Specific Neuropsychiatric Symptoms are Associated with Faster Progression in Alzheimer's Disease: Results of the Prospective Dementia Registry (PRODEM-Austria)
Specific Neuropsychiatric Symptoms are Associated with Faster Progression in Alzheimer's Disease: Results of the Prospective Dementia Registry (PRODEM-Austria)
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DOI：
10.3233/jad-190662
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发表时间：
2020-01-01
影响因子：
4
通讯作者：
Schmidt, Reinhold
中科院分区：
文献类型：
--
作者：
Defrancesco, Michaela;Marksteiner, Josef;Schmidt, Reinhold
背景：神经精神症状 (NPS) 在阿尔茨海默病 (AD) 病程中频繁出现，并被怀疑与痴呆的更快进展有关。许多报告都定义了特定的亚综合征，并总结为神经精神病学清单 (NPI) 的项目群。 目的：本研究调查了特定 NPI 亚综合征和临床患者特征对痴呆进展的影响。 方法：对奥地利痴呆症前瞻性登记处 (PRODEM) 的数据进行回顾性分析。使用简易精神状态检查 (MMSE) 和建立阿尔茨海默病痴呆神经心理学测试组合注册表联盟 (CERAD) 在基线和每年 2 次随访时确定认知功能。为了评估 NPS，使用了 NPI：NPI 项目分为三个子综合征（精神病群、行为群、情绪群）。结果：在 662 名患者中（平均年龄 76.4 +/- 8.4 岁），43% 完成了两年的随访。 MMSE 评分、命名和言语流利度方面，所有三个子综合征的较高分数与较差的认知表现之间存在显着相关性。线性混合模型分析的结果显示，精神病簇中较低的年龄和较高的分数是 MMSE 随时间变化的显着预测因子。结论：在这项研究中，我们报告了精神病亚综合征和较低的年龄对早期 AD 中 MMSE 更快下降的影响。这些结果强调了不仅评估而且区分 AD 早期亚综合征中的神经精神症状作为疾病进展的可能预测因素的重要性。
Background: Neuropsychiatric symptoms (NPS) occur frequently in the course of Alzheimer's disease (AD) and are suspected to be associated with a faster dementia progression. Numerous reports have defined specific subsyndromes, summarized in clusters of items of the Neuropsychiatric Inventory (NPI).Objective: This study investigated the influence of specific NPI subsyndromes and clinical patient characteristics on dementia progression.Methods: Data of the prospective registry on dementia in Austria (PRODEM) were retrospectively analyzed. Cognitive functioning was determined at baseline and 2 yearly follow-up visits using the Mini-Mental State Examination (MMSE) and the Consortium to Establish a Registry for Alzheimer's dementia neuropsychological test battery (CERAD). To assess NPS, the NPI was used: NPI items were classified in three subsyndromes (psychotic cluster, behavioral cluster, emotional cluster).Results: Out of the 662 included patients (mean age 76.4 +/- 8.4 years), 43% completed follow-up visits for two years. Significant correlation between higher scores in all three subsyndromes and worse cognitive performance were found for MMSE score, naming, and verbal fluency. Results of linear mixed model analysis revealed lower age and higher scores in the psychotic cluster as significant predictors of changes in MMSE with time.Conclusion: In this study, we report the influence of psychotic subsyndromes and lower age on faster MMSE decline in early AD. These results emphasize the importance of not only assessing but also differentiating neuropsychiatric symptoms in subsyndromes in the early stages of AD as a possible predictor of disease progression.