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Onisiforou A, Zanos P, Georgiou P. Molecular signatures of premature aging in Major Depression and Substance Use Disorders. Sci Data 2024; 11:698. [PMID: 38926475 PMCID: PMC11208564 DOI: 10.1038/s41597-024-03538-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 06/17/2024] [Indexed: 06/28/2024] Open
Abstract
Major depressive disorder (MDD) and substance-use disorders (SUDs) often lead to premature aging, increasing vulnerability to cognitive decline and other forms of dementia. This study utilized advanced systems bioinformatics to identify aging "signatures" in MDD and SUDs and evaluated the potential for known lifespan-extending drugs to target and reverse these signatures. The results suggest that inhibiting the transcriptional activation of FOS gene family members holds promise in mitigating premature aging in MDD and SUDs. Conversely, antidepressant drugs activating the PI3K/Akt/mTOR pathway, a common mechanism in rapid-acting antidepressants, may accelerate aging in MDD patients, making them unsuitable for those with comorbid aging-related conditions like dementia and Alzheimer's disease. Additionally, this innovative approach identifies potential anti-aging interventions for MDD patients, such as Deferoxamine, Resveratrol, Estradiol valerate, and natural compounds like zinc acetate, genistein, and ascorbic acid, regardless of comorbid anxiety disorders. These findings illuminate the premature aging effects of MDD and SUDs and offer insights into treatment strategies for patients with comorbid aging-related conditions, including dementia and Alzheimer's disease.
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Affiliation(s)
- Anna Onisiforou
- Department of Psychology, University of Cyprus, Nicosia, Cyprus.
| | - Panos Zanos
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Polymnia Georgiou
- Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus.
- Department of Psychology, University of Wisconsin Milwaukee, Milwaukee, Wisconsin, USA.
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Polsinelli AJ, Wonderlin RJ, Hammers DB, Pena Garcia A, Eloyan A, Taurone A, Thangarajah M, Beckett L, Gao S, Wang S, Kirby K, Logan PE, Aisen P, Dage JL, Foroud T, Griffin P, Iaccarino L, Kramer JH, Koeppe R, Kukull WA, La Joie R, Mundada NS, Murray ME, Nudelman K, Soleimani-Meigooni DN, Rumbaugh M, Toga AW, Touroutoglou A, Vemuri P, Atri A, Day GS, Duara R, Graff-Radford NR, Honig LS, Jones DT, Masdeu J, Mendez MF, Womack K, Musiek E, Onyike CU, Riddle M, Rogalski E, Salloway S, Sha SJ, Turner RS, Wingo TS, Wolk DA, Carrillo MC, Dickerson BC, Rabinovici GD, Apostolova LG. Baseline neuropsychiatric symptoms and psychotropic medication use midway through data collection of the Longitudinal Early-Onset Alzheimer's Disease Study (LEADS) cohort. Alzheimers Dement 2023; 19 Suppl 9:S42-S48. [PMID: 37296082 PMCID: PMC10709525 DOI: 10.1002/alz.13344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/12/2023]
Abstract
INTRODUCTION We examined neuropsychiatric symptoms (NPS) and psychotropic medication use in a large sample of individuals with early-onset Alzheimer's disease (EOAD; onset 40-64 years) at the midway point of data collection for the Longitudinal Early-onset Alzheimer's Disease Study (LEADS). METHODS Baseline NPS (Neuropsychiatric Inventory - Questionnaire; Geriatric Depression Scale) and psychotropic medication use from 282 participants enrolled in LEADS were compared across diagnostic groups - amyloid-positive EOAD (n = 212) and amyloid negative early-onset non-Alzheimer's disease (EOnonAD; n = 70). RESULTS Affective behaviors were the most common NPS in EOAD at similar frequencies to EOnonAD. Tension and impulse control behaviors were more common in EOnonAD. A minority of participants were using psychotropic medications, and use was higher in EOnonAD. DISCUSSION Overall NPS burden and psychotropic medication use were higher in EOnonAD than EOAD participants. Future research will investigate moderators and etiological drivers of NPS, and NPS differences in EOAD versus late-onset AD.
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Affiliation(s)
- Angelina J. Polsinelli
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, 46202, USA
| | - Ryan J. Wonderlin
- Marian University College of Osteopathic Medicine, Indianapolis, Indiana, 46222, USA
| | - Dustin B. Hammers
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, 46202, USA
| | - Alex Pena Garcia
- Marian University College of Osteopathic Medicine, Indianapolis, Indiana, 46222, USA
| | - Ani Eloyan
- Department of Biostatistics, Center for Statistical Sciences, Brown University, Providence, Rhode Island, 02912, USA
| | - Alexander Taurone
- Department of Biostatistics, Center for Statistical Sciences, Brown University, Providence, Rhode Island, 02912, USA
| | - Maryanne Thangarajah
- Department of Biostatistics, Center for Statistical Sciences, Brown University, Providence, Rhode Island, 02912, USA
| | - Laurel Beckett
- Department of Public Health Sciences, University of California – Davis, Davis, California, 95616, USA
| | - Sujuan Gao
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, 46202, USA
| | - Sophia Wang
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, 46202, USA
| | - Kala Kirby
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, 46202, USA
| | - Paige E. Logan
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, 46202, USA
| | - Paul Aisen
- Alzheimer’s Therapeutic Research Institute, University of Southern California, San Diego, California, 92121, USA
| | - Jeffrey L. Dage
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, 46202, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, 46202, USA
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, 46202, USA
| | - Percy Griffin
- Medical & Scientific Relations Division, Alzheimer’s Association, Chicago, Illinois, 60603, USA
| | - Leonardo Iaccarino
- Department of Neurology, University of California – San Francisco, San Francisco, California, 94143, USA
| | - Joel H. Kramer
- Department of Neurology, University of California – San Francisco, San Francisco, California, 94143, USA
| | - Robert Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, 48109, USA
| | - Walter A. Kukull
- Department of Epidemiology, University of Washington, Seattle, Washington, 98195, USA
| | - Renaud La Joie
- Department of Neurology, University of California – San Francisco, San Francisco, California, 94143, USA
| | - Nidhi S Mundada
- Department of Neurology, University of California – San Francisco, San Francisco, California, 94143, USA
| | - Melissa E. Murray
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, 32224, USA
| | - Kelly Nudelman
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, 46202, USA
| | | | - Malia Rumbaugh
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, 46202, USA
| | - Arthur W. Toga
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Los Angeles, California, 90033, USA
| | - Alexandra Touroutoglou
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, 02114, USA
| | - Prashanthi Vemuri
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, 55123, USA
| | - Alireza Atri
- Banner Sun Health Research Institute, Sun City, Arizona, 85351, USA
| | - Gregory S. Day
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, 32224, USA
| | - Ranjan Duara
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami, Florida, 33140, USA
| | | | - Lawrence S. Honig
- Taub Institute and Department of Neurology, Columbia University Irving Medical Center, New York, New York, 10032, USA
| | - David T. Jones
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, 55123, USA
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, 55905, USA
| | - Joseph Masdeu
- Nantz National Alzheimer Center, Houston Methodist and Weill Cornell Medicine, Houston, Texas, 77030, USA
| | - Mario F. Mendez
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, 90095, USA
| | - Kyle Womack
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Erik Musiek
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Chiadi U. Onyike
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21205, USA
| | - Meghan Riddle
- Department of Psychiatry, Alpert Medical School, Brown University, Providence, Rhode Island, 02912, USA
| | - Emily Rogalski
- Department of Psychiatry and Behavioral Sciences, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, 60611, USA
| | - Steven Salloway
- Department of Psychiatry, Alpert Medical School, Brown University, Providence, Rhode Island, 02912, USA
| | - Sharon J. Sha
- Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, California, 94304, USA
| | - Raymond S. Turner
- Department of Neurology, Georgetown University, Washington D.C., 20057, USA
| | - Thomas S. Wingo
- Department of Neurology and Human Genetics, Emory University School of Medicine, Atlanta, Georgia, 30307, USA
| | - David A. Wolk
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Maria C. Carrillo
- Medical & Scientific Relations Division, Alzheimer’s Association, Chicago, Illinois, 60603, USA
| | - Bradford C. Dickerson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, 02114, USA
| | - Gil D. Rabinovici
- Department of Neurology, University of California – San Francisco, San Francisco, California, 94143, USA
| | - Liana G. Apostolova
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, 46202, USA
- Alzheimer’s Therapeutic Research Institute, University of Southern California, San Diego, California, 92121, USA
- Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine Indianapolis, Indianapolis, Indiana, 46202, USA
| | - LEADS Consortium
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, 46202, USA
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Hammers DB, Eloyan A, Taurone A, Thangarajah M, Beckett L, Gao S, Kirby K, Aisen P, Dage JL, Foroud T, Griffin P, Grinberg LT, Jack CR, Kramer J, Koeppe R, Kukull WA, Mundada NS, Joie RL, Soleimani-Meigooni DN, Iaccarino L, Murray ME, Nudelman K, Polsinelli AJ, Rumbaugh M, Toga A, Touroutoglou A, Vemuri P, Atri A, Day GS, Duara R, Graff-Radford NR, Honig LS, Jones DT, Masdeu J, Mendez MF, Womack K, Musiek E, Onyike CU, Riddle M, Rogalski E, Salloway S, Sha SJ, Turner RS, Wingo TS, Wolk DA, Carrillo MC, Dickerson BC, Rabinovici GD, Apostolova LG. Profiling baseline performance on the Longitudinal Early-Onset Alzheimer's Disease Study (LEADS) cohort near the midpoint of data collection. Alzheimers Dement 2023; 19 Suppl 9:S8-S18. [PMID: 37256497 PMCID: PMC10806768 DOI: 10.1002/alz.13160] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVE The Longitudinal Early-Onset Alzheimer's Disease Study (LEADS) seeks to provide comprehensive understanding of early-onset Alzheimer's disease (EOAD; onset <65 years), with the current study profiling baseline clinical, cognitive, biomarker, and genetic characteristics of the cohort nearing the data-collection mid-point. METHODS Data from 371 LEADS participants were compared based on diagnostic group classification (cognitively normal [n = 89], amyloid-positive EOAD [n = 212], and amyloid-negative early-onset non-Alzheimer's disease [EOnonAD; n = 70]). RESULTS Cognitive performance was worse for EOAD than other groups, and EOAD participants were apolipoprotein E (APOE) ε4 homozygotes at higher rates. An amnestic presentation was common among impaired participants (81%), with several clinical phenotypes present. LEADS participants generally consented at high rates to optional trial procedures. CONCLUSIONS We present the most comprehensive baseline characterization of sporadic EOAD in the United States to date. EOAD presents with widespread cognitive impairment within and across clinical phenotypes, with differences in APOE ε4 allele carrier status appearing to be relevant. HIGHLIGHTS Findings represent the most comprehensive baseline characterization of sporadic early-onset Alzheimer's disease (EOAD) to date. Cognitive impairment was widespread for EOAD participants and more severe than other groups. EOAD participants were homozygous apolipoprotein E (APOE) ε4 carriers at higher rates than the EOnonAD group. Amnestic presentation predominated in EOAD and EOnonAD participants, but other clinical phenotypes were present.
