Multivariate neuroanatomical correlates of behavioral and psychological symptoms in dementia and the moderating role of education

Kwak, Seyul; Park, Soowon; Kim, Jeongsim; Park, Seho; Lee, Jun-Young

doi:10.1016/j.nicl.2020.102452

Cited by 12 publications

(6 citation statements)

References 57 publications

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“…As for the NPI, apart from confirming the efficacy of CST-IT in counteracting the severity and frequency of behavioral and neuropsychiatric symptoms (see Carbone et al, 2021 ), after accounting for the influence of the individual characteristics considered, we found that NPI scores differed as a function of education in younger individuals with more severe baseline depressive symptoms. As well as confirming that education (as a proxy for CR) can mitigate the severity of behavioral and affective symptoms of dementia ( Kwak et al, 2020 ), this pattern of results further corroborates the complex relationships between cognitive, depressive, behavioral and neuropsychiatric symptoms in people with mild-to-moderate dementia ( Dillon et al, 2013 ), and the neurobiological link between mood disturbances, neural degeneration and cognitive impairment (e.g., Köhler et al, 2015 ; Andrews et al, 2018 ).…”

Section: Discussionsupporting

confidence: 71%

The Role of Individual Characteristics in Predicting Short- and Long-Term Cognitive and Psychological Benefits of Cognitive Stimulation Therapy for Mild-to-Moderate Dementia

Carbone

Piras

Pastore

et al. 2022

Front. Aging Neurosci.

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Introduction: This study examined the role of individual characteristics in predicting short- and long-term benefits of the Italian version of Cognitive Stimulation Therapy (CST-IT), an evidence-based intervention for people with mild-to-moderate dementia.Materials and Methods: Data were drawn from a sample (N = 123) of people with dementia (PwD) who took part in a multicenter controlled clinical trial of CST-IT. Assessments at pre-test, immediately after completing the treatment, and 3 months later investigated the following outcomes: general cognitive functioning and language, mood and behavior, everyday functioning, and quality of life. Age, education and baseline (pre-test) cognitive functioning, mood (depression) and behavioral and neuropsychiatric symptoms were considered as predictors of any short- and long-term benefits.Results: Linear mixed-effects models showed that different individual characteristics -particularly education and age- influenced the benefits of CST-IT, depending on the outcome measures considered. Higher education predicted larger gains in general cognitive functioning and, along with less severe depressive symptoms, in language (magnification effects). Older age was associated with positive changes in mood (compensation effects). Albeit very modestly, older age was also associated with larger gains in everyday functioning (compensation effects). Gains in quality of life were predicted by older age and lower education (compensation effects). Baseline cognitive functioning, mood and/or behavioral symptoms broadly influenced performance too, but their role again depended on the outcomes considered.Discussion: These findings underscore the importance of considering and further exploring how psychosocial interventions like CST are affected by individual characteristics in order to maximize their efficacy for PwD.

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Section: Discussionsupporting

confidence: 71%

The Role of Individual Characteristics in Predicting Short- and Long-Term Cognitive and Psychological Benefits of Cognitive Stimulation Therapy for Mild-to-Moderate Dementia

Carbone

Piras

Pastore

et al. 2022

Front. Aging Neurosci.

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“…However, revealing the complexity of the construct, it is assumed that the assessment should include at least one factor besides the educational level, given that schooling is an idiosyncratic feature that does not remain dynamic throughout life. For this purpose, we excluded all the papers that addressed the CR by a single proxy (e.g., educational level; Alattar et al, 2020 ), despite the fact that it is the easiest way to assess it in clinical populations (e.g., Alzheimer’s disease; Kwak et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

