zaman, Larry Deon Adams, Olivia Gardner, Rajabli Farid, Takiyah D. Starks, Faina C. Lacroix, Kara Hamilton‐Nelson, Pedro Mena, Sergio Tejada, Renee Laux, Yeunjoo E. Song, Allison Caban‐Holt, Briseida Feliciano‐Astacio, Jeffery M. Vance, Jonathan L. Haines, Goldie S. Byrd, Gary W. Beecham, Margaret A. Pericak‐Vance, Michael L. Cuccaro
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,840
Awards: Neuroanatomical associations with the factor structure underlying neuropsychiatric symptoms in Alzheimer's disease, Replication and Extension of ADSP Discoveries in African-Americans, Using RDoC Negative and Positive Valence Paradigms to Investigate the Mechanisms of Neuropsychiatric Symptoms (NPS) in Alzheimer's Disease and Related Dementias, Genomic Characterization of Alzheimer's Disease Risk in the Puerto Rican Population, Genomic Characterization of Alzheimer Disease Risk in Admixed Populations with Native American and Southern European Genetic Ancestry, The Origins of Alzheimer Disease in African Americans, Genetic and neuroanatomical basis of neuropsychiatric symptoms in Alzheimer's disease in populations of diverse ancestry, Alzheimer's Disease Research Center
OpenAlex ID: W4386346983