Research Summary

Neuropsychiatric Symptoms in Patients With Alzheimer Disease Associated With Functional Decline

Miranda Manier, BA

Neuropsychiatric symptoms (NPS) in dementia are frequently under-recognized, despite their significant effect on patient prognosis. This study aimed to explore the association of various NPS with functional decline in individuals with Alzheimer disease (AD) and Lewy body dementia (LBD), using data from the Dementia Study of Western Norway (DemVest).

The analysis included 196 patients, 111 with AD and 85 with LBD. The researchers followed up with participants annually, using the Neuropsychiatric Inventory (NPI) to assess NPS as well as the Rapid Disability Rating Scale (RDRS-2) to measure activities of daily living and functional decline. Linear mixed models analyzed the relationships between NPI total scores, specific NPS items, and changes in RDRS-2 scores over time.

Throughout the 5-year follow-up, several NPS were significantly associated with worsening functional abilities. In individuals with AD, hallucinations, aggression, depression, anxiety, apathy, disinhibition, aberrant motor behavior, nighttime behavior disturbances, and abnormal eating patterns were linked to functional decline. For patients with LBD, irritability and aberrant motor behavior were particularly associated with decreasing functional capacities.

The study's limitations include a small sample size and a focus on a specific geographical region. Additionally, it did not account for the effects of treatment interventions, and while associations between neuropsychiatric symptoms and functional decline were identified, causality was not established.

“These results highlight the relevance of early detection and intervention of these particularly relevant NPS, due to its potential of also impacting physical function,” the study authors concluded. “Better detection and management of these NPS could improve functional prognosis in people living with dementia.”

 

Reference:

Borda MG, Brønnick KK, Garcia-Cifuentes E, et al. Specific neuropsychiatric symptoms are associated with functional decline trajectories in Alzheimer’s disease and Lewy body dementia. Front Med (Lausanne). 2023;10:1267060. doi:10.3389/fmed.2023.1267060.