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Affiliation(s)
- Dustin B. Hammers
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ani Eloyan
- Department of Biostatistics, Center for Statistical Sciences, Brown University, Providence, Rhode Island, USA
| | - Alexander Taurone
- Department of Biostatistics, Center for Statistical Sciences, Brown University, Providence, Rhode Island, USA
| | - Maryanne Thangarajah
- Department of Biostatistics, Center for Statistical Sciences, Brown University, Providence, Rhode Island, USA
| | - Laurel Beckett
- Department of Public Health Sciences, University of California – Davis, Davis, California, USA
| | - Sujuan Gao
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kala Kirby
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Paul Aisen
- Alzheimer’s Therapeutic Research Institute, University of Southern California, San Diego, California, USA
| | - Jeffrey L. Dage
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Percy Griffin
- Medical & Scientific Relations Division, Alzheimer’s Association, Chicago, Illinois, USA
| | - Lea T. Grinberg
- Department of Pathology, University of California – San Francisco, San Francisco, California, USA
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | | | - Joel Kramer
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | - Robert Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Walter A. Kukull
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Nidhi S Mundada
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | - Renaud La Joie
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | | | - Leonardo Iaccarino
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | | | - Kelly Nudelman
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Angelina J. Polsinelli
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Malia Rumbaugh
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Arthur Toga
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Alexandra Touroutoglou
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Alireza Atri
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Gregory S. Day
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
| | - Ranjan Duara
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami, Florida, USA
| | | | - Lawrence S. Honig
- Taub Institute and Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - David T. Jones
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joseph Masdeu
- Nantz National Alzheimer Center, Houston Methodist and Weill Cornell Medicine, Houston, Texas, USA
| | - Mario F. Mendez
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Kyle Womack
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Erik Musiek
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Chiadi U. Onyike
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Meghan Riddle
- Department of Neurology, Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Emily Rogalski
- Department of Psychiatry and Behavioral Sciences, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Steven Salloway
- Department of Neurology, Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Sharon J. Sha
- Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, California, USA
| | | | - Thomas S. Wingo
- Department of Neurology and Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - David A. Wolk
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Maria C. Carrillo
- Medical & Scientific Relations Division, Alzheimer’s Association, Chicago, Illinois, USA
| | - Bradford C. Dickerson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Gil D. Rabinovici
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | - Liana G. Apostolova
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine Indianapolis, Indianapolis, Indiana, USA
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Muacevic A, Adler JR. Young-Onset Dementia and Neurodegenerative Disorders of the Young With an Emphasis on Clinical Manifestations. Cureus 2022; 14:e30025. [PMID: 36381805 PMCID: PMC9637441 DOI: 10.7759/cureus.30025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/07/2022] [Indexed: 01/25/2023] Open
Abstract
Young-onset dementia (YOD) refers to a neurological ailment primarily affecting people below 65 years of age in roughly about 8% of cases found through various researches. The high rate of prevalence of secondary dementias among older patients proves that younger people show a better prognosis of the conditions causing dementia than older people. However, effective interventions have to be usually provided early in the course of cognitive decline to help facilitate cognitive improvement. The risk of development of prodromal dementia is high if there is a development of psychoses in middle-aged or older people. When there is a development of psychoses in middle to late life, the likelihood of this indicates prodromal dementia is high. The clinical presentation is quite variable and often subtle in frontotemporal dementia (FTD) but may be dominated by personality change, behavioral disturbances, motivation, or the loss of empathy. There is great heterogeneity in the probable causes of dementia in young age as compared to dementia in old age, and some observed differences also exist in the course and characteristics of the disease. These causes may range from the most probable cause such as Alzheimer's disease (AD) to causes with low probability, such as metabolic disorders and prion diseases. The symptoms of young-onset dementia include a gradual development of personality and behavioral changes over a period of years. However, in the initial stages of young-onset dementia, this change can be attributed to various issues, such as depression, marital problems, and menopause. Other neurodegenerative diseases such as Huntington's disease show presentations such as changes in personality, chorea, and depression that can be observed in patients in their early adulthood. A few other neurodegenerative disorders are myoclonic epilepsy with ragged red fibers (MERRF) and mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) with presentations such as characterized muscle weakness, poor growth, problems with vision and hearing, and the involvement of the multi-organ system, including the central nervous system to name a few. There is also the prevalence of juvenile parkinsonism in the community, which represents a group of clinicopathological entities present before the age of 21. Young-onset Parkinson's disease (PD) (YOPD) appears to have the same pathological presentation as late-onset Parkinson's disease (LOPD). Recent researches have proved that "gene therapy" can be useful in the treatment and in preventing the progression of symptoms in cases of neurodegenerative diseases.
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Loreto F, Fitzgerald A, Golemme M, Gunning S, Win Z, Patel N, Carswell C, Perry R, Kennedy A, Edison P, Malhotra P. Prevalence of Depressive Symptoms in a Memory Clinic Cohort: A Retrospective Study. J Alzheimers Dis 2022; 88:1179-1187. [PMID: 35754270 DOI: 10.3233/jad-220170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Depression has been suggested to be a cause of reversible cognitive impairment but also a risk factor for neurodegenerative disease. Studies suggest that depression prevalence may be high in early onset dementia, particularly Alzheimer's disease, but this has not been systematically assessed in a biomarker-validated clinical dementia cohort to date. OBJECTIVE To examine the prevalence, features, and association with amyloid pathology of lifetime depressive symptoms in a memory clinic cohort meeting appropriate use criteria for amyloid PET imaging. METHODS We included 300 patients from a single-center memory clinic cohort that received diagnostic biomarker evaluation with amyloid PET imaging according to appropriate use criteria. History of lifetime depressive symptoms was retrospectively assessed through structured review of clinical correspondence. RESULTS One hundred forty-two (47%) patients had a history of significant depressive symptoms ('D+'). Of these, 89% had ongoing symptoms and 60% were on antidepressants at the time of presentation to our Clinic. Depressive symptoms were equally highly prevalent in the amyloid-positive and the heterogeneous group of amyloid-negative patients. CONCLUSION Approximately half of patients who meet appropriate use criteria for amyloid PET had a history of depressive symptoms. We suggest that depression is an important feature of both neurodegenerative and non-neurodegenerative cognitive impairment and may contribute to the diagnostic uncertainty behind referral to amyloid PET.
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Affiliation(s)
- Flavia Loreto
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Anna Fitzgerald
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Mara Golemme
- Department of Neurology, Imperial College Healthcare NHS Trust, London, UK.,UK Dementia Research Institute Care Research and Technology Centre, Imperial College London and the University of Surrey, UK
| | - Stephen Gunning
- Department of Neuropsychology, Imperial College Healthcare NHS Trust, London, UK
| | - Zarni Win
- Department of Nuclear Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Neva Patel
- Department of Nuclear Medicine, Imperial College Healthcare NHS Trust, London, UK
| | | | - Richard Perry
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK.,Department of Neurology, Imperial College Healthcare NHS Trust, London, UK
| | - Angus Kennedy
- Department of Neurology, Imperial College Healthcare NHS Trust, London, UK
| | - Paul Edison
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Paresh Malhotra
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK.,Department of Neurology, Imperial College Healthcare NHS Trust, London, UK.,UK Dementia Research Institute Care Research and Technology Centre, Imperial College London and the University of Surrey, UK
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Hendriks S, Peetoom K, Tange H, van Bokhoven MA, van der Flier WM, Bakker C, Papma JM, Koopmans R, Verhey F, Köhler S, de Vugt M. Pre-Diagnostic Symptoms of Young-Onset Dementia in the General Practice up to Five Years Before Diagnosis. J Alzheimers Dis 2022; 88:229-239. [PMID: 35570494 PMCID: PMC9277692 DOI: 10.3233/jad-220215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Young-onset dementia (YOD) has many underlying etiologies, leading to a large heterogeneity in first symptoms. This makes it difficult for general practitioners (GPs) to recognize YOD. Objective: Identify early symptoms that are more common in the pre-diagnostic phase of YOD. Methods: We performed a case-control study nested in a primary-care registry on 89 cases and 162 matched controls, where we compared symptoms of people with YOD up to 5 years before diagnosis to their matched control group without YOD. The variables included in this study were International Classification of Primary Care codes and symptoms extracted from written GP notes and categorized in groups. We used Generalized Equation Estimation to analyze symptom’s time-trajectories and logistic regression and ROC-curves to analyze differences in number of symptom categories reported. Results: Cognitive symptoms were more common in people with YOD 5 years before diagnosis, affective symptoms 4 years before diagnosis, social symptoms 3 years, behavioral symptoms 2 years, and daily functioning disturbances 1 year before diagnosis. The ROC-curve suggested that reporting two or more symptom categories at the GP gave the best trade-off between sensitivity (85%) and specificity (77%), for the highest percentage of correctly diagnosed persons. Conclusion: This study showed people with YOD present differently than people without YOD. However, it may still be difficult for GPs to use these symptom categories to distinguish people with YOD, since the symptoms also occur in people with other diseases. A combination of reported symptom categories increases the probability of an underlying cause of YOD.
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Affiliation(s)
- Stevie Hendriks
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, Netherlands
| | - Kirsten Peetoom
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, Netherlands
| | - Huibert Tange
- Care and Public Health Research Institute (CAPHRI), Department of Family Medicine, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Marloes A. van Bokhoven
- Care and Public Health Research Institute (CAPHRI), Department of Family Medicine, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Wiesje M. van der Flier
- Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Christian Bakker
- Medical Center, Radboud, Department of Primary and Community Care, The Netherlands
- Radboudumc Alzheimer Center, Nijmegen, The Netherlands
- Groenhuysen, Center for Specialized Geriatric Care, Roosendaal, The Netherlands
| | - Janne M. Papma
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Raymond Koopmans
- Medical Center, Radboud, Department of Primary and Community Care, The Netherlands
- Radboudumc Alzheimer Center, Nijmegen, The Netherlands
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, Netherlands
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, Netherlands
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Hosseini AA, Brown T, Mannino L, Gran B, Junaid K, Mukaetova-Ladinska EB. Clinical Utility of Cerebrospinal Fluid Aβ42 and Tau Measures in Diagnosing Mild Cognitive Impairment in Early Onset Dementia. J Alzheimers Dis 2022; 87:771-780. [PMID: 35404281 PMCID: PMC10741365 DOI: 10.3233/jad-215650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND The differentiation of a preclinical or prodromal Alzheimer's disease (AD) is challenging particularly in patients with early onset Alzheimer's or related dementias (EOARD). We report our experience on diagnostic lumbar puncture to diagnose EOARD at a tertiary neurocognitive referral center in Nottingham, England from March 2018 to October 2020. OBJECTIVE To assess amyloid-β42 (Aβ42), total tau, and Thr181-phosphorylated tau (p-tau) measurements in the cerebrospinal fluid (CSF) in patients with mild cognitive impairment (MCI) and in relation to their follow-up cognitive performance. METHODS Thirty participants aged 32-68 years old (mean 59 years; 57% female) were included. Clinical diagnosis was based on clinical presentation, neurocognitive profile, neuroradiological features (MRI, FDG-PET CT) and CSF Aβ42, total tau, and p-tau measurements. RESULTS Patients with MCI who progressed to AD (prodromal AD) had significantly higher CSF total (797.63 pg/ml) and p-tau (82.31 pg/ml), and lower Aβ42 levels (398.94 pg/ml) in comparison to their counterparts with stable MCI (total tau 303.67 pg/ml, p-tau 43.56 pg/ml, Aβ42 873.44 pg/ml) (p < 0.01 for CSF total and p-tau measures and p < 0.0001 for CSF Aβ42 measures). None of the CSF biomarkers correlated with any of the cognitive performance measures. Principal component analysis confirmed that the clinical diagnosis of MCI secondary to AD, namely prodromal AD (as per NIA-AA criteria) in younger adults, was associated with decreased CSF Aβ42. CONCLUSION In early onset AD, low levels of CSF Aβ42 appear to be more sensitive than total and p-tau measures in differentiating AD MCI from other forms of dementia. Further work on larger samples of EOARD in clinical practice will address the cost effectiveness of making an earlier diagnosis.
