Session Title: Alzheimer's Disease (AD) including Non-Cognitive Aspects
NEUROPSYCHIATRIC SYMPTOMS AS PREDICTORS OF FUNCTIONAL DECLINE IN ALZHEIMER'S DISEASE
F. Lupo, K. Palmer, G. Salamone, L. Cravello, R. Perri, M. Musicco, C. Caltagirone
Background: Neuropsychiatric symptoms often occur in Alzheimer's Disease (AD) but it is unclear what role they play on disease progression and functional decline.
Results: The most common NPI symptoms in AD were depression (46.6%), apathy (55.1%), and anxiety (38.2%). Functional decline on ADL and IADL was more common in patients with baseline anxiety, depression, apathy, disinhibition, irritability and difficulties sleeping. 30 (25.2%) patients had no NPI symptom at baseline. Only 6.7% of patients without neuropsychiatric symptoms declined in ADL over follow-up. Compared to these patients, the risk of functional decline was higher in patients with depression (HR=3.9: 0.9-16.3), anxiety (HR=5.4: 1.2-23.2), disinhibition (HR=6.4: 1.2-33.4), and irritability (HR=4.5: 1.0-19.1) after adjustment for age, sex, education, and baseline cognitive and functional status.
Conclusions: Neuropsychiatric symptoms can be used as markers to predict functional decline in AD patients. Patients free from neuropsychiatric symptoms are less likely to suffer a rapid decline in functioning. These results may help long-term planning of care and treatment in AD.