P3‐307: Neuropsychiatric Symptoms as Predictors of Progression in Mild Cognitive Impairment (Mci) and Mild Alzheimer's Disease (Ad): The Role of Apathy

Low, Kristabella; Ali, Noorhazlina; Chan, Mark; Tay, Laura; Lim, Wee Shiong; Chew, Justin

doi:10.1016/j.jalz.2019.06.3339

Cited by 2 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…15 These medications also treat neuropsychiatric symptoms, which can trigger or exacerbate inpatient care needs. [16][17][18] An early and clear diagnosis also plays a role in improved overall care plans, ensuring the implementation of safety nets around key elements of care (eg, correct use of medications and fall prevention) that can prevent accidents and reduce morbidity and mortality in patients with cognitive impairment.…”

Section: Discussionmentioning

confidence: 99%

“…Use of symptomatic drugs for AD, such as cholinesterase inhibitors and memantine, which in the IDEAS study were altered in 43% of patients after amyloid PET, had a modest association with rates of hospitalizations and time to institutionalization in a skilled nursing facility, and other studies suggested an association with reduced risk of mortality . These medications also treat neuropsychiatric symptoms, which can trigger or exacerbate inpatient care needs . An early and clear diagnosis also plays a role in improved overall care plans, ensuring the implementation of safety nets around key elements of care (eg, correct use of medications and fall prevention) that can prevent accidents and reduce morbidity and mortality in patients with cognitive impairment.…”

Section: Discussionmentioning

confidence: 99%

“…1 In clinical care, amyloid PET can be a useful adjunct to a specialist evaluation of cognitive decline of uncertain etiology, leading to substantial changes in diagnosis and management in select patients. [2][3][4] Three Aβ tracers, [ 18 F]-florbetapir, [ 18 F]flutemetamol, and [ 18 F]florbetaben, are approved for clinical use in the US, but reimbursement has been limited in part due to a paucity of data examining patient-oriented outcomes.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Amyloid Positron Emission Tomography and Subsequent Health Care Use Among Medicare Beneficiaries With Mild Cognitive Impairment or Dementia

Rabinovici,

Carrillo,

Apgar

et al. 2023

JAMA Neurol

View full text Add to dashboard Cite

ImportanceResults of amyloid positron emission tomography (PET) have been shown to change the management of patients with mild cognitive impairment (MCI) or dementia who meet Appropriate Use Criteria (AUC).ObjectiveTo determine if amyloid PET is associated with reduced hospitalizations and emergency department (ED) visits over 12 months in patients with MCI or dementia.Design, Setting, and ParticipantsThis nonrandomized controlled trial analyzed participants in the Imaging Dementia–Evidence for Amyloid Scanning (IDEAS) study, an open-label, multisite, longitudinal study that enrolled participants between February 2016 and December 2017 and followed up through December 2018. These participants were recruited at 595 clinical sites that provide specialty memory care across the US. Eligible participants were Medicare beneficiaries 65 years or older with a diagnosis of MCI or dementia within the past 24 months who met published AUC for amyloid PET. Each IDEAS study participant was matched to a control Medicare beneficiary who had not undergone amyloid PET. Data analysis was conducted on December 13, 2022.ExposureParticipants underwent amyloid PET at imaging centers.Main Outcomes and MeasuresThe primary end points were the proportions of patients with 12-month inpatient hospital admissions and ED visits. One of 4 secondary end points was the rate of hospitalizations and rate of ED visits in participants with positive vs negative amyloid PET results. Health care use was ascertained from Medicare claims data.ResultsThe 2 cohorts (IDEAS study participants and controls) each comprised 12 684 adults, including 6467 females (51.0%) with a median (IQR) age of 77 (73-81) years. Over 12 months, 24.0% of the IDEAS study participants were hospitalized, compared with 25.1% of the matched control cohort, for a relative reduction of −4.49% (97.5% CI, −9.09% to 0.34%). The 12-month ED visit rates were nearly identical between the 2 cohorts (44.8% in both IDEAS study and control cohorts) for a relative reduction of −0.12% (97.5% CI, −3.19% to 3.05%). Both outcomes fell short of the prespecified effect size of 10% or greater relative reduction. Overall, 1467 of 6848 participants (21.4%) with positive amyloid PET scans were hospitalized within 12 months compared with 1081 of 4209 participants (25.7%) with negative amyloid PET scans (adjusted odds ratio, 0.83; 95% CI, 0.78-0.89).Conclusions and RelevanceResults of this nonrandomized controlled trial showed that use of amyloid PET was not associated with a significant reduction in 12-month hospitalizations or ED visits. Rates of hospitalization were lower in patients with positive vs negative amyloid PET results.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Amyloid Positron Emission Tomography and Subsequent Health Care Use Among Medicare Beneficiaries With Mild Cognitive Impairment or Dementia

