Baseline neuropsychiatric symptoms and psychotropic medication use midway through data collection of the Longitudinal Early‐ Onset Alzheimer’s Disease Study (LEADS) Cohort
Year: 2023
Type: article
Abstract: Background We examined neuropsychiatric symptoms (NPS) and psychotropic medication use at the midway point of data collection of the Longitudinal Early‐onset Alzheimer’s Disease Study (LEADS). We compared amyloid‐positive early‐onset Alzheimer’s disease (EOAD) participants and amyloid‐negative early‐onset non‐Alzheimer’s disease [EOnonAD]) participants across NPS domains and psychotropic medication categories. Method 282 participants enrolled in LEADS were compared across diagnostic groups – amyloid‐positive EOAD (n = 212) and amyloid‐negative EOnonAD (n = 70). All participants were between ages 40 and 64 at baseline. NPS were measured with the Neuropsychiatric Inventory – Questionnaire (NPI‐Q) and Geriatric Depression Scale – Short Form (GDS‐SF). Medications were categorized into psychotropic category (e.g., antidepressants, antipsychotics, benzodiazepines). Groups were compared on NPI‐Q using binary logistic regression adjusting for sex and disease severity, on GDS‐SF using linear regression adjusting for sex and disease severity, and on psychotropic medication use using Chi square or Fisher’s exact test. Result Demographic data are presented in Table 1. Average total NPI‐Q score was higher in EOnonAD than EOAD (p = .002, ŋp 2 = .03). Regardless of diagnostic group, informants endorsed Affective behaviors most frequently (76.2%). EOAD informants endorsed fewer Distress‐Tension behaviors (p = .02, OR = .498) and Impulse Control behaviors (p = .01, OR = .438). EOAD informants also endorsed apathy (p < .001, OR = .316), irritability (p = .02, OR = .498), and disinhibition (p = .04, OR = .476) at lower frequency than EOnonAD. GDS‐SF showed that the EOnonAD participants self‐reported more symptoms of depression than the EOAD group (p = .002, ŋp 2 = .03). (Table 2A). A minority of participants, regardless of diagnostic group, reported psychotropic medication use (35%). There was higher use in EOnonAD (38%) than EOAD (24%) (p = .03, Cohen W = .14) (Table 2B). Conclusion NPS burden and psychotropic medication use were higher in EOnonAD than EOAD participants, despite EOnonAD being less severely impaired. LEADS continues to collect data. Future studies will examine etiologies that may be larger drivers of NPS than AD neuropathology, mediators (e.g., race, ethnicity) in the association between NPS and diagnostic group classication, compare NPS in EOAD vs. LOAD, and examine longitudinal changes in neuropsychiatric profiles.
Source: Alzheimer s & Dementia
DOI: 10.1002/alz.083140
Authors: Angelina J Polsinelli, Ryan J Wonderlin, Dustin B. Hammers, Alex Pena Garcia, Ani Eloyan, Alexander Taurone, Maryanne Thangarajah, Laurel Beckett, Sujuan Gao, Sophia Wang, Kala Kirby, Paige E. Logan, Paul S. S Aisen, Jeff L. Dage, Tatiana M. Foroud, Percy Griffin, Leo Iaccarino, Joel H. Kramer, Robert A. Koeppe, Walter A. Kukull, Renaud La Joie, Nidhi S Mundada, Melissa E. Murray, Kelly N. H. Nudelman, David N. Soleimani‐Meigooni, Malia C. Rumbaugh, Arthur W. Toga, Alexandra Touroutoglou, Prashanthi Vemuri, Alireza Atri, Gregory S. Day, Ranjan Duara, Neill R Graff‐Radford, Lawrence S. Honig, David T. Jones, Joseph C. Masdeu, Mario F. Mendez, Erik S. Musiek, Chiadi Onyike, Meghan C. Riddle, Emily J Rogalski, Stephen Salloway, Sharon Sha, Raymond Scott Turner, Thomas S. Wingo, David Wolk, Kyle B. Womack, Maria C. Carrillo, Brad C. Dickerson, Gil D. Rabinovici, Liana G. Apostolova
Institutions: Indiana University School of Medicine, Marian University - Indiana, Brown University, University of California, Davis, University of Southern California, Alzheimer's Association, University of California, San Francisco, University of Michigan, University of Washington, Mayo Clinic in Florida, Indiana University Indianapolis, Massachusetts General Hospital, Mayo Clinic, Banner Sun Health Research Institute, Columbia University, Houston Methodist, University of California, Los Angeles, Washington University in St. Louis, Johns Hopkins University, Northwestern University, Stanford Medicine, Stanford University, Georgetown University Medical Center, Emory University, University of Pennsylvania, Harvard University
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4390192072