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Affiliation(s)
- Akram A. Hosseini
- Department of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK
- Mental Health and Clinical Neurosciences Academic Unit, University of Nottingham, Nottingham, UK
- Working Age Dementia Services, Nottinghamshire Healthcare NHS Foundation Trust, Nottinghamshire, UK
| | - Thomas Brown
- Department of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Luca Mannino
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Bruno Gran
- Department of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK
- Mental Health and Clinical Neurosciences Academic Unit, University of Nottingham, Nottingham, UK
| | - Kehinde Junaid
- Working Age Dementia Services, Nottinghamshire Healthcare NHS Foundation Trust, Nottinghamshire, UK
| | - Elizabeta B. Mukaetova-Ladinska
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
- The Evington Centre, Leicester General Hospital, Gwendolen Road, Leicester, UK
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8
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Halse I, Bjørkløf GH, Engedal K, Selbæk G, Barca ML. Locus of Control and Its Associations with Depressive Symptoms amongst People with Dementia. Dement Geriatr Cogn Disord 2021; 50:258-265. [PMID: 34384076 DOI: 10.1159/000517936] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 06/11/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Depression is common amongst people with dementia. This study examines whether locus of control (LoC), a perceived control construct influential in the coping process, is related to depressive symptoms in this population. METHODS In this prospective observational study, 257 community-dwelling older adults with a confirmed dementia diagnosis were included. At baseline, measures of depressive symptoms, LoC, cognition, independent functional ability, general health, dementia severity, and dementia disease insight were collected. At follow-up, measures of depressive symptoms and cognition were collected. Multiple linear regression using degree of depressive symptoms as measured with Montgomery-Asberg Depression Rating Scale as a dependent variable was applied to assess whether LoC was associated with depressive symptoms at baseline and follow-up while controlling for covariates. RESULTS LoC (p < 0.001), general health (p = 0.003), and insight (p = 0.010) were associated with severity of depressive symptoms at baseline, accounting for 28% of the variance. LoC (p = 0.025) and depressive symptoms (p < 0.001) at baseline were associated with severity of depressive symptoms at follow-up, accounting for 56.3% of the variance. CONCLUSION LoC was significantly associated with severity of depressive symptoms in people with dementia at baseline and at follow-up. Attention to LoC may be valuable for our understanding of depression in people with dementia, and interventions targeting depression could benefit from including a focus on internalizing perceived control. However, these findings are novel, and more research is needed.
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Affiliation(s)
- Ingeborg Halse
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital-Ullevaal, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Guro Hanevold Bjørkløf
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital-Ullevaal, Oslo, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital-Ullevaal, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Maria Lage Barca
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital-Ullevaal, Oslo, Norway
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9
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Sousa S, Paúl C, Teixeira L. Predictors of Major Depressive Disorder in Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211894. [PMID: 34831649 PMCID: PMC8624368 DOI: 10.3390/ijerph182211894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 11/22/2022]
Abstract
Major depressive disorder (MDD) is one of the most common mental disorders in older people. There are several biological, psychological, and social factors associated with this disorder. This study aimed to describe the depressive state to identify the associated factors and potential predictors of MDD in a population of community-dwelling older people with probable MDD. The sample consisted of 378 participants with probable dementia, with 47.3% of them presenting MDD. The factors that were found to be associated with MDD were sex, living status, mobility, and nutritional status. Knowing the factors that can predict a condition such as MDD is extremely important, both for prevention and for the customization of interventions.
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Affiliation(s)
- Susana Sousa
- Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), 4050-313 Porto, Portugal; (C.P.); (L.T.)
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal
- Correspondence: ; Tel.: +351-969815253
| | - Constança Paúl
- Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), 4050-313 Porto, Portugal; (C.P.); (L.T.)
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal
| | - Laetitia Teixeira
- Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), 4050-313 Porto, Portugal; (C.P.); (L.T.)
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal
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10
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Grundberg Å, Sandberg J, Craftman ÅG. Childrens' and young adults' perspectives of having a parent with dementia diagnosis: A scoping review. DEMENTIA 2021; 20:2933-2956. [PMID: 34096358 DOI: 10.1177/14713012211023653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Dementia is a key health issue worldwide. In Sweden, as in other European countries, most persons with dementia live in domestic settings and are often cared for by their family members. This scoping review aims to describe the perspectives of children and young adults with a parent diagnosed with dementia. Young family members may be alone and without support despite their high level of care burden. DESIGN AND METHODS Three electronic databases (PubMed, Web of Science and PsycINFO) were used to search for English-language articles focusing on children and young adults between the ages of 6 and 34 who have a parent diagnosed with dementia. A thematic synthesis of the included articles was performed. FINDINGS Sixteen original published qualitative studies were identified. These studies were categorised based on information about the authors, year of publication, study location, participants, aim of the study, data collection, analysis and main findings. Five main analytical themes were identified: (1) children and young adults identify changes in their parents' behaviour and personality, (2) children and young adults experience changed roles and relationships within the family, (3) children and young adults need to cope with an uncertain future, (4) children and young adults relate changes in their parent to their own mixed emotions and (5) children and young adults need help and seek it out but experience inadequate support. CONCLUSIONS The children and young adults in the included studies seem to provide significant levels of care and support to their affected parent, which may affect their own health, social relations, community participation, employment, education, finances and sense of security. This means that it is important for health care systems and social services to identify barriers to these young family members' access to relevant care and support for themselves.
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Affiliation(s)
- Åke Grundberg
- Department of Learning, Informatics, Management and Ethics, LIME, 27106Karolinska Institutet, Solna, Sweden
| | - Jonas Sandberg
- Department of Caring Science, Sophiahemmet University, Stockholm, Sweden
| | - Åsa G Craftman
- Department of Caring Science, Sophiahemmet University, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, NVS, 27106Karolinska Institutet, Huddinge, Sweden
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11
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Yeung M, MacFarland K, Mlilo V, Dean N, Underwood BR. Patients with young-onset dementia in an older people's mental health service. BJPsych Bull 2021; 45:81-86. [PMID: 32799951 PMCID: PMC8111944 DOI: 10.1192/bjb.2020.89] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIMS AND METHOD Currently, no separate service exists for patients with young-onset dementia in Cambridgeshire. These patients are managed together with late-onset dementia patients within old age psychiatry services. To inform service design, we sought to characterise young-onset dementia patients in our population. We first analysed service-level data and supplemented this with a detailed case review of 90 patients. RESULTS Young-onset dementia remains a relatively rare condition. Only a small proportion of those referred for assessment receive a diagnosis of dementia. Data collected on presenting complaints, comorbidities, medication and Health of the Nation Outcome Scales scores associated young-onset dementia with a greater incidence of depression than late-onset dementia. Outcomes in the two groups did not appear to differ. CLINICAL IMPLICATIONS The data presented here do not suggest a need to create a separate service. Practitioners should be aware of the increased incidence of depression observed in this group.
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Affiliation(s)
| | | | - Vincent Mlilo
- Cambridgeshire and Peterborough NHS Foundation Trust
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12
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Sociodemographic and Clinical Characteristics of 1350 Patients With Young Onset Dementia. Alzheimer Dis Assoc Disord 2021; 35:200-207. [DOI: 10.1097/wad.0000000000000435] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 12/15/2020] [Indexed: 11/26/2022]
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13
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Gumus M, Multani N, Mack ML, Tartaglia MC. Progression of neuropsychiatric symptoms in young-onset versus late-onset Alzheimer's disease. GeroScience 2021; 43:213-223. [PMID: 33420706 DOI: 10.1007/s11357-020-00304-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/18/2020] [Indexed: 12/19/2022] Open
Abstract
Young-onset and late-onset Alzheimer's disease has different clinical presentations with late-onset presenting most often with memory deficits while young-onset often presents with a non-amnestic syndrome. However, it is unknown whether there are differences in presentation and progression of neuropsychiatric symptoms in young- versus late-onset Alzheimer's disease. We aimed to investigate differences in the prevalence and severity of neuropsychiatric symptoms in patients with young- and late-onset Alzheimer's disease longitudinally with and without accounting for the effect of medication usage. Sex differences were also considered in these patient groups. We included 126 young-onset and 505 late-onset Alzheimer's disease patients from National Alzheimer's Coordinating Center-Uniform Data Set (NACC-UDS) and Alzheimer's Disease Neuroimaging Initiative (ADNI). We investigated the prevalence and severity of neuropsychiatric symptoms using the Neuropsychiatric Inventory-Questionnaire over 4 visits with 1-year intervals, using a linear mixed-effects model. The prevalence of depression was significantly higher in young-onset than late-onset Alzheimer's disease over a 4-year interval when antidepressant usage was included in our analyses. Our findings suggest that neuropsychiatric symptom profiles of young- and late-onset Alzheimer's disease differ cross-sectionally but also display significant differences in progression.
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Affiliation(s)
- Melisa Gumus
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Ave., Toronto, ON, M5T 2S8, Canada
| | - Namita Multani
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Ave., Toronto, ON, M5T 2S8, Canada
| | - Michael L Mack
- Department of Psychology, Faculty of Arts and Science, University of Toronto, Sidney Smith Hall, 100 St. George Street, Toronto, ON, M5S 3G3, Canada
| | - Maria Carmela Tartaglia
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada. .,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Ave., Toronto, ON, M5T 2S8, Canada. .,Division of Neurology, Toronto Western Hospital, University Health Network, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada.
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14
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Gerritsen AAJ, Bakker C, Bruls E, Verhey FRJ, Pijnenburg YAL, Millenaar JK, de Vugt ME, Koopmans RTCM. Psychotropic drug use in community-dwelling people with young-onset dementia: two-year course and determinants. Aging Ment Health 2021; 25:179-186. [PMID: 31746238 DOI: 10.1080/13607863.2019.1691145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The aim of this study was to describe the course of psychotropic drug use in people with young-onset dementia and to explore possible associations with age, sex, dementia severity, dementia subtype and neuropsychiatric symptoms. METHODS Psychotropic drug use was studied in 198 community-dwelling persons participating in the Needs in Young-onset Dementia study. Data about psychotropic drug use were retrieved at baseline, as well as at 6, 12, 18 and 24 months and was classified into five groups (antiepileptics, antipsychotics, anxiolytics, hypnotics/sedatives and antidepressants) and quantified as 'present' or 'absent'. Generalized Estimating Equation modeling and chi-square tests were used to study associations between the determinants and psychotropic drug use. RESULTS There was a statistically significant increase in the prevalence of psychotropic drug use from 52.3% to 62.6% during the course of the study. Almost three-quarters (72.4%) of the participants were treated with any psychotropic drug during the study, and more than one-third (37.4%) received psychotropic drugs continuously. Antipsychotics were used continuously in more than 10% of the participants and antidepressants in more than 25%. Increasing age was positively associated (p = .018) with psychotropic drug use at baseline, while apathy symptoms were negatively associated (p = .018). CONCLUSIONS Despite the recommendations of various guidelines, the prolonged use of psychotropic drugs in community-dwelling people with young-onset dementia is high. Therefore, more attention is needed to timely evaluate psychotropic drug use and the introduction of self-management programs for caregivers should be encouraged to support caregivers in dealing with the neuropsychiatric symptoms caused by the dementia.
