Psychosocial or clinico‐demographic factors related to neuropsychiatric symptoms in patients with Alzheimer's disease needing interventional treatment: analysis of the CATIE‐AD study

Nagata, Tomoyuki; Nakajima, Shinichiro; Shinagawa, Shunichiro; Plitman, Eric; Graff‐Guerrero, Ariel; Mimura, Masaru; Nakayama, Keiichi I.

doi:10.1002/gps.4607

Cited by 27 publications

(22 citation statements)

References 44 publications

(105 reference statements)

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“…One example is the Clinical Antipsychotic Trials of Intervention Effectiveness—CATIE-AD study (n = 421 AD outpatients), which implemented psychoeducation training for GP and non-specialists to the early identification of behavior disturbances, clarifying its main behavior dimensions. A total of 4 distinct clusters have been identified: a) agitation and irritability, b) apathy and eating problems, c) psychosis (delusions and hallucinations, and d) emotion and disinhibition (depression, euphoria and disinhibition) ( 42 ).…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Home-Setting Psychoeducation Interventions for Behavioral Changes in Dementia: Some Lessons for the COVID-19 Pandemic and Post-Pandemic Assistance

et al. 2020

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Background Impacts of social isolation measures imposed by COVID-19 Pandemic on mental health and quality of life of older adults living with dementia and their caregivers remain unexplored. Studies have shown that psychoeducational and psychosocial interventions can manage behavioral and psychological symptoms in dementia (BPSD) and reduce the emotional burden on family members when applied in home-setting scenarios. Method a comprehensive systematic review of useful interventions for easing the BPSD burden in patients with dementia (PwD) and their caregivers in the context of COVID-19 quarantine was performed from January 2010 to March 2020. Results From a total of 187 articles retrieved from electronic databases (MEDLINE, LILACS, Cochrane and SCOPUS), 43 studies were eligible for this review. Most of the psychosocial and psychoeducational interventions described were person-centered strategies based on the cognitive-behavioral approach or informational tools to enhance care providers’ knowledge of dementia. Most studies achieved successful results in handling BPSD and mood-anxiety symptoms of care providers, contributing to an overall improvement in dyad life quality. Conclusion Evidence from the last few years suggest that low-cost techniques, tailored to the dyad well-being, with increasing use of technology through friendly online platforms and application robots, can be an alternative to conventional assistance during COVID-19 Pandemic. Nevertheless, the world’s current experience regarding the duration of the COVID-19 Pandemic and its effects on the cognition, behavior, and life quality of PwD will demand research on preventive and protective factors of dementia and the pursue of efficient interventions in different scenarios.

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Section: Resultsmentioning

confidence: 99%

A Systematic Review of Home-Setting Psychoeducation Interventions for Behavioral Changes in Dementia: Some Lessons for the COVID-19 Pandemic and Post-Pandemic Assistance

et al. 2020

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“…Thus, environmental manipulations aimed at decreasing cognitive demands in the aforementioned domains (eg, reducing sensory stimuli, breaking down communication into simple phrases, scheduling quiet time, etc) may be a strategy to prevent agitation or reduce its severity. Creating and maintaining an environment better suited to the PWD's level of cognitive abilities may decrease NPS, which would be a significant contribution given the higher caregiver burden [8][9][10] and increased rates of nursing home placement associated with NPS in care recipients. 11 The fluctuating nature of agitation/aggression and other NPS would be consistent with the notion that varying environmental demands elicit such behaviors in persons with increasingly compromised cognitive status and behavioral control.…”

Section: Discussionmentioning

confidence: 99%

“…Hallucinations and euphoria are somewhat less common, but their occurrence generally remains stable over the course of dementia. burden [8][9][10] as well as nursing home placement. 7 The occurrence of NPS in general has been found to predict degree of caregiver Presented in preliminary form at the Rocky Mountain Psychological Association Convention, (2017), Salt Lake City, UT.…”

Section: Introductionmentioning

confidence: 99%

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Neuropsychiatric symptoms in severe dementia: Associations with specific cognitive domains the Cache County Dementia Progression Study

