Neuropsychiatric Symptoms of Alzheimer's Disease in Down Syndrome and Its Impact on Caregiver Distress

Author(s):Show less -

Fonseca, Luciana Mascarenhas ^{[1, 2]} ; Mattar, Guilherme Prado ^[2] ; Haddad, Glenda Guerra ^[2] ; Burduli, Ekaterina ^[3] ; McPherson, Sterling M. ^[1] ; de Figueiredo Ferreira Guilhoto, Laura Maria ^[4] ; Yassuda, Monica Sanches ^[5] ; Busatto, Geraldo Filho ^{[2, 6]} ; Bottino, Cassio Machado de Campos ^[2] ; Hoexter, Marcelo Queiroz ^[7] ; Chaytor, Naomi Sage ^[1]

Affiliation

^[1] Washington State Univ, Dept Med Educ & Clin Sci, Spokane, WA 99202 - USA

^[2] Univ Sao Paulo, Dept & Inst Psychiat, Old Age Res Grp, Programa Terceira Idade PROTER, Sch Med, Sao Paulo - Brazil

^[3] Washington State Univ, Coll Nursing, Spokane, WA 99202 - USA

^[4] Inst Jo Clemente, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Sch Arts Sci & Humanities, Sao Paulo - Brazil

^[6] Univ Sao Paulo Sch Med, Dept & Inst Psychiat, Lab Neuroimagem Psiquiatria LIM21, Lab Psychiat Neuroimaging, Sao Paulo - Brazil

^[7] Univ Sao Paulo, Projeto Transtornos Espectro Obsess Compuls PROTO, Obsess Compuls Spectrum Disorders Program, Dept & Inst Psychiat, Sch Med, Sao Paulo - Brazil

• Document type: Journal article
• Source: JOURNAL OF ALZHEIMER'S DISEASE; v. 81, n. 1, p. 137-154, 2021.
• Web of Science Citations: 0

Abstract

Background: Neuropsychiatric symptoms (NPS) are non-cognitive manifestations common to dementia and other medical conditions, with important consequences for the patient, caregivers, and society. Studies investigating NPS in individuals with Down syndrome (DS) and dementia are scarce. Objective: Characterize NPS and caregiver distress among adults with DS using the Neuropsychiatric Inventory (NPI). Methods: We evaluated 92 individuals with DS (>= 30 years of age), divided by clinical diagnosis: stable cognition, prodromal dementia, and AD. Diagnosis was determined by a psychiatrist using the Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and Others with Intellectual Disabilities (CAMDEX-DS). NPS and caregiver distress were evaluated by an independent psychiatrist using the NPI, and participants underwent a neuropsychological assessment with Cambridge Cognitive Examination (CAMCOG-DS). Results: Symptom severity differed between-groups for delusion, agitation, apathy, aberrant motor behavior, nighttime behavior disturbance, and total NPI scores, with NPS total score being found to be a predictor of AD in comparison to stable cognition (OR for one-point increase in the NPI = 1.342, p = 0.012). Agitation, apathy, nighttime behavior disturbances, and total NPI were associated with CAMCOG-DS, and 62% of caregivers of individuals with AD reported severe distress related to NPS. Caregiver distress was most impacted by symptoms of apathy followed by nighttime behavior, appetite/eating abnormalities, anxiety, irritability, disinhibition, and depression (R-2 = 0.627, F(15,76) = 8.510, p < 0.001). Conclusion: NPS are frequent and severe in individuals with DS and AD, contributing to caregiver distress. NPS in DS must be considered of critical relevance demanding management and treatment. Further studies are warranted to understand the biological underpinnings of such symptoms. (AU)

• FAPESP's process: 16/22123-5 - Proposal of research internship on dementia, Down syndrome and neuroimage at Department of Psychiatry of University of Cambridge
• Grantee: Luciana Mascarenhas Fonseca
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate (Direct)