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Affiliation(s)
- Adrie A J Gerritsen
- De Wever, Center for Elderly Care, Tilburg, The Netherlands.,Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboudumc, Alzheimer Center, Nijmegen, The Netherlands
| | - Christian Bakker
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboudumc, Alzheimer Center, Nijmegen, The Netherlands.,Groenhuysen, Center for Specialized Geriatric Care, Roosendaal, The Netherlands
| | - Esther Bruls
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frans R J Verhey
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Yolande A L Pijnenburg
- Department of Neurology and Alzheimer Center, Amsterdam University Medical Centers, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Joany K Millenaar
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marjolein E de Vugt
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Raymond T C M Koopmans
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboudumc, Alzheimer Center, Nijmegen, The Netherlands.,Joachim en Anna, Center for Specialized Geriatric Care, Nijmegen, The Netherlands
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15
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Byeon H. Best early-onset Parkinson dementia predictor using ensemble learning among Parkinson's symptoms, rapid eye movement sleep disorder, and neuropsychological profile. World J Psychiatry 2020; 10:245-259. [PMID: 33269221 PMCID: PMC7672787 DOI: 10.5498/wjp.v10.i11.245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/27/2020] [Accepted: 10/11/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Despite the frequent progression from Parkinson’s disease (PD) to Parkinson’s disease dementia (PDD), the basis to diagnose early-onset Parkinson dementia (EOPD) in the early stage is still insufficient.
AIM To explore the prediction accuracy of sociodemographic factors, Parkinson's motor symptoms, Parkinson’s non-motor symptoms, and rapid eye movement sleep disorder for diagnosing EOPD using PD multicenter registry data.
METHODS This study analyzed 342 Parkinson patients (66 EOPD patients and 276 PD patients with normal cognition), younger than 65 years. An EOPD prediction model was developed using a random forest algorithm and the accuracy of the developed model was compared with the naive Bayesian model and discriminant analysis.
RESULTS The overall accuracy of the random forest was 89.5%, and was higher than that of discriminant analysis (78.3%) and that of the naive Bayesian model (85.8%). In the random forest model, the Korean Mini Mental State Examination (K-MMSE) score, Korean Montreal Cognitive Assessment (K-MoCA), sum of boxes in Clinical Dementia Rating (CDR), global score of CDR, motor score of Untitled Parkinson’s Disease Rating (UPDRS), and Korean Instrumental Activities of Daily Living (K-IADL) score were confirmed as the major variables with high weight for EOPD prediction. Among them, the K-MMSE score was the most important factor in the final model.
CONCLUSION It was found that Parkinson-related motor symptoms (e.g., motor score of UPDRS) and instrumental daily performance (e.g., K-IADL score) in addition to cognitive screening indicators (e.g., K-MMSE score and K-MoCA score) were predictors with high accuracy in EOPD prediction.
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Affiliation(s)
- Haewon Byeon
- Department of Medical Big Data, College of AI Convergence, Inje University, Gimhae 50834, Gyeonsangnamdo, South Korea
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16
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Velayudhan L, Baillon S, Daby L, Suntharamoorthy P, Kablan A, Tromans S, Lindesay J. Predictors of Disease Progression in Early-Onset Alzheimer's Dementia: A Retrospective Cohort Study. J Am Med Dir Assoc 2020; 21:1735-1739. [PMID: 32636170 DOI: 10.1016/j.jamda.2020.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 05/07/2020] [Accepted: 05/10/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Early-onset Alzheimer's disease (EOAD), defined as onset of AD before the age of 65 years, is less common than the late-onset type, and little is known about the factors affecting disease progression. The aim of the study was to investigate factors influencing disease progression in people with EOAD. DESIGN Retrospective cohort study. SETTING AND PARTICIPANTS People with EOAD who were assessed and attended the specialist memory service at a university teaching hospital in a European setting, between 2000 and 2010. MEASURES Sociodemographic details and clinical and cognitive assessments at initial assessment were used as potential predictors of change in clinical status and outcome at final follow-up within the memory service. RESULTS Of the 101 people diagnosed with EOAD during this period, 96 patients were followed up (53 women; aged 59 ± 4.9 years; mean follow-up 36.3 ± 29.12 months). Patients were classified as Stable (n = 25) if continued within the memory service or discharged to primary care, and those transferred to other specialist services (n = 66) for further inputs, institutional care (n = 4), or died (n = 1) were classified as Worseners (n = 71). Lower education (P = .008), lower Cambridge Cognition Examination scores (P = .049), and presence of family history of dementia [P = .012, χ2 (1) = 8.84] was associated with worse change in clinical status. Furthermore, cognitive deficits such as lower scores on comprehension, recent memory, and executive functions were found to predict a worse clinical outcome. CONCLUSIONS AND IMPLICATIONS Identification of predictors of faster disease progression has significant clinical benefit, allowing clinicians to estimate prognosis and plan patient care accordingly.
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Affiliation(s)
- Latha Velayudhan
- Department of Old Age Psychiatry, Academic Sciences Division, Institute of Psychiatry, Psychology and Neurosciences, London, United Kingdom; Psychiatry for Elderly, Department of Health Sciences, College of Life Sciences, George Davies Centre, Leicester, United Kingdom.
| | - Sarah Baillon
- Leicestershire Partnership NHS Trust, Leicester, United Kingdom; Department of Health Sciences, College of Life Sciences, George Davies Centre, Leicester, United Kingdom
| | - Laura Daby
- Doncaster Royal Infirmary, Doncaster, United Kingdom
| | | | | | - Samuel Tromans
- Department of Health Sciences, College of Life Sciences, George Davies Centre, Leicester, United Kingdom
| | - James Lindesay
- Psychiatry for Elderly, Department of Health Sciences, College of Life Sciences, George Davies Centre, Leicester, United Kingdom
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17
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Differences in Awareness of Disease Between Young-onset and Late-onset Dementia. Alzheimer Dis Assoc Disord 2020; 33:129-135. [PMID: 30870144 DOI: 10.1097/wad.0000000000000299] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Awareness of disease is the ability to acknowledge changes caused by deficits related to the disease process. We aimed to investigate whether there are differences in awareness of disease between young-onset dementia (YOD) and late-onset dementia (LOD) and examined how awareness interacts with cognitive and clinical variables. MATERIALS AND METHODS Using a cross-sectional design, 49 people with YOD and 83 with LOD and their caregivers were included. We assessed awareness of disease, cognition, functionality, stage of dementia, mood, neuropsychiatric symptoms, and caregivers' quality of life (QoL) and burden. RESULTS We found that people with YOD were more aware of the disease than people with LOD (P<0.005). Multivariate linear regression revealed that higher impairment in functional level was associated with unawareness in both groups (YOD=P<0.001; LOD=P<0.001). In the YOD group, preserved awareness was related to worse self-reported QoL (P<0.05), whereas, in LOD, deficits in awareness were related to caregivers' worst perceptions about people with dementia QoL (P<0.001). CONCLUSIONS The findings highlight the distinct nature of awareness between YOD and LOD. The YOD group had higher levels of disease awareness compared with the LOD group, even though the first group had a greater impairment in functionality.
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18
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Prodi E, Rossi S, Bertaina I, Pravatà E, Sacco L. Report of a Case of Creutzfeldt-Jakob Disease With an Unusual Clinical Presentation. Front Behav Neurosci 2020; 14:55. [PMID: 32327983 PMCID: PMC7161217 DOI: 10.3389/fnbeh.2020.00055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/24/2020] [Indexed: 11/20/2022] Open
Abstract
We describe the clinical features, neuropsychological tests, laboratory, electroencephalography (EEG), magnetic resonance imaging (MRI) and positron emission tomography (PET) findings of a 59-year-old woman who presented to our Centre for cognitive impairment since few months, with language disturbances, particularly anomia, dyscalculia, and memory loss. The clinical and neuropsychological features were non-specific and overlapping with those of other rapidly progressing neurodegenerative disorders. However, brain MRI played a pivotal role in the diagnosis, showing cortical diffusion restriction, particularly in the parietal lobes and posterior cingulum, with sparing of the perirolandic cortex, typical of Creutzfeldt-Jakob disease (CJD). Brain MRI abnormalities were visible since the first evaluation and remained stable at 2 and 6 weeks follow up. Basal ganglia and thalami were never involved. PET showed left lateralized reduced glucose metabolism, with partial overlap with MRI signal abnormalities. Despite MRI were strongly indicative of CJD, clinical, laboratory and EEG findings did not fulfill the diagnostic criteria for CJD which applied at the time of clinical assessment. Indeed, neither myoclonus, visual or cerebellar signs or akinetic mutism were present. Also, the characteristic periodic sharp wave complexes were absent at baseline EEG, and the CSF assay for 14–3–3 was negative. We, therefore, performed a real-time quaking-induced conversion (RT-QuIC) assay on a frozen sample of corticospinal fluid (CSF), which showed a positive result. RT-QuIC is a prion protein conversion assay that has shown high diagnostic sensitivity and specificity for the diagnosis of CJD. RT-QuIC has been recently incorporated in the National CJD Research and Surveillance Unit and Center for Disease Control and Prevention (CDC) diagnostic criteria for CJD. The fatal evolution of the disease brought the patient to death 13 months after symptoms onset. Pathology proved the diagnosis of sporadic CJD, subtype MM/MV 2C.
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Affiliation(s)
- Elena Prodi
- Department of Neuroradiology, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Stefania Rossi
- Department of Neurology, Neuropsychology and Behavioral Neurology Research Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Ilaria Bertaina
- Department of Neurology, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Emanuele Pravatà
- Department of Neuroradiology, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Leonardo Sacco
- Department of Neurology, Neuropsychology and Behavioral Neurology Research Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
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19
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Hvidsten L, Engedal K, Selbæk G, Wyller TB, Benth JŠ, Kersten H. Quality of Life in People with Young-Onset Dementia: A Nordic Two-Year Observational Multicenter Study. J Alzheimers Dis 2020; 67:197-210. [PMID: 30530973 DOI: 10.3233/jad-180479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Cross-sectional studies of quality of life (QOL) of people with young-onset dementia show diverging results. OBJECTIVE To identify factors associated with QOL in people with young-onset Alzheimer's (AD) and frontotemporal dementia (FTD) and explore development in QOL over a two-year period, including differences between the two subtypes. METHODS A two-year cohort study of 88 community-dwelling people with young-onset AD and FTD recruited from Nordic memory clinics. QOL was assessed using the proxy version of the Quality of Life - Alzheimer's Disease questionnaire, dementia severity was rated with the Clinical Dementia Rating scale, depressive symptoms by the Cornell Scale for Depression in Dementia, awareness with the Reed anosognosia scale, and needs using the Camberwell Assessment of Needs in the Elderly questionnaire. Factors associated with QOL and development in QOL over time were explored with growth mixture model trajectories and mixed model analyses. RESULTS We identified two groups of people following trajectories with better (n = 35) versus poorer (n = 53) QOL. People with more depressive symptoms at baseline had higher odds of belonging to poorer QOL group, OR 1.2 (CI 1.1; 1.5, p = 0.011). Having Alzheimer's disease was associated with significantly better QOL (p = 0.047 at baseline, p = 0.009 at T1 and p = 0.033 at T2). Increasing number of unmet needs was significantly associated with poorer QOL at baseline (p = 0.007), but not later in follow-up. CONCLUSION Early assessment and treatment based on dementia subtype, depression, and individual needs may enhance quality of life in young-onset dementia.