Cooley

Vernon

et al. 2019

Int J Geriat Psychiatry

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Objectives To examine the prevalence of neuropsychiatric symptoms (NPS) and cognitive correlates in severe dementia. Methods A population‐based sample of 56 individuals with severe dementia (85.7% Alzheimer's type; 67.9% female) were assessed with the Severe Cognitive Impairment Profile (SCIP) and the Neuropsychiatric Inventory (NPI). Descriptive statistics displayed the frequency of NPS and bivariate and multiple regression analyses examined the associations between cognitive domains on the SCIP and NPS total, domain, and cluster scores. Results NPS were common in severe dementia with 98% of the sample exhibiting at least one symptom. Most common were delusions, apathy, agitation/aggression, and aberrant motor behavior, affecting 50% or more of participants. SCIP comportment was significantly associated with NPI total score and apathy (r = −.350 and −.292, respectively). All SCIP domains except for arithmetic, visuospatial, comportment, and motor behavior were significantly associated with agitation/aggression (r = −.285 to −.350). These associations remained in individual multiple regression models. Conclusion In severe dementia, impairment in specific cognitive domains was associated with more severe NPS. Environmental manipulations to reduce processing demands in persons with severe dementia may be a useful strategy to target agitation and aggressive behaviors.

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“…This 247 amino acid neurotrophin participates in axonal growth, pathfinding and in the modulation of dendritic growth and morphology, is a master regulator of synaptic plasticity and thus plays a key role in memory formation and storage (Faria et al, 2014; Nagata et al, 2014, 2016; Song et al, 2015). Therefore, the involvement of BDNF in dementia has been extensively investigated, and several reports indicate that BDNF expression is decreased in hippocampus and neocortex of AD brains (Figure 1; Peng et al, 2005; Song et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Genetics of Aggression in Alzheimer’s Disease (AD)

Lukiw

Rogaev

2017

Front. Aging Neurosci.

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Alzheimer’s disease (AD) is a terminal, age-related neurological syndrome exhibiting progressive cognitive and memory decline, however AD patients in addition exhibit ancillary neuropsychiatric symptoms (NPSs) and these include aggression. In this communication we provide recent evidence for the mis-regulation of a small family of genes expressed in the human hippocampus that appear to be significantly involved in expression patterns common to both AD and aggression. DNA array- and mRNA transcriptome-based gene expression analysis and candidate gene association and/or genome-wide association studies (CGAS, GWAS) of aggressive attributes in humans have revealed a surprisingly small subset of six brain genes that are also strongly associated with altered gene expression patterns in AD. These genes encoded on five different chromosomes (chr) include the androgen receptor (AR; chrXq12), brain-derived neurotrophic factor (BDNF; chr11p14.1), catechol-O-methyl transferase (COMT; chr22q11.21), neuronal specific nitric oxide synthase (NOS1; chr12q24.22), dopamine beta-hydroxylase (DBH chr9q34.2) and tryptophan hydroxylase (TPH1, chr11p15.1 and TPH2, chr12q21.1). Interestingly, (i) the expression of three of these six genes (COMT, DBH, NOS1) are highly variable; (ii) three of these six genes (COMT, DBH, TPH1) are involved in DA or serotonin metabolism, biosynthesis and/or neurotransmission; and (iii) five of these six genes (AR, BDNF, COMT, DBH, NOS1) have been implicated in the development, onset and/or propagation of schizophrenia. The magnitude of the expression of genes implicated in aggressive behavior appears to be more pronounced in the later stages of AD when compared to MCI. These recent genetic data further indicate that the extent of cognitive impairment may have some bearing on the degree of aggression which accompanies the AD phenotype.

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Psychosocial or clinico‐demographic factors related to neuropsychiatric symptoms in patients with Alzheimer's disease needing interventional treatment: analysis of the CATIE‐AD study

Abstract: Among the four NPS clusters, apathy/eating problems and emotion/disinhibition were associated with psychosocial as well as clinico-demographic factors in AD patients with psychotic symptoms or agitation needed interventional treatment. Copyright © 2016 John Wiley & Sons, Ltd.

Cited by 27 publications

References 44 publications

A Systematic Review of Home-Setting Psychoeducation Interventions for Behavioral Changes in Dementia: Some Lessons for the COVID-19 Pandemic and Post-Pandemic Assistance

A Systematic Review of Home-Setting Psychoeducation Interventions for Behavioral Changes in Dementia: Some Lessons for the COVID-19 Pandemic and Post-Pandemic Assistance

Neuropsychiatric symptoms in severe dementia: Associations with specific cognitive domains the Cache County Dementia Progression Study

Genetics of Aggression in Alzheimer’s Disease (AD)

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