Co-occurrence of neuropsychiatric symptoms in ADAMS, ADNI and NACC studies as assessed by Neuropsychiatric Inventory
medRxiv (Cold Spring Harbor Laboratory),
Год журнала:
2025,
Номер
unknown
Опубликована: Янв. 15, 2025
ABSTRACT
Objective
Neuropsychiatric
symptoms
(NPS)
are
very
common
and
associated
with
high
levels
of
distress,
both
in
dementia
patients
their
caregivers.
Especially
at
more
advanced
disease
stages,
NPS
rarely
occur
isolation,
the
presence
two
or
may
affect
severity
as
well
response
to
therapy.
There
is
limited
quantitative
information
on
prevalence
specific
symptom
combinations
general
population,
populations
recruited
for
symptom-specific
investigations.
Methods
We
performed
cross-sectional
analyses
publicly
accessible
Inventory
Mini
Mental
State
Examination
(MMSE)
data
from
three
longitudinal
studies
(Aging,
Demographics,
Memory
Study
(ADAMS),
Alzheimer’s
Disease
Neuroimaging
Initiative
(ADNI)
National
Coordinating
Center
(NACC)).
Mean
(with
95%
confidence
interval)
was
calculated
all
possible
pairs
(aberrant
motor
behavior,
agitation/aggression,
anxiety,
apathy/indifference,
appetite/eating
changes,
delusions;
depression/dysphoria;
disinhibition;
elation/euphoria;
hallucinations;
irritability/lability
nighttime
behavioral
disturbances)
different
MMSE
strata.
In
addition,
conditional
one
given
another
provided
combinations.
Results
strata,
we
observed
every
pair
combination,
commonly
recognized
discussed
associations
(e.g.,
hallucinations
delusions)
what
might
be
seen
rather
counter-intuitive
patterns
apathy
agitation).
Prevalence
cannot
readily
predicted
based
individual
symptoms.
Presence
cognitive
deficit
degree
impairment
affected
pairs,
albeit
a
degree.
For
example,
most
symptom,
depression,
subjects
without
deficit,
differed
less
than
two-fold.
contrast,
differences
psychotic
(hallucinations
and/or
were
much
stronger
(6-
38-fold).
Conclusions
The
present
study
illustrates
that,
while
there
possibility
any
combination
neuropsychiatric
presenting
during
course
dementia,
co-occurrence
Thus,
our
results
can
serve
source
reference
inform
design
recruitment
strategies
future
clinical
epidemiological
research
people
dementia.
Highlights
What
primary
question
addressed
by
this
study?—The
must
only
sentence
.
despite
growing
number
drug
development
field.
main
finding
sentences
All
frequently
even
mild,
minimal
no
protocol-based
studies.
Co-occurrence
meaning
finding?—The
provide
studies,
Язык: Английский
Malnutrition exacerbating neuropsychiatric symptoms on the Alzheimer's continuum is relevant to the cAMP signaling pathway: Human and mouse studies
Alzheimer s & Dementia,
Год журнала:
2025,
Номер
unknown
Опубликована: Янв. 27, 2025
Abstract
INTRODUCTION
Malnutrition
correlates
with
neuropsychiatric
symptoms
(NPSs)
in
Alzheimer's
disease
(AD);
however,
the
potential
mechanism
underlying
this
association
remains
unclear.
METHODS
Baseline
and
longitudinal
associations
of
nutritional
status
NPSs
were
analyzed
374
patients
on
AD
continuum
61
healthy
controls.
Serum
biomarkers,
behavioral
tests,
cerebral
neurotransmitters,
differentially
gene
expression
evaluated
standard
malnourished
diet–fed
transgenic
APPswe/PSEN1dE9
(APP/PS1)
mice.
RESULTS
Poor
increased
blood
flow
midbrain
striatum
associated
severe
general
subtypes,
especially
depression,
anxiety,
apathy.
