Neuropsychiatric Symptoms and Executive Functioning in Patients with Mild Cognitive Impairment: Relationship to Caregiver Burden

Ryan, Kelly A.; Weldon, Anne L.; Persad, Carol; Heidebrink, Judith L.; Barbas, Nancy R.; Giordani, Bruno

doi:10.1159/000339955

Cited by 39 publications

(45 citation statements)

References 48 publications

(47 reference statements)

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“…Thus, it is important to identify factors in the patient, the caregiver, and in the patient-caregiver relationship that create greater vulnerability or resilience to the negative effects of caregiving. Previous research has indicated that declines in patients’ emotional functioning are strongly linked with increased psychological distress in caregivers [14–16]. In addition, declines in patients’ emotional functioning can negatively impact the marital relationship.…”

Section: Introductionmentioning

confidence: 99%

Lower Visual Avoidance in Dementia Patients Is Associated with Greater Psychological Distress in Caregivers

Otero

Levenson²

2017

Dement Geriatr Cogn Disord

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Caring for a spouse with dementia can lead to increased health problems in caregivers. The present study examined whether patient deficits in visual avoidance, a common form of emotion regulation, are related to greater psychological distress in caregivers. Participants were 43 Alzheimer disease (AD) patients, 43 behavioral variant frontotemporal dementia (bvFTD) patients, and their spousal caregivers. Patient visual avoidance (e.g., gaze aversion) was measured using behavioral coding of head, body, and eye position while viewing a disgusting film. Caregiver psychological distress was measured using a standard self-report symptom inventory. Lower use of visual avoidance by patients was associated with greater psychological distress in their caregivers. This relationship was partially mediated by patient overall emotional functioning (as reported by caregivers), such that patients with less visual avoidance were seen as having worse emotional functioning, which in turn related to greater caregiver psychological distress. Dementia diagnosis moderated this effect, with diminished patient visual avoidance particularly detrimental to psychological distress of bvFTD caregivers. Findings suggest that the use of visual avoidance may serve as a marker of overall emotional functioning in patients and that preservation of this emotion regulatory behavior may help reduce the negative effects of caregiving.

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Section: Introductionmentioning

confidence: 99%

Lower Visual Avoidance in Dementia Patients Is Associated with Greater Psychological Distress in Caregivers

Otero

Levenson²

2017

Dement Geriatr Cogn Disord

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“…Depression in AD is associated with several adverse consequences, including negative influences on the patients' quality of life and activities of daily living, early requirements for hospitalization, and increased caregiver burden [4,5,6,7]. In MCI patients, depression is associated not only with negative clinical impacts but also with an increased risk for conversion to AD [8,9]. …”

Section: Introductionmentioning

confidence: 99%

Frequency of Depressive Syndromes in Elderly Individuals with No Cognitive Impairment, Mild Cognitive Impairment, and Alzheimer's Disease Dementia in a Memory Clinic Setting

Lee

Byun

et al. 2016

Dement Geriatr Cogn Disord

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Aims: The aims of this study were to investigate the frequency of various depressive syndromes in elderly individuals with no cognitive impairment (NC), mild cognitive impairment (MCI), and Alzheimer's disease dementia (AD) in a memory clinic setting, and then to test whether severe and milder forms of depressive syndromes are differentially associated with the cognitive groups. Methods: For 216 NC, 478 MCI, and 316 AD subjects, we investigated the frequency of depressive syndromes, defined by three different categories: major and minor depressive disorder (MaDD and MiDD) according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, as well as depression according to the National Institute of Mental Health provisional diagnostic criteria for depression in Alzheimer's disease (NIMH-dAD). Results: The frequency of MaDD did not show any significant difference among NC, MCI, and AD. In contrast, the frequencies of MiDD and NIMH-dAD were higher than those of MaDD and showed significant group differences with a gradual increase from NC to AD. Conclusion: The findings suggest that the degenerative process of Alzheimer's disease contributes to the occurrence of mild depressive conditions, but not to severe depression.

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“…Although Parkinson's disease (PD) is considered primarily a movement disorder [Reichmann et al, 2016], and Alzheimer's disease (AD) is generally construed as an escalating dementia [Geda, et al, 2013], it has become increasingly clear-and generally recognized-that the burden of accompanying neuropsychiatric disorders contribute to increased morbidity and mortality in these patients [Panza et al, 2015;Szeto and Lewis, 2016]. As such, these comorbidities add an additional burden on society [Ryan et al, 2012;Martinez-Martin et al, 2015] where, currently, the treatment of behavioral and psychological symptoms that accompany both AD and PD remains a challenge [Rabins and Lyketsos, 2007;Gauthier et al, 2010]. The current treatment strategies of these neuropsychiatric disorders mainly focus on agitation, aggression, delusions, and hallucinations [Rabins and Lyketsos, 2007;Soto et al, 2015].…”

Section: Introductionmentioning

confidence: 99%

Psychotropic Drug Development Strategies that Target Neuropsychiatric Etiologies in Alzheimer's and Parkinson's Diseases

Schyf

2016

Drug Development Research

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Preclinical Research Neuropsychiatric symptoms are currently recognized as a common burden in patients suffering from Alzheimer's disease (AD), Parkinson's disease (PD), and many other neurodegenerative disorders. Earlier theories positing that these symptoms emerge predominantly in patients with late-stage disease have been largely dismissed. It is now generally accepted that many neuropsychiatric symptoms commonly manifest very early in neurodegenerative disease stages, and in many cases are even considered prodromal indicators. Despite intense research efforts, no reliable drug treatment strategies have been found for the neuropsychiatric symptoms associated with AD and PD. Among the medications commonly used at this stage, many present significant risks for patients in this particular cohort. Transcriptomic tools and proteomic profiling have clearly indicated that neurodegenerative diseases and their associated neuropsychiatric comorbidities are multifactorial in origin. As such, multiple-and in many cases divergent-disease etiologies lead to the neuropsychiatric symptoms associated with AD, PD, and other neurodegenerative disorders. The complexity of these pathways (initiated by a cascade of molecular events that involve several neurotransmitter systems) offer significant challenges to drug discovery efforts aimed at addressing these symptoms. In response to this complexity, a new paradigm has emerged that challenges the widely held assumption that "targeted" drug design is superior to the development of "multi-targeted" drugs as a strategy to address the neuropsychiatric symptoms associated with AD and PD. In this Overview, I offer an overview of drug discovery strategies and investigative drugs currently under development that address multiple CNS etiological targets associated with an array of neuropsychiatric symptoms. Drug Dev Res 77 : 458-468, 2016. © 2016 Wiley Periodicals, Inc.

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Neuropsychiatric Symptoms and Executive Functioning in Patients with Mild Cognitive Impairment: Relationship to Caregiver Burden

Cited by 39 publications

References 48 publications

Lower Visual Avoidance in Dementia Patients Is Associated with Greater Psychological Distress in Caregivers

Lower Visual Avoidance in Dementia Patients Is Associated with Greater Psychological Distress in Caregivers

Frequency of Depressive Syndromes in Elderly Individuals with No Cognitive Impairment, Mild Cognitive Impairment, and Alzheimer's Disease Dementia in a Memory Clinic Setting

Psychotropic Drug Development Strategies that Target Neuropsychiatric Etiologies in Alzheimer's and Parkinson's Diseases

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