Rabinovici,

Carrillo,

Apgar

et al. 2023

JAMA Neurol

View full text Add to dashboard Cite

show abstract

“…As a result, subtle NPS is one of the first preclinical signs of AD (8,11,12). So, detection and treatment of NPS, especially apathy, in early dementia can delay the progression of the disease (13).…”

Section: Introductionmentioning

confidence: 99%

Neuropsychiatric Symptoms of Alzheimer's Disease and Caregiver Burden

Iravani

Abdollahi

Eslamdoust-Siahestalkhi

et al. 2022

Front. Neurol.

View full text Add to dashboard Cite

Introduction/ObjectivesIn addition to cognitive decline, one of the most important problems for caregivers of patients with Alzheimer's is neuropsychiatric symptoms (NPS). This study aimed to evaluate the NPS in patients with Alzheimer's disease (AD) and investigate its relationship with caregiver burden (CB).MethodsIn a cross-sectional study of 85 patients with AD referred to Shafa Hospital in Rasht and their caregivers in 2020, information was collected using a demographic questionnaire, Neuropsychiatric Inventory Questionnaire (NPI-Q), and the Caregiver Burden Inventory (CBI). Data were analyzed by Spearman correlation, t-test, and linear regression, with SPSS version 22.ResultsThe mean age of the patients and their caregivers were 74.95 ± 8.87 years and 43.98 ± 11.38 years, respectively. The mean total score of NPS in patients with AD was 44.25 (0–144) and the mean CB score was 36.27 (0–96), which was a moderate level. According to the results, 91% of patients had apathy, while happiness/euphoria was reported as the most uncommon symptom. In addition, there was a significant relationship between the score of NPS and CB (r = 0.542, P < 0.0001), as well as all its sub-components, time-dependence burden with more correlation (r = 0.509, P < 0.0001), and social burden with less correlation (r = 0.352, P < 0.001). NPS, hallucination, aberrant motor behavior (AMB), delusion, and depression were most correlated with CB. Also, the mean score of CB was significantly higher in women than in men (P = 0.045). Living in a rural area had a significant relationship with NPS score (P = 0.026). Also, linear regression showed that with increasing 1 year of patients' age, the mean score of patient's NPS decreased by 0.374 (P = 0.048).ConclusionNeuropsychiatric symptoms, especially hallucination, aberrant motor behavior (AMB), delusion, and depression were associated with caregiver burden. Apathy was the most common symptom in patients with AD.

show abstract

P3‐307: Neuropsychiatric Symptoms as Predictors of Progression in Mild Cognitive Impairment (Mci) and Mild Alzheimer's Disease (Ad): The Role of Apathy

Cited by 2 publications

References 0 publications

Amyloid Positron Emission Tomography and Subsequent Health Care Use Among Medicare Beneficiaries With Mild Cognitive Impairment or Dementia

Amyloid Positron Emission Tomography and Subsequent Health Care Use Among Medicare Beneficiaries With Mild Cognitive Impairment or Dementia

Neuropsychiatric Symptoms of Alzheimer's Disease and Caregiver Burden

Contact Info

Product

Resources

About