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Affiliation(s)
- Lara Hvidsten
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Division for Mental Health and Addiction, Vestfold Hospital Trust, Tønsberg, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Vestfold Hospital Trust, Tønsberg, Norway.,Oslo University Hospital, Department of Geriatric Medicine, Oslo, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,The Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Torgeir Bruun Wyller
- Oslo University Hospital, Department of Geriatric Medicine, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Hege Kersten
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Pharmaceutical Bioscience, School of Pharmacy, University of Oslo, Oslo, Norway.,Department of Research and Development, Telemark Hospital, Skien, Norway
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20
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Reddy Mukku S, Desai G, Chaturvedi S. Depression and somatic symptoms in dementia: A narrative review. JOURNAL OF GERIATRIC MENTAL HEALTH 2020. [DOI: 10.4103/jgmh.jgmh_4_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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21
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Abstract
PURPOSE OF REVIEW Although young onset dementia (YOD) causes high levels of burden and distress, factors that contribute to its onset are not well understood. Identifying relevant modifiable risk and protective factors for YOD can inform efforts to prevent or delay onset of symptoms to later in life. RECENT FINDINGS Studies of modifiable factors for YOD have increased in frequency in recent years. Poor educational attainment and low socioeconomic status, a history of heavy alcohol use, and poor cardiovascular health may be key targets for YOD prevention or delay. Traumatic brain injury has attracted significant attention but evidence of its importance is limited except in cases occurring secondarily to the injury. SUMMARY A growing body of evidence suggests that modifiable risk factors have a role in modulating the age of dementia onset. Clinicians should be aware that many people with YOD will present with complex histories of multifactorial (including modifiable and nonmodifiable) risk exposure. Exploring trajectories of risk and gene-environment interactions is an important future research direction and will inform targeted prevention efforts.
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22
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Kimura NRS, Neto JPS, Santos RL, Baptista MAT, Portugal G, Johannessen A, Barca ML, Engedal K, Laks J, Rodrigues VM, Dourado MCN. Resilience in Carers of People With Young-Onset Alzheimer Disease. J Geriatr Psychiatry Neurol 2019; 32:59-67. [PMID: 30651027 DOI: 10.1177/0891988718824039] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Young-onset Alzheimer disease (YOAD) causes psychological and emotional difficulties for carers. However, even in the face of considerable caregiving demands and burden, some carers are resistant to stress, which may be a sign of resilience. This study investigated whether the clinical symptoms of the person with YOAD might be associated with resilience in their carers. A consecutive series of 43 persons with YOAD and their 43 family caregivers were assessed. The carers showed moderate to high level of resilience, low level of anxiety and depressive symptoms, and moderate level of burden. No relationship was found between resilience and sociodemographic characteristics of both carers and care recipient and with clinical characteristics of persons with YOAD. A linear regression analysis showed that resilience was inversely associated with carers' depressive symptoms. The findings suggest that resilience may mainly be related to carers' mental health.
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Affiliation(s)
- Nathália R S Kimura
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - José Pedro Simões Neto
- Department of Political Sociology, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Raquel Luiza Santos
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Alice Tourinho Baptista
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Glória Portugal
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aud Johannessen
- Norwegian Advisory Unit for Aging and Health Vestfold Health Trust, Tønsberg, Norway.,VID Specialized University College, Oslo, Norway
| | - Maria Lage Barca
- Norwegian Advisory Unit for Aging and Health Vestfold Health Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Knut Engedal
- Norwegian Advisory Unit for Aging and Health Vestfold Health Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Jerson Laks
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Post-graduation Program of Translational Biomedicine, Universidade do Grande Rio (Unigranrio), Duque de Caxias, Brazil
| | - Valeska Marinho Rodrigues
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia C N Dourado
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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23
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Kuring JK, Mathias JL, Ward L. Prevalence of Depression, Anxiety and PTSD in People with Dementia: a Systematic Review and Meta-Analysis. Neuropsychol Rev 2018; 28:393-416. [PMID: 30536144 DOI: 10.1007/s11065-018-9396-2] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 11/19/2018] [Indexed: 12/31/2022]
Abstract
There appears to be a link between depression/anxiety/PTSD and dementia, although the evidence is incomplete and the reason is unclear. Mental illness may cause dementia or may be prodromal or comorbid with dementia, or dementia may trigger a relapse of symptoms in individuals with a history of mental illness. This study examined the link between depression/anxiety/PTSD and dementia by evaluating the prevalence of these disorders in people with dementia, relative to their healthy peers. Existing meta-analyses have examined the prevalence of clinically-significant depression and anxiety in Alzheimer's disease (AD), and depression in frontotemporal dementia (FTD), but have not considered vascular dementia (VaD), dementia with Lewy bodies (DLB), PTSD, or anxiety in FTD. The current meta-analysis compared the prevalence of clinically-significant depression, anxiety and PTSD in the four most common types of dementia (AD, VaD, DLB, FTD) and in unspecified dementia to that of healthy controls (PROSPERO number: CRD42017082086). PubMed, EMBASE, PsycINFO and CINAHL database searches identified 120 eligible studies. Prevalence rates were calculated for depression and anxiety in AD, VaD, DLB, FTD, unspecified dementia, and controls. PTSD data were only available for unspecified dementia. Subgroup analyses indicated that depression, but not anxiety, was more prevalent in people with dementia compared to controls; however, the anxiety analyses were probably under-powered. The results support a link between depression and dementia; however, the link between anxiety or PTSD and dementia remains unclear due to insufficient data. Longitudinal data is now needed to clarify whether depression/anxiety/PTSD may be risk factors for dementia.
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Affiliation(s)
- J K Kuring
- School of Psychology, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - J L Mathias
- School of Psychology, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia.
| | - L Ward
- School of Psychology, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
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Dourado MCN, Laks J, Kimura NR, Baptista MAT, Barca ML, Engedal K, Tveit B, Johannessen A. Young-onset Alzheimer dementia: a comparison of Brazilian and Norwegian carers' experiences and needs for assistance. Int J Geriatr Psychiatry 2018; 33:824-831. [PMID: 28370411 DOI: 10.1002/gps.4717] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 03/09/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Although dementia typically occurs in older people, it can also emerge in people aged younger than 65 years in the form of young-onset dementia, the most common type of which is Alzheimer's disease (AD). However, few studies have examined the needs of persons with young-onset AD (YO-AD) and their families, and cross-cultural research on the topic is even scarcer. In response, we investigated the situations, experiences and needs for assistance of carers of persons with YO-AD in Brazil and Norway. METHODS As part of our qualitative study, we formed a convenience sample of Brazilian (n = 9; 7 women) and Norwegian carers (n = 11; 6 women) in 2014 and 2015, respectively, and analysed data in light of a modified version of grounded theory. RESULTS Carers' narratives from both countries revealed five common themes in terms of how YO-AD affected carers' psychological and emotional well-being, physical well-being, professional and financial well-being, social lives and need for support services. CONCLUSIONS The infrequent differences between carers of persons with YO-AD in Brazil and Norway indicate that carers' problems are highly similar regardless of cultural differences and public services provided. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- M C N Dourado
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - J Laks
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - N R Kimura
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - M A T Baptista
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - M L Barca
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - K Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - B Tveit
- VID Specialized University College, Oslo, Norway
| | - A Johannessen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,VID Specialized University College, Oslo, Norway
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25
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Kimura NRS, Baptista MAT, Santos RL, Portugal MDG, Johannenssen A, Barca ML, Engedal K, Laks J, Simões JP, Rodrigues VM, Dourado MCN. Caregivers' Perspectives of Quality of Life of People With Young- and Late-Onset Alzheimer Disease. J Geriatr Psychiatry Neurol 2018; 31:76-83. [PMID: 29658428 DOI: 10.1177/0891988718759601] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Quality of life (QoL) is a growing area of interest in dementia research. This study aims to investigate the caregivers' perspective about the QoL of people with young-onset Alzheimer disease (YOAD) and late-onset Alzheimer disease (LOAD). We also aim to investigate factors that might be associated to caregivers' perspective in YOAD and LOAD. METHODS We included 110 people with Alzheimer disease (PwAD; 53 YOAD) and their primary caregivers. The PwAD completed assessments about their QoL and cognition. The caregivers provided information about the PwAD (demographics, QoL, ability to perform activities of daily living, mood, and dementia severity) and had burden of care assessed. RESULTS We did not find a difference in caregivers' perspectives of PwAD QoL according to the age at onset. However, the linear regression analysis indicated that caregivers' burden ( P < .01) and PwAD depressive symptoms ( P < .05) were significantly related to the caregivers' perspective of YOAD QoL. Caregivers' burden ( P < .01), years of education ( P < .05), and self-reported QoL ( P < .01) were significantly related to the caregivers' perspective of LOAD QoL. CONCLUSIONS The factors that drive the perceptions of caregivers of PwAD QoL may vary according to the age at onset. The study provides basic information on caregivers' perspectives of PwAD QoL to create more effective interventions according to the age at onset.
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Affiliation(s)
- Nathália R S Kimura
- 1 Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Maria Alice T Baptista
- 1 Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Raquel L Santos
- 1 Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Maria da Gloria Portugal
- 1 Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Aud Johannenssen
- 2 Norwegian Advisory Unit for Aging and Health, Vestfold Health Trust, Tønsberg, Norway
| | - Maria L Barca
- 2 Norwegian Advisory Unit for Aging and Health, Vestfold Health Trust, Tønsberg, Norway.,3 Department of Geriatric Medicine, Ullevaal University Hospital, Oslo, Norway
| | - Knut Engedal
- 2 Norwegian Advisory Unit for Aging and Health, Vestfold Health Trust, Tønsberg, Norway.,3 Department of Geriatric Medicine, Ullevaal University Hospital, Oslo, Norway
| | - Jerson Laks
- 1 Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,4 Universidade do Grande Rio (Unigranrio), Postgraduation Program of Translational Biomedicine, Duque de Caxias, Brazil
| | - José Pedro Simões
- 5 Department of Political Sociology, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Valeska Marinho Rodrigues
- 1 Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Marcia C N Dourado
- 1 Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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26
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Rodgers C, Rogerson D, Stevenson J, Porock D. Physical activity for people with young-onset dementia and carers: protocol for a scoping review. Syst Rev 2018; 7:36. [PMID: 29482653 PMCID: PMC5827995 DOI: 10.1186/s13643-018-0698-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 02/14/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Physical activity has been cited as a potential symptomatic treatment option for people living with dementia. At present, much of the research concerning physical activity and dementia considers older adults, and there are several review articles summarising the evidence in this area. Less is known about physical activity for younger people with dementia, despite the marked differences in needs and preferences between the two groups. The aim of this scoping review is to systematically explore and critically appraise the current state of the evidence regarding physical activity for people with young-onset dementia and carers. METHODS Several electronic databases (i.e. MEDLINE, SPORTDiscus, CINAHL, Cochrane Library, PsycINFO, Applied Social Sciences Index & Abstracts (ASSIA) and Scopus), grey literature (i.e. NICE Evidence Search (UK) and targeted international organisations e.g. Alzheimer's Society (UK), Age UK, Young Dementia UK, Alzheimer's Association (USA), Dementia Australia) and trial registries (i.e. UK Clinical Trials Gateway, International Clinical Trials Registry Platform and EU Clinical Trials Register) will be searched for published and unpublished evidence regarding physical activity for people with young-onset dementia and carers. Studies included in the review will be subjected to a narrative synthesis to explore similarities and differences, both within and between studies, to identify patterns and themes and to postulate explanations for research findings (e.g. how and why certain interventions or programmes have worked (or not); factors that might have influenced the findings ). DISCUSSION This will be the first review to systematically explore and critically appraise the current state of the evidence regarding physical activity for people with young-onset dementia and carers. It is hoped that findings from this review will be used to inform the development of future physical activity interventions, to serve as a basis for consultation with key stakeholders and to identify appropriate outcome measures relevant to people with young-onset dementia and carers. SYSTEMATIC REVIEW REGISTRATION At present, scoping reviews are not eligible for registration on the international prospective register of systematic reviews (i.e. PROSPERO).