The Assessment of Cognitive Reserve: A Systematic Review of the Most Used Quantitative Measurement Methods of Cognitive Reserve for Aging

et al. 2022

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The cognitive reserve (CR) is widely accepted as the active ability to cope with brain damage, using preexisting cognitive and compensatory processes. The common CR proxies used are the number of formal years of education, intelligence quotient (IQ) or premorbid functioning, occupation attainment, and participation in leisure activities. More recently, it has employed the level of literacy and engagement in high-level cognitive demand of professional activities. This study aims to identify and summarize published methodologies to assess the CR quantitatively. We searched for published studies on PubMed, ScienceDirect, and Web of Science between September 2018 and September 2021. We only included those studies that characterized the CR assessment methodology. The search strategy identified 1,285 publications, of which 25 were included. Most of the instruments targeted proxies individually. The lack of a gold standard tool that incorporates all proxies and cognitive tests highlights the need to develop a more holistic battery for the quantitative assessment of CR. Further studies should focus on a quantitative methodology that includes all these proxies supported by normative data to improve the use of CR as a valid measure in clinical contexts.

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“…Loss of cognitive functions in the early stage of dementia is highly associated with neuronal death boosted by the crosstalk between peripheral and CNS inflammation [44, 45], which includes different mechanisms such as vagal reflex-induced inflammation from the periphery to the brain [46, 47], blood-brain barrier disruption [13], and direct entry of peripheral immune cells into the brain parenchyma [12]. Decline of noncognitive functions has been related to changes in anatomic structures [48], circadian rhythm dysfunction [49], metabolic changes [50], and imbalance in the production of neurotransmitters [51, 52], but less is known about how much systemic inflammation aggravates noncognitive symptoms. Hence, our results open a debate on whether there is an underlying mechanism that produces a negative feedback in leukocytes, especially in late stages of dementia with BPSD, making leukocytosis values a reliable biomarker to identify CNS inflammation and damage at the time of BPSD onset.…”

Section: Discussionmentioning

confidence: 99%

Peripheral Leukocytosis Predicts Cognitive Decline but Not Behavioral Disturbances: A Nationwide Study of Alzheimer’s and Parkinson’s Disease Patients

Unda

Antoniazzi

Altschul

et al. 2021

Dement Geriatr Cogn Disord

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Introduction: Peripheral and central nervous system inflammation have been linked to the classic symptoms of Parkinson’s disease (PD) and Alzheimer’s disease (AD). However, it remains unclear whether the analysis of routine systemic inflammatory markers could represent a useful prediction tool to identify clinical subtypes in patients with Parkinson’s and Alzheimer’s at higher risk of dementia-associated symptoms, such as behavioral and psychological symptoms of dementia (BPSD). Methods: We performed a multivariate logistic regression using the 2016 and 2017 National Inpatient Sample with International Classification of Diseases 10th edition codes to assess if pro-inflammatory white blood cells (WBCs) anomalies correlate with dementia and BPSD in patients with these disorders. Results: We found that leukocytosis was the most common WBC inflammatory marker identified in 3.9% of Alzheimer’s and 3.3% Parkinson’s patients. Leukocytosis was also found to be an independent risk factor for Parkinson’s dementia. Multivariate analysis of both cohorts showed that leukocytosis is significantly decreased in patients with BPSD compared to patients without BPSD. Conclusions: These results suggest a link between leukocytosis and the pathophysiology of cognitive dysfunction in both PD and AD. A better understanding of the role of systemic neuroinflammation on these devastating neurodegenerative disorders may facilitate the development of cost-effective blood biomarkers for patient’s early diagnosis and more accurate prognosis.

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Multivariate neuroanatomical correlates of behavioral and psychological symptoms in dementia and the moderating role of education

Cited by 12 publications

References 57 publications

The Role of Individual Characteristics in Predicting Short- and Long-Term Cognitive and Psychological Benefits of Cognitive Stimulation Therapy for Mild-to-Moderate Dementia

The Role of Individual Characteristics in Predicting Short- and Long-Term Cognitive and Psychological Benefits of Cognitive Stimulation Therapy for Mild-to-Moderate Dementia

The Assessment of Cognitive Reserve: A Systematic Review of the Most Used Quantitative Measurement Methods of Cognitive Reserve for Aging

Peripheral Leukocytosis Predicts Cognitive Decline but Not Behavioral Disturbances: A Nationwide Study of Alzheimer’s and Parkinson’s Disease Patients

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