APP/PS1
mice
fed
a
diet
showed
poor
status,
depression‐
anxiety‐like
behaviors,
altered
neurotransmitter
levels,
downregulated
c‐Fos
striatum;
these
suppressed
cyclic
adenosine
monophosphate
(cAMP)
signaling
pathway.
DISCUSSION
exacerbating
is
relevant
to
cAMP
pathway
striatum,
suggesting
for
targeted
interventions
mitigate
continuum.
Highlights
linked
specific
symptom
(NPS)
deterioration.
affects
NPSs,
usually
involving
striatum.
Malnourished
induces
behaviors
exacerbates
Язык: Английский
Drug-induced dementia: a real-world pharmacovigilance study using the FDA Adverse Event Reporting System database
Therapeutic Advances in Neurological Disorders,
Год журнала:
2025,
Номер
18
Опубликована: Янв. 1, 2025
Dementia
is
a
serious
adverse
event
(AE)
that
requires
attention
in
clinical
practice.
However,
information
on
drug-induced
dementia
limited.
The
U.S.
FDA
Adverse
Event
Reporting
System
(FAERS)
serves
as
an
important
resource
for
identifying
real-world
drug
reactions
and
safety
signals.
This
study
aimed
to
use
FAERS
data
identify
drugs
associated
with
increased
risk.
A
secondary
analysis
of
the
database
was
conducted
using
disproportionality
methods.
We
reviewed
dementia-related
reports
from
first
quarter
2004
fourth
2023,
used
Medical
Dictionary
Regulatory
Activity
cases
summarized
corresponding
list
potential
medications,
counted
dementia-causing
medication
classes
highest
frequency
reports,
disaggregated
all
medications.
identified
31,881
AEs
database,
increasing
trend
over
time,
particularly
among
females
individuals
65.
Apixaban
had
most
(1631).
Disproportionality
analyses
revealed
rivastigmine,
nicergoline,
aducanumab,
amlodipine/atorvastatin,
dihydroergometrine
risk,
based
reporting
odds
ratio,
proportional
component.
Only
valproate
tramadol
top
50
included
risk
their
package
inserts.
medications
many
which
lack
warnings
labels.
Increased
monitoring
necessary
high-risk
individuals,
further
research
required
clarify
these
associations
improve
patient
safety.
Язык: Английский
Escitalopram for agitation in Alzheimer’s dementia: a randomized controlled phase 3 trial
Nature Medicine,
Год журнала:
2025,
Номер
unknown
Опубликована: Март 25, 2025
Язык: Английский
Neuropsychiatric presentations of common dementia syndromes: A concise review for primary care team members
Journal of the American Geriatrics Society,
Год журнала:
2024,
Номер
unknown
Опубликована: Окт. 10, 2024
Abstract
Dementia
is
a
syndrome
characterized
by
cognitive
changes
which
interfere
with
daily
functioning.
Neuropsychiatric
symptoms
(NPS)
are
also
pervasive
and
may
even
occur
prior
to
any
noticeable
decline.
Still,
NPS
less
associated
the
early
stages
of
disease
course,
despite
mounting
research
evidence
that
present
often
in
several
dementia
syndromes,
absence
decline
(i.e.,
mild
behavioral
impairment
[MBI]).
Primary
care
teams
at
forefront
care,
yet
they
frequently
report
insufficient
training
diagnosis
management.
This
poses
serious
problem
considering
timely
critical
for
optimal
outcomes
maximum
efficacy
intervention.
We
provide
concise
narrative
review
four
syndromes
(Alzheimer's
disease,
vascular
dementia,
Lewy
bodies,
variant
frontotemporal
dementia)
their
neuropsychiatric
presentations,
as
well
at‐a‐glance
clinical
guides,
help
primary
team
members
recognize
possible
prodromal
neurodegenerative
prompt
further
workup.
next
steps
management
MBI
members.