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Affiliation(s)
- Chloe Rodgers
- Academy of Sport and Physical activity, Sheffield Hallam University, Sheffield, UK. .,A214 Collegiate Hall, Collegiate Crescent, Sheffield Hallam University, Sheffield, S10 2BP, UK.
| | - David Rogerson
- Academy of Sport and Physical activity, Sheffield Hallam University, Sheffield, UK
| | - Judy Stevenson
- Academy of Sport and Physical activity, Sheffield Hallam University, Sheffield, UK
| | - Davina Porock
- Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
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Baptista MAT, Santos RL, Kimura N, Lacerda IB, Dourado MCN. Disease awareness may increase risk of suicide in young onset dementia: A case report. Dement Neuropsychol 2017; 11:308-311. [PMID: 29213530 PMCID: PMC5674677 DOI: 10.1590/1980-57642016dn11-030015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Studies report that people with young onset Alzheimer's disease (YOAD) have higher levels of disease awareness compared to those with late onset AD. We report a case of a man with YOAD who had preserved awareness of disease, depression and risk of suicide associated with the development of the dementia. Cognitive functioning, disease severity, depressive symptoms and awareness of disease were assessed using validated measures. The person with YOAD showed a moderate level of disease severity and high degree of dependence for activities of daily living. There was recognition of memory problems and routine changes with presence of intense pessimism, low self-esteem and suicidal ideation. This case points to the existence of specific issues related to young onset dementia and the clinical importance of identifying and treating patients who might be aware of their condition.
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Affiliation(s)
- Maria Alice Tourinho Baptista
- MSc, Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Raquel Luiza Santos
- PhD, Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Nathália Kimura
- MSc, Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Isabel Barbeito Lacerda
- MSc, Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
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Abstract
Early-onset Alzheimer disease (EOAD), with onset in individuals younger than 65 years, although overshadowed by the more common late-onset AD (LOAD), differs significantly from LOAD. EOAD comprises approximately 5% of AD and is associated with delays in diagnosis, aggressive course, and age-related psychosocial needs. One source of confusion is that a substantial percentage of EOAD are phenotypic variants that differ from the usual memory-disordered presentation of typical AD. The management of EOAD is similar to that for LOAD, but special emphasis should be placed on targeting the specific cognitive areas involved and more age-appropriate psychosocial support and education.
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Affiliation(s)
- Mario F Mendez
- Behavioral Neurology Program, David Geffen School of Medicine at UCLA, 300 Westwood Plaza, Suite B-200, Box 956975, Los Angeles, CA 90095, USA; Neurobehavior Unit, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Building 206, Los Angeles, CA 90073, USA.
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29
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Johannessen A, Helvik AS, Engedal K, Thorsen K. Experiences and needs of spouses of persons with young-onset frontotemporal lobe dementia during the progression of the disease. Scand J Caring Sci 2017; 31:779-788. [PMID: 28276143 DOI: 10.1111/scs.12397] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 09/11/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND Two of the most common types of young-onset dementia (<65 years old) are Alzheimer's disease and frontotemporal lobe dementia (FTLD). A limited amount of research that focuses on the needs of spouses of persons with young-onset FTLD (yo-FTLD) has been published. Thus, we have carried out a study aiming to examine the spouses of yo-FTLD experiences and needs for assistance in daily life. METHOD Qualitative interviews with 16 informants (aged 51-69 years; nine wives, six husbands and one male cohabitant) were conducted in 2014 and 2015. The data were analysed by reformulated and modified method of Grounded Theory. FINDINGS From the interviews, three main themes with subthemes emerged: The first main theme that appeared is sneaking signs at the early stage of dementia. It covers two subthemes: incomprehensible early signs and lack of self-insight. The second main theme that appeared is other relations, and it covers three subthemes: the torment, interference with work and vanishing social relations. The third main theme: needs for assistance through all stages of dementia, are described under three subthemes: Relief of the diagnosis, support at home and the path to the nursing home. CONCLUSION The interviews showed that spouses and the whole family of yo-FTLD need interdisciplinary, individualised and specialised support throughout the progression of the disorder. Furthermore, there is a need for more knowledge about yo-FTLD among health personnel, including general practitioners. IT-solutions can contribute to developing such services and support to the entire family.
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Affiliation(s)
- Aud Johannessen
- Vestfold Hospital Trust, Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
| | - Anne-Sofie Helvik
- Vestfold Hospital Trust, Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway.,Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,St. Olav's University Hospital, Trondheim, Norway
| | - Knut Engedal
- Vestfold Hospital Trust, Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
| | - Kirsten Thorsen
- Vestfold Hospital Trust, Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway.,Norwegian Social Research (NOVA), University College of Oslo and Akershus, Oslo, Norway
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Draper B, Cations M, White F, Trollor J, Loy C, Brodaty H, Sachdev P, Gonski P, Demirkol A, Cumming RG, Withall A. Time to diagnosis in young-onset dementia and its determinants: the INSPIRED study. Int J Geriatr Psychiatry 2016; 31:1217-1224. [PMID: 26807846 DOI: 10.1002/gps.4430] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 12/07/2015] [Accepted: 12/10/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The objective of this study is to identify factors determining the time to diagnosis for young-onset dementia (YOD), defined as dementia with symptom onset before age 65 years, by mapping the diagnostic pathways. METHODS Participants were recruited via healthcare professionals, community support organisations or were self-referred. Information was obtained by interviews with the person with YOD and their carer, and medical record reviews. Clinical dementia diagnoses were independently ratified by consensus review. RESULTS Participants included 88 people with YOD (mean age of onset = 55.4 years), due to Alzheimer's disease (AD) (53.4%, n = 47), frontotemporal dementia (FTD) (15.9%, n = 14) and other causes (30.7%, n = 27). Median time from symptom onset to first consultation was 2.3 years, to dementia diagnosis 3.2 years, to family awareness of dementia diagnosis 3.5 years and to final diagnosis of the type of dementia 4.7 years. Non-dementia diagnoses occurred in 48.9%, including depression (30.7%) and mild cognitive impairment (MCI) (17.0%). Participants with younger age of onset had significantly longer time to first consultation and family awareness of the dementia diagnosis. The time to dementia diagnosis was significantly longer when the participant presented with MCI or depression and when the dementia was other than AD or FTD. MCI was associated with significantly longer time to family awareness of dementia diagnosis. CONCLUSIONS Factors impacting on time to diagnosis vary with the stage of diagnosis in YOD. Longer time to dementia diagnosis occurred in people who were younger at symptom onset, when MCI or depression was present, and in dementias other than AD and FTD. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Brian Draper
- Dementia Collaborative Research Centre - ABC, School of Psychiatry, University of NSW, Sydney, NSW, Australia. .,Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia.
| | - Monica Cations
- Dementia Collaborative Research Centre - ABC, School of Psychiatry, University of NSW, Sydney, NSW, Australia.,School of Public Health and Community Medicine, UNSW, Sydney, NSW, Australia
| | - Fiona White
- Dementia Collaborative Research Centre - ABC, School of Psychiatry, University of NSW, Sydney, NSW, Australia
| | - Julian Trollor
- Centre for Healthy Brain Ageing, UNSW Australia, Sydney, NSW, Australia.,Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Australia, Sydney, NSW, Australia
| | - Clement Loy
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Henry Brodaty
- Dementia Collaborative Research Centre - ABC, School of Psychiatry, University of NSW, Sydney, NSW, Australia.,Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia.,Centre for Healthy Brain Ageing, UNSW Australia, Sydney, NSW, Australia
| | - Perminder Sachdev
- Dementia Collaborative Research Centre - ABC, School of Psychiatry, University of NSW, Sydney, NSW, Australia.,Centre for Healthy Brain Ageing, UNSW Australia, Sydney, NSW, Australia.,Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Peter Gonski
- Division of Aged and Extended Care (Southcare), Sutherland Hospital, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Apo Demirkol
- The Langton Centre, South Eastern Sydney Local Health District, Drug and Alcohol Services, Surry Hills, NSW, Australia
| | - Robert G Cumming
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Adrienne Withall
- School of Public Health and Community Medicine, UNSW, Sydney, NSW, Australia
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Spreadbury JH, Kipps CM. Measuring younger onset dementia: A comprehensive literature search of the quantitative psychosocial research. DEMENTIA 2016; 18:135-156. [PMID: 27509918 DOI: 10.1177/1471301216661427] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Research is beginning to demonstrate the unique psychosocial effects of young onset dementia. Theorising remains at an early stage and there has been little discussion about measurement and methodological issues. Our aim was to conduct a comprehensive literature search of the young onset dementia psychosocial research, and to identify the domains of experience measured with patients and caregivers. METHOD We conducted a search of five electronic databases (Medline, CINAHL, PsycINFO, Embase, the Cochrane Library) using equivalent database controlled vocabulary terms. We supplemented this search by using free text searches within electronic databases, searching reference sections of salient papers, and using online search engines. We defined psychosocial as referring to patient and caregiver psychological, behavioural, and social functioning in the context of living with young onset dementia. RESULTS We identified 72 published articles, 49 quantitative and 23 qualitative. The quantitative articles form the focus of the present review. We identified 10 domains of patient experience measured and 14 domains of caregiver experience. The patient domains measured most often were behaviour, cognition, functioning, and severity, and reflected a focus on symptoms and clinical features. Quality of Life (QoL) was the patient domain measured least often. The caregiver domains measured most often were mental health and burden, and reflected a focus on psychological well-being and coping. CONCLUSION The scope of measurement is broader in caregivers than patients. QoL although under-researched may be a useful domain to measure in future research. Risk factors, measurement and methodological issues are discussed.
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Affiliation(s)
- J H Spreadbury
- Faculty of Medicine, University of Southampton, Southampton, UK; Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC), Wessex, UK
| | - C M Kipps
- Faculty of Medicine, University of Southampton, Southampton, UK; Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC), Wessex, UK; Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Draper B, Withall A. Young onset dementia. Intern Med J 2016; 46:779-86. [DOI: 10.1111/imj.13099] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 10/18/2015] [Accepted: 10/19/2015] [Indexed: 11/27/2022]
Affiliation(s)
- B. Draper
- Schools of Psychiatry; University of NSW; Sydney New South Wales Australia
| | - A. Withall
- Schools of Public Health and Community Medicine; University of NSW; Sydney New South Wales Australia
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Novek S, Shooshtari S, Menec VH. Comparing the Overall Health, Stress, and Characteristics of Canadians with Early-Onset and Late-Onset Dementia. J Aging Health 2016; 28:1016-37. [DOI: 10.1177/0898264315615575] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective: Dementia is increasingly recognized as a public health priority, but little is known about persons with early-onset dementia (EOD). The objectives of this article are (a) to compare the socio-demographic and health characteristics of people with EOD and late-onset dementia (LOD) and (b) to examine the relationships between EOD and overall health and life stress. Method: Data were from the Survey on Living With Neurological Conditions in Canada (SLNCC). Logistic regression models were used to identify the characteristics associated with EOD and LOD, and to assess the impact of EOD on overall health and life stress. Results: Compared with LOD, individuals with EOD were more likely to be male, to have a mood disorder, and to have a longer illness duration. EOD was associated with high life stress, but not with negative overall health. Discussion: This study identified attributes associated with EOD that have important implications for service planning.
