scholarly journals The Relationship Between Anxiety and Alzheimer’s Disease

2021 ◽  
pp. 1-7
Author(s):  
Mario F. Mendez
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Neuropsychiatric Symptoms ◽  
Management Strategies ◽  
Lewy Bodies ◽  
Sensorimotor Gating ◽  
Clinical Syndrome ◽  
Pathological Examination ◽  
Behavioral Management ◽  
The Relationship

Although Alzheimer’s disease (AD) is primarily a neurocognitive disorder, it also results in prominent neuropsychiatric symptoms (NPS). Much literature has investigated the NPS of apathy and depression in association with AD, but relatively less is known regarding anxiety, the third most common NPS in this disorder. The prevalence of anxiety symptoms in AD is about 40%, and it can be a prelude of AD. Anxiety can be especially present among patients with mild cognitive impairment, mild dementia, or early-onset forms of the disease, and can promote progression or conversion to Alzheimer’s clinical syndrome. A number of studies have established that anxiety is associated with positive amyloid scans, mesial temporal changes with atrophy and hypometabolism in the entorhinal region, and neurofibrillary tangles present on pathological examination of this region. Proposed neurobiological mechanisms for increased anxiety in AD include decreased sensorimotor gating, relatively increased activation of amygdalae or the Salience Network, and the presence of comorbid pathology, particularly Lewy bodies. Having management strategies for anxiety in patients with AD is important as anxiety can worsen cognitive deficits. Interventions involves psychological support, behavioral management, and the judicious use of the psychiatric armamentarium of medications.

scholarly journals RESTING HEART RATE MODERATES THE RELATIONSHIP BETWEEN NEUROPSYCHIATRIC SYMPTOMS, MCI, AND ALZHEIMER’S DISEASE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S641-S641
Author(s):  
Shanna L Burke
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Heart Rate ◽  
Relative Risk ◽  
Neuropsychiatric Symptoms ◽  
Cognitive Status ◽  
Resting Heart Rate ◽  
Data Set ◽  
Increased Risk ◽  
The Relationship

Abstract Little is known about how resting heart rate moderates the relationship between neuropsychiatric symptoms and cognitive status. This study examined the relative risk of NPS on increasingly severe cognitive statuses and examined the extent to which resting heart rate moderates this relationship. A secondary analysis of the National Alzheimer’s Coordinating Center Uniform Data Set was undertaken, using observations from participants with normal cognition at baseline (13,470). The relative risk of diagnosis with a more severe cognitive status at a future visit was examined using log-binomial regression for each neuropsychiatric symptom. The moderating effect of resting heart rate among those who are later diagnosed with mild cognitive impairment (MCI) or Alzheimer’s disease (AD) was assessed. Delusions, hallucinations, agitation, depression, anxiety, elation, apathy, disinhibition, irritability, motor disturbance, nighttime behaviors, and appetite disturbance were all significantly associated (p<.001) with an increased risk of AD, and a reduced risk of MCI. Resting heart rate increased the risk of AD but reduced the relative risk of MCI. Depression significantly interacted with resting heart rate to increase the relative risk of MCI (RR: 1.07 (95% CI: 1.00-1.01), p<.001), but not AD. Neuropsychiatric symptoms increase the relative risk of AD but not MCI, which may mean that the deleterious effect of NPS is delayed until later and more severe stages of the disease course. Resting heart rate increases the relative risk of MCI among those with depression. Practitioners considering early intervention in neuropsychiatric symptomology may consider the downstream benefits of treatment considering the long-term effects of NPS.

scholarly journals The individual course of neuropsychiatric symptoms in people with Alzheimer's and Lewy body dementia: 12-year longitudinal cohort study

2019 ◽  
Vol 216 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Audun Osland Vik-Mo ◽  
Lasse Melvaer Giil ◽  
Miguel Germán Borda ◽  
Clive Ballard ◽  
Dag Aarsland
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Neuropsychiatric Symptoms ◽  
Personalised Medicine ◽  
Lewy Bodies ◽  
Lewy Body Dementia ◽  
Psychotic Symptoms ◽  
Primary Inclusion ◽  
The Individual

