Affective Neuropsychiatric Symptom Metrics in the National Alzheimer’s Coordinating Center Dataset
Year: 2025
Type: preprint
Abstract: Background: In dementia research, affective neuropsychiatric symptoms (NPS) - depression, anxiety, and apathy - remain understudied. Improving strategies to accurately identify clinically relevant NPS is essential for more robust research. Objectives: We sought to determine how often objective metrics and clinical gestalt metrics agree on NPS presence or absence. We further sought to determine optimal cut-offs for affective NPS presence/absence using the Neuropsychiatric Inventory Questionnaire (NPI-Q) severity ratings. Methods: We assessed agreement for NPS presence/absence among 5 different depression metrics, 4 anxiety metrics, and 2 apathy metrics via Jaccard indices using the National Alzheimer's Coordinating Centers (NACC) dataset. Analysis included exploring different NPIQ severity rating thresholds of >0, >1, >2, and 0 and >1. Results: NPIQ cut-off >1 for presence and =0 for absence of an NPS led to the best agreement with other metrics. However, there was poor agreement for NPS presence across depression metrics (6%) and across anxiety metrics (7%). Choice of metric could greatly skew the frequency of an NPS being present. All 3 affective NPS were more common in Lewy Body Disorder compared to Alzheimer's Disease or Vascular Cognitive Impairment, regardless of metric. Conclusions: Though NPIQ severity rating cut-off choice should depend on study design, using a severity score of >1 for presence and =0 for absence may best fit clinical gestalt for affective NPS. Lewy Body Disorders present with more affective NPS than other common dementia etiologies. Future consensus on criteria for depression and anxiety syndromes in dementia may improve their identification.
Source: medRxiv
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1024368718, G1058046096, G1069732457, G1075639496, G120189231, G1265869611, G1293354362, G1369195717, G1458362881, G1531775036, G1593128567, G1753564228, G1793654115, G1859882300, G2142974134, G2190936067, G253265979, G2675915175, G2887984396, 1Florida Alzheimer's Disease Research Center, G3284295768, G333817976, G348743638, G3703765782, G371566797, G3952091757, A geroscience approach for treating Alzheimer's disease, G504619356, G5056789898, G5640525220, Vanderbilt Alzheimer's Disease Research Center, Modulation of Alzheimers disease by Herpes simplex virus infection , G855012155, G9000000175, G9000000449, G9000004438, G9000011165, G9000038514, G9000044512, G9000059605, G9000063279, G9000065392, G9000065952, G9000082286, G9000085578, G9000087139, G9000087364, G9000112075, G9000115163, G9000120982, G9000134521, G9000148901, G9000208313, G9000224607, G9000254440, G9000266300, G9000271511, G9000315395, G9000330862, G9000331231, G9000332211, Yale Alzheimer Disease Research Center, UCSD Shiley-Marcos Alzheimer's Disease Research Center P30, Joint Estimate Diffusion Imaging (JEDI) for improved Tissue Characterization and Neural Connectivity in Aging and Alzheimer's Disease, Michigan Alzheimer's Disease Research Center, University of Kansas Alzheimer's Disease Research Center (KU ADRC), Alzheimer's Disease Research Center, Johns Hopkins Alzheimer's Disease Research Center, Cleveland Alzheimers Disease Research Center, New Approaches to Dementia Heterogeneity, Serotonin Modulation of Neural Circuitry in bvFTD: Understanding the Neurobiology of Mood and Cognitive Symptoms, Stanford Alzheimer's Disease Research Center, Mayo Alzheimer's Disease Research Center, University of Washington Alzheimer's Disease Research Center, New Mexico Alzheimer's Disease Research Center, Duke/UNC Alzheimer's Disease Research Center, Wisconsin Alzheimer's Disease Research Center, UAB Alzheimer's Disease Research Center, University of Kentucky Alzheimer's Disease Research Center, Alzheimer's Disease Research Center, South Texas Alzheimer's Disease Center, Goizueta Alzheimer's Disease Research Center
OpenAlex ID: W4415531102