As
evidenced
profiles
these
subacute
new
onset
psychiatric
an
older
adult
should
consideration
emerging
process
workup
such,
Язык: Английский
Efficacy of therapeutic intervention with NanoBEO to manage agitation and pain in patients suffering from severe dementia: a pilot clinical trial
Frontiers in Pharmacology,
Год журнала:
2024,
Номер
15
Опубликована: Авг. 1, 2024
Background
An
estimated
57.4
million
people
live
with
dementia
worldwide,
the
social
burden
of
disease
steadily
growing.
Despite
approval
lecanemab
and
ongoing
trials,
there
is
still
a
lack
effective
safe
treatments
for
behavioral
psychological
symptoms
(BPSD),
which
affect
99%
patients.
Agitation
one
most
disabling
BPSD,
cross-sectional
prevalence
≥50%
in
nursing
homes,
refers
to
help-seeking
behavior
response
various
sources
discomfort,
among
pain
crucial
component.
Methods
This
pilot
phase
BRAINAID
(NCT04321889)
trial
aimed
assess
effectiveness
patented
nanotechnological
device
NanoBEO
older
(≥65
years)
severe
dementia.
randomized
placebo-controlled
trial,
quadruple
masking
that
involved
all
operators
participants,
followed
SPIRIT
CONSORT
statements.
A
total
29
patients
completed
trial.
The
were
randomly
allocated
1:1
ratio
or
placebo
group,
corresponding
product
was
applied
on
both
arms
once
daily
4
weeks,
4-week
follow-up
period.
primary
endpoint
efficacy
against
agitation.
secondary
endpoints
agitation
at
pain.
Any
adverse
events
reported,
biochemical
analyses
performed.
Results
intervention
reduced
frequency
(28%)
level
disruptiveness
agitated
behaviors.
effect
statistically
significant
after
2
weeks
treatment.
behaviors
lasted
entire
treatment
No
additional
psychotropic
drugs
prescribed
throughout
study
duration.
results
1
week
demonstrated
had
analgesic
(45.46%
improvement
intensity).
well
tolerated.
Discussion
investigated
therapy
managing
need
rescue
medications
recorded,
strengthening
prolonged
advanced-stage
usefulness
deprescription
potentially
harmful
drugs.
provided
robust
rationale
application
subsequent
large-scale
pivotal
allow
clinical
translation
product.
Clinical
Trial
Registration:
ClinicalTrials.gov
,
identifier
NCT04321889.
Язык: Английский
Clinical and Market Analysis of NanoBEO: A Public-Worth, Innovative Therapy for Behavioral and Psychological Symptoms of Dementia (BPSD)—Emerging Evidence and Its Implications for a Health Technology Assessment (HTA) and Decision-Making in National Health Systems
Pharmaceutics,
Год журнала:
2024,
Номер
16(10), С. 1253 - 1253
Опубликована: Сен. 27, 2024
According
to
scientific
literature,
some
99%
of
patients
affected
by
Alzheimer's
disease
(AD)
suffer
from
behavioral
and
psychological
symptoms
dementia
(BPSD),
also
known
as
neuropsychiatric
(NPSs).
In
particular,
agitation
is
one
the
most
difficult
disorders
treat.
States
represent
a
very
serious
problem
they
make
these
subjects
dangerous
for
themselves
others
worsen
advances.
To
date,
there
are
no
specific
solutions
treating
agitation.
The
only
authorized
drug
risperidone
(as
well
brexpiprazole,
approved
FDA
on
11
May
2023),
which
can
be
used
longer
than
6-12
weeks
because
it
increases
risk
death-owing
cardiocerebrovascular
accidents-by
1.6-1.7
times.
Язык: Английский
A critical review of brexpiprazole oral tablets as the first drug approved to treat agitation symptoms associated with dementia due to Alzheimer’s disease
Expert Review of Neurotherapeutics,
Год журнала:
2024,
Номер
unknown, С. 1 - 9
Опубликована: Сен. 29, 2024
Agitation
is
a
common
and
disruptive
syndrome
in
dementia
due
to
Alzheimer's
disease
(AD).