IntroductionUnderstanding the natural course of neuropsychiatric symptoms (NPS) in dementia is important for planning patient care and trial design, but few studies have described the long-term course of NPS in individuals.MethodPrimary inclusion of 223 patients with suspected mild dementia from general practice were followed by annual assessment, including the Neuropsychiatric Inventory (NPI), for up to 12 years. Total and item NPI scores were classified as stable, relapsing, single episodic or not present based on 4.96 (s.d. 2.3) observations (98% completeness of longitudinal data) for 113 patients with Alzheimer's disease and 84 patients with LBD (68 dementia with Lewy bodies and 16 Parkinson's disease dementia).ResultsWe found that 80% had stable NPI total ≥1, 50% had stable modest NPI total ≥12 and 25% had stable NPI total ≥24 scores. Very severe NPS (≥48) were mostly single episodes, but 8% of patients with Alzheimer's disease had stable severe NPS. Patients with Alzheimer's disease and the highest 20% NPI total scores had a more stable or relapsing course of four key symptoms: aberrant motor behaviour, aggression/agitation, delusions and irritability (odds ratio 55, P < 0.001). This was not seen in LBD. Finally, 57% of patients with Alzheimer's disease and 84% of patients with LBD had reoccurring psychotic symptoms.ConclusionsWe observed a highly individual course of NPS, with most presenting as a single episode or relapsing; a stable course was less common, especially in LBD. These findings demonstrate the importance of an individualised approach (i.e. personalised medicine) in dementia care.

scholarly journals Commentary

1998 ◽  
Vol 4 (6) ◽  
pp. 364-366 ◽  
Author(s):  
D. Neill
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Lewy Bodies ◽  
Neuronal Loss ◽  
Pathological Process ◽  
Psychotic Symptoms ◽  
Extrapyramidal Features ◽  
Relationship Of ◽  
The Relationship

The article by Byrne gives a general overview of dementia with Lewy bodies (LBD) and discusses treatment in terms of modulation of neurotransmitter systems, treatment of psychotic symptoms and extrapyramidal features. However, as is the case with Alzheimer's disease, the dementia is related to underlying pathological processes which result in death and/or malfunction of neurons. Prevention or amelioration of this neuronal loss is therefore the ultimate aim of treatment. Such treatment is not yet available and the possibility of its development is likely to depend on further elucidation of the underlying pathological process. The relationship of LBD to Alzheimer's disease and Parkinson's disease should be considered, as this is important for the determination of the underlying pathological processes in LBD.

scholarly journals SOCIAL COGNITION AND AWARENESS IN ALZHEIMER’S DISEASE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S120-S120
Author(s):  
Marcia Dourado ◽  
Tatiana Belfort ◽  
José Simões Neto
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Social Cognition ◽  
Social Functioning ◽  
Neuropsychiatric Symptoms ◽  
Consecutive Series ◽  
Cross Sectional ◽  
Significant Difference ◽  
Impaired Awareness ◽  
The Relationship

Abstract Social cognition is the capacity to interpret and predict another’s behavior according to beliefs, intentions, and emotions, and the ability to decode environmental stimuli in order to be better able to adapt to new situations. A key question is the relationship between social cognition and awareness in dementia. This study aimed to investigate the relation between social and emotional functioning (SEF) and awareness in Alzheimer's disease (AD). In a cross-sectional design, a consecutive series of 50 people with mild to moderate AD and their 50 family caregivers were assessed. The study variables were awareness, SEF, neuropsychiatric symptoms, cognition, working memory, quality of life, functional activities, presence of depressive symptoms, and caregivers’ burden and cognition. We found a significant difference between self-rated SEF and informant-rated SEF. In 56% of the cases, self-rated SEF was lower than the informant-rated SEF. People with AD mostly (56%) had mildly impaired awareness of disease, 20% had moderate impaired awareness of disease, and 6% were unaware of the disease. A multivariate linear regression examined the association between informant-rated SEF score and the variables. The social functioning and relationship domain of awareness and informant-rated QoL of people with AD were significantly associated with informant-rated SEF. Conclusion: The relationship between informant-rated SEF and awareness of social functioning and relationship supports the multidimensional nature of awareness. SEF and awareness of social functioning shows that they are comprised of judgments related to perceptions about oneself and values qualitatively different from awareness of memory or functionality, which can be directly observed.

scholarly journals Association Between Amygdala Volume and Trajectories of Neuropsychiatric Symptoms in Alzheimer's Disease and Dementia With Lewy Bodies

2021 ◽  
Vol 12 ◽  
Author(s):  
Alberto Jaramillo-Jimenez ◽  
Lasse M. Giil ◽  
Diego A. Tovar-Rios ◽  
Miguel Germán Borda ◽  
Daniel Ferreira ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Dementia With Lewy Bodies ◽  
Neuropsychiatric Symptoms ◽  
Lewy Bodies ◽  
Magnetic Resonance Images ◽  
Depression Symptoms ◽  
Intracranial Volume ◽  
Mild Dementia ◽  
Amygdala Volume