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Kosteniuk JG, Morgan DG, O'Connell ME, Kirk A, Crossley M, Stewart NJ, Karunanayake CP. Trajectories of Depressive Symptomatology in Rural Memory Clinic Patients between Baseline Diagnosis and 1-Year Follow-Up. Dement Geriatr Cogn Dis Extra 2016; 6:161-75. [PMID: 27350776 PMCID: PMC4913763 DOI: 10.1159/000444790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS To investigate the prevalence and trajectories of depressive symptomatology at 1-year follow-up, and the severity of depressive symptoms, by dementia diagnostic group, as well as to determine the predictors of depressive symptomatology at 1-year follow-up. METHODS In rural and remote patients of an interdisciplinary memory clinic between 2004 and 2014, 144 patients diagnosed with no cognitive impairment (NCI), mild cognitive impairment, dementia due to Alzheimer's disease (AD), or non-AD dementia completed the Center for Epidemiologic Studies of Depression Scale to assess depressive symptomatology at both time points. RESULTS Among patients with data at both time points, persistence of depressive symptomatology at follow-up occurred in 22.2%, remission in 17.4%, incidence in 13.2%, and absence in 47.2%. The prevalence of depressive symptomatology at baseline and persistence at follow-up were significantly greater in the NCI group than in the other diagnostic groups, but there were no differences in severity. Depressive symptomatology at follow-up was independently associated with depressive symptomatology, lower independence in activities of daily living, and lower self-rating of memory at baseline, as well as with decreased independence in activities of daily living between time points. CONCLUSION Future studies should further examine short-term postdiagnostic trajectories in depressive symptomatology in multiple dementia diagnostic groups to inform prognoses and treatment decisions.
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Affiliation(s)
- Julie G Kosteniuk
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Sask., Canada
| | - Debra G Morgan
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Sask., Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Sask., Canada
| | - Andrew Kirk
- Division of Neurology, University of Saskatchewan, Saskatoon, Sask., Canada
| | - Margaret Crossley
- Department of Psychology, University of Saskatchewan, Saskatoon, Sask., Canada
| | - Norma J Stewart
- College of Nursing, University of Saskatchewan, Saskatoon, Sask., Canada
| | - Chandima P Karunanayake
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Sask., Canada
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Mulders AJ, Fick IW, Bor H, Verhey FR, Zuidema SU, Koopmans RT. Prevalence and Correlates of Neuropsychiatric Symptoms in Nursing Home Patients With Young-Onset Dementia: The BEYOnD Study. J Am Med Dir Assoc 2016; 17:495-500. [DOI: 10.1016/j.jamda.2016.01.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 01/04/2016] [Accepted: 01/05/2016] [Indexed: 11/26/2022]
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Ketharanathan T, Hanwella R, Weerasundera R, de Silva VA. Diagnostic Validity and Factor Analysis of Montgomery-Asberg Depression Rating Scale in Parkinson Disease Population. J Geriatr Psychiatry Neurol 2016; 29:115-9. [PMID: 26392481 DOI: 10.1177/0891988715606232] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 07/29/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Montgomery-Asberg Depression Rating Scale (MADRS) is commonly used to assess major depression in Parkinson disease (PD), but studies on its utility are few. This study examines the validity and factor structure of MADRS in population with PD. METHODS In 104 patients with idiopathic PD, major depression was diagnosed by Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision; DSM-IV-TR) criteria, and all patients were rated by MADRS. RESULTS The MADRS showed good concurrent validity with DSM-IV-TR criteria. The diagnostic cutoff was established as 16/17 (sensitivity 97.43, specificity 100%, positive predictive value 100%, and negative predictive value 98.48%). Factor analysis identified 3 factors, accounting for 76% of total variance: "sadness-anhedonia" comprising apparent sadness, reported sadness, concentration difficulties, lassitude, inability to feel, pessimistic thoughts, and suicidal ideas; "anxiety" with reduced sleep and inner tension; and "vegetative symptoms" with reduced appetite. CONCLUSION The MADRS has diagnostic utility in major depression in PD. The 3-factor structure of MADRS may help to understand the different dimensions of major depression and identify distinct symptom subgroups in this population.
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Affiliation(s)
| | - Raveen Hanwella
- Department of Psychological Medicine, University of Colombo, Colombo, Sri Lanka
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Lagogianni C, Thomas S, Lincoln N. Examining the relationship between fatigue and cognition after stroke: A systematic review. Neuropsychol Rehabil 2016; 28:57-116. [PMID: 26787096 DOI: 10.1080/09602011.2015.1127820] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Many stroke survivors experience fatigue, which is associated with a variety of factors including cognitive impairment. A few studies have examined the relationship between fatigue and cognition and have obtained conflicting results. The aim of the current study was to review the literature on the relationship between fatigue and cognition post-stroke. The following databases were searched: EMBASE (1980-February, 2014), PsycInfo (1806-February, 2014), CINAHL (1937-February, 2014), MEDLINE (1946-February, 2014), Ethos (1600-February, 2014) and DART (1999-February, 2014). Reference lists of relevant papers were screened and the citation indices of the included papers were searched using Web of Science. Studies were considered if they were on adult stroke patients and assessed the following: fatigue with quantitative measurements (≥ 3 response categories), cognition using objective measurements, and the relationship between fatigue and cognition. Overall, 413 papers were identified, of which 11 were included. Four studies found significant correlations between fatigue and memory, attention, speed of information processing and reading speed (r = -.36 to .46) whereas seven studies did not. Most studies had limitations; quality scores ranged from 9 to 14 on the Critical Appraisal Skills Programme Checklists. There was insufficient evidence to support or refute a relationship between fatigue and cognition post-stroke. More robust studies are needed.
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Affiliation(s)
- Christodouli Lagogianni
- a Division of Rehabilitation & Ageing, Medical School , University of Nottingham , Nottingham , UK.,b Queens Medical Centre , Nottingham , UK
| | - Shirley Thomas
- a Division of Rehabilitation & Ageing, Medical School , University of Nottingham , Nottingham , UK.,b Queens Medical Centre , Nottingham , UK
| | - Nadina Lincoln
- a Division of Rehabilitation & Ageing, Medical School , University of Nottingham , Nottingham , UK.,b Queens Medical Centre , Nottingham , UK
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Cations M, Withall A, Low LF, Draper B. What is the role of modifiable environmental and lifestyle risk factors in young onset dementia? Eur J Epidemiol 2015; 31:107-24. [DOI: 10.1007/s10654-015-0103-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 11/24/2015] [Indexed: 11/28/2022]
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Depressive symptomatology in severe dementia in a European sample: prevalence, associated factors and prescription rate of antidepressants. Int Psychogeriatr 2015; 27:657-67. [PMID: 25497829 DOI: 10.1017/s1041610214002610] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Depression is a common comorbid disorder of dementia. This study explores the prevalence of and factors associated with depressive symptomatology, and antidepressant prescription rates in severe dementia across eight European countries. METHODS In total, 414 people with severe dementia completed measures of cognition and quality of life (QoL), whilst carers completed proxy measures of activities of daily living (ADLs), depression, neuropsychiatric symptoms, QoL and comorbidity. RESULTS Findings indicated that 30% of the sample had depression, whilst the highest and lowest prevalence of depression was reported in Germany and Finland, respectively. Lower QoL, the presence of pain and more frequent neuropsychiatric symptoms were associated with depressive symptomatology, whilst no significant relationship between impairment of ADLs, comorbidity, and depression emerged. Spain and Estonia had the highest and lowest rates of antidepressant prescribing, respectively, whilst Germany had the highest discrepancy between depressive symptomatology and prescription. CONCLUSIONS The study highlights variations across countries in the prevalence of depressive symptomatology in severe dementia and prescription of antidepressants. Information about factors associated with depressive symptomatology may help to better identify and manage depression.
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Young DKW, Kwok TCY, Ng PYN. A single blind randomized control trial on support groups for Chinese persons with mild dementia. Clin Interv Aging 2014; 9:2105-12. [PMID: 25587218 PMCID: PMC4262377 DOI: 10.2147/cia.s68687] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Persons with mild dementia experience multiple losses and manifest depressive symptoms. This research study aimed to evaluate the effectiveness of a support group led by a social worker for Chinese persons with mild dementia. Research methods Participants were randomly assigned to either a ten-session support group or a control group. Standardized assessment tools were used for data collection at pretreatment and post-treatment periods by a research assistant who was kept blind to the group assignment of the participants. Upon completion of the study, 20 treatment group participants and 16 control group participants completed all assessments. Results At baseline, the treatment and control groups did not show any significant difference on all demographic variables, as well as on all baseline measures; over one-half (59%) of all the participants reported having depression, as assessed by a Chinese Geriatric Depression Scale score ≥8. After completing the support group, the depressive mood of the treatment group participants reduced from 8.83 (standard deviation =2.48) to 7.35 (standard deviation =2.18), which was significant (Wilcoxon signed-rank test; P=0.017, P<0.05), while the control group’s participants did not show any significant change. Conclusion This present study supports the efficacy and effectiveness of the support group for persons with mild dementia in Chinese society. In particular, this present study shows that a support group can reduce depressive symptoms for participants.
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Affiliation(s)
- Daniel K W Young
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Timothy C Y Kwok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Petrus Y N Ng
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
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Abstract
Early onset Alzheimer's disease (EOAD) poses considerable challenges to physicians both in diagnostics and treatment, to patients and caregivers trying to cope with a debilitating illness at a young age and a healthcare system that is not geared to cater to degenerating illnesses striking young persons (Van Vliet et al., 2012). Routine procedures and screening measures for elderly people possibly stricken by dementia do not assess younger dementia patients in a favourable fashion. Physicians at an outpatient clinic diagnosing elderly patients, with well established standardized cognitive batteries for an older age norm, i.e. above 65 years may have unadjusted assumptions to account for in younger patients with symptoms of EOAD (Smits et al., 2012). Although a common battery of tests is internationally widely applied in the evaluation of cognitive impairment, these tests have not been validated extensively in a sample population of AD under the age of 65.
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Prevalence and correlates of psychotropic drug use in community-dwelling people with young-onset dementia: the NeedYD-study. Int Psychogeriatr 2014; 26:1983-9. [PMID: 24411220 DOI: 10.1017/s1041610213002330] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Young-onset dementia (YOD) is defined as dementia that develops before the age of 65 years. The prevalence and type of neuropsychiatric symptoms (NPS) in YOD differ from patients with late onset dementia. NPS in dementia patients are often treated with psychotropic drugs. The aim of this study was to investigate psychotropic drug use (PDU) in Dutch community-dwelling YOD patients and the association between age, gender, dementia etiology and severity, symptoms of depression, disease awareness, unmet needs, and type of NPS. METHODS Psychotropic drug use in 196 YOD patients was registered. Drugs were categorized according to the Anatomical Therapeutical Chemical classification. The association between age, gender, dementia type, dementia stage, type of NPS, depressive symptoms, disease awareness, and amount of unmet needs on total PDU was analyzed using binomial logistic regression analysis. RESULTS Fifty-two percent of the patients were prescribed at least one psychotropic drug; 36.2% of patients used one drug, and 12.2% used two different drugs. Antidepressants (36.2%) and antipsychotic drugs (17.3%) were the most frequently prescribed psychotropic drugs. Anti-dementia drugs were prescribed in 51.5% of the patients. Increasing age and moderate to severe depressive symptoms were positively associated with the total use of psychotropic drugs. CONCLUSIONS Community-dwelling YOD patients have a high prevalence of PDU. More research is needed to study the association between unmet needs, NPS, and PDU, and psychosocial interventions have to be developed to limit the use of psychotropic drugs in YOD.