Brexpiprazole
was
recently
approved
for
this
agitation
of
AD
the
only
therapy
indication.
Язык: Английский
Sativex (Nabiximols) for the treatment of Agitation & Aggression in Alzheimer’s Dementia in UK nursing homes (STAND): a randomised, double-blind, placebo-controlled feasibility trial
medRxiv (Cold Spring Harbor Laboratory),
Год журнала:
2024,
Номер
unknown
Опубликована: Дек. 20, 2024
Abstract
Background
Alzheimer’s
Disease
(AD)
patients
often
experience
clinically
significant
agitation,
leading
to
distress,
increased
healthcare
costs,
and
earlier
institutionalisation.
Current
treatments
have
limited
efficacy
side
effects.
Cannabinoid-based
therapies,
such
as
the
nabiximols
oral
spray
(brand
name:
Sativex®;
1:1
delta-9-tetrahydrocannabinol
(THC)
cannabidiol
(CBD)),
offer
potential
alternatives.
Methods
The
‘Sativex®
for
Agitation
&
Aggression
in
Dementia’
(STAND)
trial
was
a
randomised,
double-blind,
placebo-controlled,
feasibility
study
conducted
UK
care
homes.
Participants
with
probable
AD
agitation
were
randomised
receive
placebo
or
4
weeks
on
an
up-titrated
schedule,
followed
by
4-week
observation
period.
This
is
registered
ISRCTN
7163562
.
Findings
Between
October
2021
June
2022,
53
candidates
assessed;
29
met
eligibility
criteria
randomised.
No
participants
withdrew,
adherence
high,
generally
feasible
deliver.
intervention
well
tolerated,
no
safety
concerns
reported.
Interpretation
Despite
COVID-19
pandemic
related
challenges,
administering
advanced
demonstrated
safety.
Although
statistically
treatment
effects
observed,
indications
of
positive
clinical
noted.
These
findings
support
further
investigation
into
cannabinoid-based
therapies
AD.
Язык: Английский
Unraveling the clinical–pathological correlations of subjects with isolated and mixed neurodegenerative processes in the National Alzheimer’s Coordinating Center dataset
Journal of Neuropathology & Experimental Neurology,
Год журнала:
2024,
Номер
unknown
Опубликована: Дек. 27, 2024
Abstract
Although
Alzheimer
disease
neuropathologic
change
(ADNC)
is
the
most
common
pathology
underlying
clinical
dementia,
presence
of
multiple
comorbid
neuropathologies
increasingly
being
recognized
as
a
major
contributor
to
worldwide
dementia
burden.
We
analyzed
1051
subjects
with
specific
combinations
isolated
and
mixed
pathologies
conducted
multivariate
logistic
regression
analysis
on
cohort
4624
cases
systematically
explore
independent
cognitive
contributions
each
pathology.
limbic-predominant
age-related
TDP-43
encephalopathy
(LATE-NC)
were
both
associated
primary
diagnosis
(AD)
characterized
by
an
amnestic
phenotype,
while
only
ADNC
logopenic
variant
progressive
aphasia
(PPA).
In
LATE-NC,
Lewy
body
disease,
and/or
cerebrovascular
phenotype
was
usually
diagnosed
during
life
“Probable
AD.”
Conversely,
combination
frontotemporal
lobar
degeneration
TDP-43,
supranuclear
palsy
(PSP),
or
corticobasal
(CBD)
resulted
in
picture,
variable
features
PPA
subtypes,
behavioral
FTD,
PSP
syndrome,
CBD
syndrome.
These
findings
elucidate
cumulative
effects
provide
insights
into
interactions
between
neurodegenerative
contributing
variety
presentations.
Язык: Английский