Introduction: The amygdala is implicated in psychiatric illness. Even as the amygdala undergoes significant atrophy in mild dementia, amygdala volume is underexplored as a risk factor for neuropsychiatric symptoms (NPS).Objective: To analyze the association between baseline amygdala volume and the longitudinal trajectories of NPS and cognitive decline in Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) over 5 years.Methods: Eighty-nine patients with mild dementia were included (AD = 55; DLB = 34). Amygdala volume was segmented from structural magnetic resonance images (sMRI) using a semi-automatic method (Freesurfer 6.0) and normalized by intracranial volumes. The intracranial volume-normalized amygdala was used as a predictor of the Neuropsychiatric Inventory (NPI) total score, ordinal NPI item scores (0 = absence of symptoms, 1–3 = mild symptoms, ≥4 = clinically relevant symptoms), and Mini-Mental State Examination (MMSE) as measured annually over 5 years using gamma, ordinal, and linear mixed-effects models, respectively. The models were adjusted for demographic variables, diagnosis, center of sMRI acquisition, and cognitive performance. Multiple testing-corrected p-values (q-values) are reported.Results: Larger intracranial volume-normalized amygdala was associated with less agitation/aggression (odds ratio (OR) = 0.62 [0.43, 0.90], p = 0.011, q = 0.038) and less MMSE decline per year (fixed effect = 0.70, [0.29, 1.03], p = 0.001, q = 0.010) but more depression (OR = 1.49 [1.09, 2.04], p = 0.013, q = 0.040).Conclusions: Greater amygdala volume in mild dementia is associated with lower odds of developing agitation/aggression, but higher odds of developing depression symptoms during the 5-year study period.

scholarly journals The Relationship between Neuropsychiatric Symptoms and Default-Mode Network Connectivity in Alzheimer’s Disease

2020 ◽  
Vol 17 (7) ◽  
pp. 662-666 ◽  
Author(s):  
Jung Suk Lee ◽  
Jong Hun Kim ◽  
Seon-Koo Lee
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Prefrontal Cortex ◽  
Functional Connectivity ◽  
Medial Prefrontal Cortex ◽  
Neuropsychiatric Symptoms ◽  
Neuropsychiatric Inventory ◽  
Montreal Neurological Institute ◽  
Default Mode ◽  
The Relationship

Objective Neuropsychiatric symptoms of dementia are prevalent and extremely burdening for the patient and caregivers, but the underlying mechanism of these symptoms has not been investigated. This study aimed to investigate the relationship between neuropsychiatric symptoms and default-mode functional connectivity in Alzheimer’s disease.Methods Neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory. Functional magnetic resonance imaging was conducted on seventy patients with Alzheimer’s disease during rest. We conducted a seed-based functional connectivity analysis to identify anterior and posterior default-mode networks (DMN). Seeds were the medial prefrontal cortex (Montreal Neurological Institute 12, 51, 36; seed radius=3 mm) for the anterior DMN and the precuneus (Montreal Neurological Institute -6, -63, 27; seed radius=3 mm) for the posterior DMN We then correlated the scores on neuropsychiatric inventory syndromes (apathy, hyperactivity, affective, and psychosis syndrome) with maps of connectivity in the default-mode network.Results There was a significant correlation between decreased connectivity in the medial prefrontal cortex of the anterior defaultmode network and hyperactivity (agitation, irritability, aberrant motor behavior, euphoria, and disinhibition) syndrome (p<0.05, family wise error cluster-level corrected).Conclusion Our study demonstrated that hyperactivity syndrome is related to hypoconnected default-mode network in Alzheimer’s disease. This finding suggests that specific network alterations are associated with certain neuropsychiatric syndromes.

Dementia management strategies associated with neuropsychiatric symptoms of elderly people with Alzheimer’s disease

Dementia ◽  
2018 ◽  
Vol 18 (7-8) ◽  
pp. 2747-2759 ◽  
Author(s):  
Lais Lopes Delfino ◽  
Ricardo Shoiti Komatsu ◽  
Caroline Komatsu ◽  
Anita Liberalesso Neri ◽  
Meire Cachioni
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Elderly People ◽  
Management Strategy ◽  
Neuropsychiatric Symptoms ◽  
Demographic Data ◽  
Communication Strategies ◽  
Management Strategies ◽  
The Elderly ◽  
Active Management

This study aims to investigate the association between management and communication strategies and the presence of neuropsychiatric symptoms presented by elderly people with Alzheimer’s disease. One hundred and thirty-four family caregivers answered a questionnaire with socio-demographic data and questions regarding the care context, the Small Communication Strategies Scale, the Dementia Management Strategy Scale, and the Neuropsychiatric Inventory. Caregivers used the criticism management strategy more when the elderly presented hallucination, agitation, depression, anxiety, irritability, nighttime behavior, and appetite abnormalities. The encouragement strategy was more significantly used only in the presence of euphoria/elation. The caregivers who used the most active management strategy were those who cared for the elderly with delirium, hallucination, agitation, depression, anxiety, irritability, and appetite and eating abnormalities. The use of communication strategies did not differ between groups with or without neuropsychiatric symptoms. It is concluded that criticism management and active management strategies are strongly associated with neuropsychiatric symptoms. The results of this study may be useful for planning treatment interventions that aim to modify the use of management strategies used by caregivers.