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Kosteniuk JG, Morgan DG, O'Connell ME, Crossley M, Kirk A, Stewart NJ, Karunanayake CP. Prevalence and covariates of elevated depressive symptoms in rural memory clinic patients with mild cognitive impairment or dementia. Dement Geriatr Cogn Dis Extra 2014; 4:209-20. [PMID: 25177329 PMCID: PMC4132249 DOI: 10.1159/000363226] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background/Aims To estimate the prevalence, severity, and covariates of depressive symptoms in rural memory clinic patients diagnosed with either mild cognitive impairment (MCI) or dementia. Methods In a cross-sectional study of 216 rural individuals who attended an interdisciplinary memory clinic between March 2004 and July 2012, 51 patients were diagnosed with MCI and 165 with either dementia due to Alzheimer's disease (AD) or non-AD dementia. The Center for Epidemiologic Studies of Depression Scale (CES-D) was used to estimate the severity and prevalence of clinically elevated depressive symptomatology. Results The prevalence of elevated depressive symptoms was 51.0% in the MCI patients and 30.9% in the dementia patients. Depressive symptoms were more severe in the MCI patients than in the dementia patients. Elevated depressive symptoms were statistically associated with younger age for the MCI group, with lower self-rated memory for the dementia group, and with increased alcohol use and lower quality of life ratings for all patients. In the logistic regression models, elevated depressive symptoms remained negatively associated with self-rated memory and quality of life for the patients with dementia, but significant bivariate associations did not persist in the MCI group. Conclusions The high prevalence and severity of depressive symptoms among rural memory clinic patients diagnosed with either MCI or dementia warrant continued investigation.
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Affiliation(s)
- Julie G Kosteniuk
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, Saskatoon, Sask., Canada
| | - Debra G Morgan
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, Saskatoon, Sask., Canada
| | - Megan E O'Connell
- Department of Psychology, College of Medicine, Saskatoon, Sask., Canada
| | - Margaret Crossley
- Department of Psychology, College of Medicine, Saskatoon, Sask., Canada
| | - Andrew Kirk
- Division of Neurology, College of Medicine, Saskatoon, Sask., Canada
| | - Norma J Stewart
- College of Nursing, University of Saskatchewan, Saskatoon, Sask., Canada
| | - Chandima P Karunanayake
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, Saskatoon, Sask., Canada
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Knapskog AB, Barca ML, Engedal K. Prevalence of depression among memory clinic patients as measured by the Cornell Scale of Depression in Dementia. Aging Ment Health 2014; 18:579-87. [PMID: 23998196 DOI: 10.1080/13607863.2013.827630] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Depression in dementia is common, but the prevalence rates differ according to the populations studied and which diagnostic tools are being used. The aim of this study is to explore the prevalence of depression among patients referred to a memory clinic or an outpatient clinic as measured by the Cornell Scale of Depression in dementia (CSDD) and to investigate which factors are associated with depression. METHOD The CSDD was completed for 1470 patients on their first visit to a memory clinic or an outpatient clinic. The prevalence of depression using three different cut-off points was calculated. Logistic regression and correlation analyses were performed. RESULTS Half of the patients had dementia. The mean CSDD was 6.7 (SD: 5.3) for the whole group, and 50.2% had a score above 5, whereas 37.5% had depression defined as a CSDD score above 7, and 14.1% had a score above 12. The mean scores were higher among those with dementia other than Alzheimer's disease, those with previous depression, and those with greater impairment in the activities of daily living (ADL). In the logistic regression analyses, younger age, ADL dysfunction, and previous depression were significantly associated with higher CSDD scores. CONCLUSION We found that depressive symptoms are common among patients referred for a dementia assessment in specialist health care. The strongest factors associated with depressive symptoms were younger age, ADL impairment, and previous depression.
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Affiliation(s)
- Anne-Brita Knapskog
- a Department of Geriatric Medicine, Institute of Clinical Medicine , Oslo University Hospital , Oslo , Norway
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Curran EM, Loi S. Depression and dementia. Med J Aust 2013; 199:S40-4. [DOI: 10.5694/mja12.10567] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Accepted: 08/29/2012] [Indexed: 11/17/2022]
Affiliation(s)
| | - Samantha Loi
- St Vincent's Hospital, Melbourne, VIC
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, University of Melbourne, Melbourne, VIC
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Uemura Y, Wada-Isoe K, Nakashita S, Nakashima K. Depression and cognitive impairment in patients with mild parkinsonian signs. Acta Neurol Scand 2013; 128:153-9. [PMID: 23397887 DOI: 10.1111/ane.12089] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Mild parkinsonian signs (MPS) are reported to be associated with increased risk of dementia, Parkinson's disease, parkinsonism, and vascular lesions of white matter and are also a significant predictor of mortality. Although more than 20% of subjects aged 60 years and older suffer from MPS in Japan, it is often unrecognized and underestimated by patients and medical physicians. We used neuropsychological methods to examine cognitive function and depressive symptoms in subjects with MPS. METHODS We performed a population-based study in Ama-cho, a rural island town in western Japan. Participants included 951 subjects aged 65 years and older, 613 of whom completed all questionnaires, neurological examinations, and neuropsychological assessments and were included in the data analysis. Subjects were assessed for depression and subjective cognitive impairment using the Geriatric Depression Scale (GDS-15), Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), and modified Unified Parkinson's Disease Rating Scale (mUPDRS). RESULTS Of the 613 participants, 143 were diagnosed with MPS. GDS scores were significantly higher in the MPS group compared with the motor control group, while MMSE scores were significantly lower. CONCLUSIONS We demonstrated that MPS correlate with both depressive symptoms and cognitive impairment.
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Affiliation(s)
- Y. Uemura
- Department of Neurology; Matsue Seikyo General Hospital; Matsue; Japan
| | - K. Wada-Isoe
- Division of Neurology; Department of Brain and Neurosciences; Faculty of Medicine; Tottori University; Yonago; Japan
| | - S. Nakashita
- Division of Neurology; Department of Brain and Neurosciences; Faculty of Medicine; Tottori University; Yonago; Japan
| | - K. Nakashima
- Division of Neurology; Department of Brain and Neurosciences; Faculty of Medicine; Tottori University; Yonago; Japan
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Engedal K, Gausdal M, Gjøra L, Haugen PK. Assessment of dementia by a primary health care dementia team cooperating with the family doctor - the Norwegian model. Dement Geriatr Cogn Disord 2013. [PMID: 23183640 DOI: 10.1159/000345435] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To describe how dementia assessment could be organized in primary health care and how it works. METHODS The project had two phases. In phase one 104 elderly patients were assessed by a local authority dementia team that used a standardized examination protocol, which enabled the family doctors to establish a dementia diagnosis. After evaluation and adjustments the model was extended to 31 local authorities and 474 patients were assessed. RESULTS The mean age of the patients was 84.4 (SD 5.6) and 81.8 (SD 7.8) years, respectively; 81 and 67% were women, respectively. The mean Mini Mental State Examination scores were 21.1 (SD 5.0) and 19.2 (SD 5.1), respectively. All patients in phase one and 70% in phase two were diagnosed with dementia. In 15 local authorities a specially assigned family doctor assisted in establishing diagnoses. In these local authorities 80% of the patients were diagnosed. CONCLUSION A local authority dementia team can collect the information required to enable a family doctor to establish a dementia diagnosis. Ideally, such teams should be assisted by a family doctor interested in dementia diagnostics.
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Affiliation(s)
- Knut Engedal
- Norwegian Centre for Ageing and Health, Oslo University Hospital, Ullevaal and Vestfold Mental Health Trust, Tønsberg, Norway.
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van Vliet D, de Vugt ME, Aalten P, Bakker C, Pijnenburg YAL, Vernooij-Dassen MJFJ, Koopmans RTCM, Verhey FRJ. Prevalence of neuropsychiatric symptoms in young-onset compared to late-onset Alzheimer's disease - part 1: findings of the two-year longitudinal NeedYD-study. Dement Geriatr Cogn Disord 2013. [PMID: 23208452 DOI: 10.1159/000342824] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND/AIMS Knowledge about neuropsychiatric symptoms in young-onset Alzheimer's disease (YO-AD) is scarce, but essential to establish a prognosis and plan care for YO-AD patients. The aim of this study is to assess frequency parameters of neuropsychiatric symptoms in YO-AD over 2 years and investigate whether there are differences compared with late-onset Alzheimer's disease (LO-AD). METHODS 98 YO-AD and 123 LO-AD patients and caregivers from two prospective cohort studies were included and assessed every 6 months for 2 years, using the Neuropsychiatric Inventory to evaluate neuropsychiatric symptoms. RESULTS Over the course of 2 years, the incidence, prevalence and persistence of neuropsychiatric symptoms were in general lower in YO-AD than in LO-AD, specifically for delusions, agitation, depression, anxiety, apathy, irritability and aberrant motor behavior. Frequency of individual symptoms showed large variability in both groups. Within the group of YO-AD patients, apathy was the most prevalent symptom. CONCLUSION Neuropsychiatric symptoms, notably apathy, should be paid appropriate attention to in the diagnosis and treatment of YO-AD patients. Further research is needed to gain insight into the mechanisms underlying the differences in neuropsychiatric symptoms between YO-AD and LO-AD.
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Affiliation(s)
- Deliane van Vliet
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
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Abstract
BACKGROUND The purpose of this study was to investigate the relationship between dementia severity, age, gender, and prescription of psychotropics, and syndromes of agitation and depression in a sample of nursing home residents with dementia. METHODS The Cohen-Mansfield Agitation Inventory (CMAI) was administered to residents with dementia (N = 304) of 18 nursing homes. Agitation symptoms were clustered using factorial analysis. Depression was estimated using the Dementia Mood Assessment Scale (DMAS). Dementia severity was assessed categorically using predefined cut-off scores derived from the Mini-Mental State Examination (MMSE). The relationship between agitation and its sub-syndromes, depression, and dementia severity was calculated using χ 2-statistics. Linear regression analyses were used to calculate the effect of dementia severity and psychotropic prescriptions on agitation and depression, controlling for age and gender. RESULTS Increasing stages of dementia severity were associated with higher risk for physically aggressive (p < 0.001) and non-aggressive (p < 0.01) behaviors, verbally agitated behavior (p < 0.05), and depression (p < 0.001). Depressive symptoms were associated with physically aggressive (p < 0.001) and verbally agitated (p < 0.05) behaviors, beyond the effects of dementia severity. Prescription of antipsychotics was correlated with depression and all agitation sub-syndromes except hiding and hoarding. CONCLUSIONS Dementia severity is a predictor for agitation and depression. Beyond that, depression increased with dementia severity, and the severity of depression was associated with both physically and verbally aggressive behaviors, indicating that, in advanced stages of dementia, depression in some patients might underlie aggressive behavior.
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Barca ML, Engedal K, Laks J, Selbaek G. Factors associated with a depressive disorder in Alzheimer's disease are different from those found for other dementia disorders. Dement Geriatr Cogn Dis Extra 2012; 2:19-28. [PMID: 22479262 PMCID: PMC3318937 DOI: 10.1159/000335775] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background This study explores factors associated with depression in Alzheimer's disease (AD) compared with mild cognitive impairment (MCI) and other dementia disorders. Method In a prospective study we included 195 patients: 31 with MCI, 112 with AD and 52 with other dementias. Results According to the ICD-10 and the DSM-IV criteria, 88 (44.1%) and 59 (30.3%), respectively, had a depressive disorder. An adjusted multiple regression analysis showed that previous depression (p < 0.05) was significantly associated with depression in AD patients. Severity of dementia (p < 0.05) was significantly associated with a depressive disorder in a group of patients with frontotemporal dementia, vascular dementia, or dementia due to Lewy Body disease or Parkinson's disease. Conclusion We found different factors associated with a depressive disorder in AD compared to those found for other dementia disorders.
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Affiliation(s)
- Maria Lage Barca
- Norwegian Centre for Dementia Research, Centre for Ageing and Health, Department of Geriatric Medicine, Oslo University Hospital, Ullevål, Norway
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