Neuropsychiatric symptoms and α-Synuclein profile of patients with Parkinson’s disease dementia, dementia with Lewy bodies and Alzheimer’s disease

2018 ◽  
Vol 265 (10) ◽  
pp. 2295-2301 ◽  
Author(s):  
Anastasia Bougea ◽  
Leonidas Stefanis ◽  
George P. Paraskevas ◽  
Evangelia Emmanouilidou ◽  
Efthimia Efthymiopoulou ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Parkinson’S Disease ◽  
Alzheimer's Disease ◽  
Parkinson's Disease ◽  
Dementia With Lewy Bodies ◽  
Neuropsychiatric Symptoms ◽  
Lewy Bodies ◽  
Parkinson’S Disease Dementia

scholarly journals C-10 Interaction of ApoE4 and Gender in Neuropsychiatric Presentation in Probable Alzheimer’s Disease

2019 ◽  
Vol 34 (6) ◽  
pp. 1037-1037
Author(s):  
C Alexander ◽  
J Suhr
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Mini Mental State Examination ◽  
Neuropsychiatric Symptoms ◽  
Depression And Anxiety ◽  
Apoe4 Allele ◽  
And Gender ◽  
Relationship Of ◽  
The Relationship ◽  
State Examination

Abstract Objective Individuals with probable Alzheimer’s disease (pAD) often have neuropsychiatric symptoms; however, the relationship of these symptoms and ApoE4 status is unclear. Recent research suggests gender moderates the relationship of ApoE4 to AD. We examined how ApoE4 genetic status and gender predict neuropsychiatric symptoms in older adults with pAD. Method Data from the National Alzheimer’s Coordinating Centers (NACC) was utilized in the present study. We included only individuals diagnosed with pAD with collaterals who were judged reliable by clinical NACC staff and who saw the participant at least three times per week. The selected sample (N = 6943) was 52% male; 85.6% White, 10.2% African American; and 7.5% Hispanic. Average age was 73 years. The Neuropsychiatric Inventory-Questionnaire, completed by the participant’s collateral, was used to assess symptoms. Analyses controlled for age and cognitive impairment as measured by the Mini-Mental State Examination. Results The presence of at least one ApoE4 allele predicted higher severity of delusions, p = .04. Males had higher severity of agitation, apathy, and irritability; females had higher delusions, depression, and anxiety, all p’s < .05. Gender moderated the relationship of ApoE4 with disinhibition, night disturbances, and appetite, all p’s < .05. In all three cases, for males, scores were higher for non-carriers than for ApoE4 carriers; however, for females, differences did not exist between carriers and non-carriers. Conclusions Differences between ApoE4 carriers and non-carriers as well as between genders are demonstrated, and evidence supports the hypothesis that gender and ApoE4 status interact to predict some pAD neuropsychiatric symptomatology.

scholarly journals Hippocampal subfields and decline in activities of daily living in Alzheimer’s disease and dementia with Lewy bodies

2020 ◽  
Vol 10 (6) ◽  
pp. 357-367
Author(s):  
Miguel Germán Borda ◽  
Alberto Jaramillo-Jimenez ◽  
Diego A Tovar-Rios ◽  
Daniel Ferreira ◽  
Elkin Garcia-Cifuentes ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Dementia With Lewy Bodies ◽  
Rating Scale ◽  
Neuropsychiatric Symptoms ◽  
Functional Decline ◽  
Lewy Bodies ◽  
Magnetic Resonance Images

Background: Hippocampal atrophy is presented in Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB). Cognition, dual-tasks, muscular function, goal-related behaviors and neuropsychiatric symptoms are linked to hippocampal volumes and may lead to functional decline in activities of daily living. We examined the association between baseline hippocampal subfield volumes (HSv) in mild AD and DLB, and functional decline. Materials & methods: 12 HSv were computed from structural magnetic resonance images using Freesurfer 6.0 segmentation. Functional decline was assessed using the rapid disability rating scale score. Linear regressions were conducted. Results: In AD, HSv were smaller bilaterally. However, HSv were not associated with functional decline. Conclusion: Functional decline does not depend on HSv in mild AD and DLB.

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