Amnestic and non-amnestic symptoms of dementia: An international study of Alzheimer's disease in people with Down's syndrome

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Fonseca, Luciana M. ^{[1, 2, 3]} ; Padilla, Concepcion ^[1] ; Jones, Elizabeth ^[1] ; Neale, Natalie ^[4] ; Haddad, Glenda G. ^[2] ; Mattar, Guilherme P. ^[2] ; Barros, Eriton ^[5] ; Clare, Isabel C. H. ^{[1, 6, 7]} ; Busatto, Geraldo F. ^{[2, 8]} ; Bottino, Cassio M. C. ^[2] ; Hoexter, Marcelo Q. ^[9] ; Holland, Anthony J. ^[1] ; Zaman, Shahid ^{[1, 6]}

Afiliação do(s) autor(es)

^[1] Univ Cambridge, Dept Psychiat, Cambridge - England

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

^[3] Washington State Univ, Dept Med Educ & Clin Sci, Spokane, WA - USA

^[4] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 - USA

^[5] Univ Sao Paulo, Inst Math & Stat, Sao Paulo - Brazil

^[6] Cambridgeshire & Peterborough NHS Fdn Trust, Cambridge - England

^[7] NIHR Appl Res Collaborat East England, Cambridge - England

^[8] Univ Sao Paulo, Dept & Inst Psychiat, Lab Neuroimagem Psiquiatria, Lab Psychiat Neuroimaging, LIM21, Sch Med, Sao Paulo - Brazil

^[9] Univ Sao Paulo, Projeto Transtornos Espectro Obsess Compuls, Obsess Compuls Spectrum Disorders Program, Dept & Inst Psychiat, Sch Med, PROTOC, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY; v. 35, n. 6, p. 650-661, JUN 2020.
• Citações Web of Science: 0

Resumo

The presence of age-related neuropathology characteristic of Alzheimer's disease (AD) in people with Down syndrome (DS) is well-established. However, the early symptoms of dementia may be atypical and appear related to dysfunction of prefrontal circuitry. Objective To characterize the initial informant reported age-related neuropsychiatric symptoms of dementia in people with DS, and their relationship to AD and frontal lobe function. Methods Non-amnestic informant reported symptoms (disinhibition, apathy, and executive dysfunction) and amnestic symptoms from the CAMDEX-DS informant interview were analyzed in a cross-sectional cohort of 162 participants with DS over 30 years of age, divided into three groups: stable cognition, prodromal dementia, and AD. To investigate age-related symptoms prior to evidence of prodromal dementia we stratified the stable cognition group by age. Results Amnestic and non-amnestic symptoms were present before evidence of informant-reported cognitive decline. In those who received the diagnosis of AD, symptoms tended to be more marked. Memory impairments were more marked in the prodromal dementia than the stable cognition group (OR = 35.07; P < .001), as was executive dysfunction (OR = 7.16; P < .001). Disinhibition was greater in the AD than in the prodromal dementia group (OR = 3.54; P = .04). Apathy was more pronounced in the AD than in the stable cognition group (OR = 34.18; P < .001). Conclusion Premorbid amnestic and non-amnestic symptoms as reported by informants increase with the progression to AD. For the formal diagnosis of AD in DS this progression of symptoms needs to be taken into account. An understanding of the unique clinical presentation of DS in AD should inform treatment options. (AU)

• Processo FAPESP: 13/11571-9 - Investigação sobre fatores de risco para declínio cognitivo e demência em adultos com Síndrome de Down e validação do CAMDEX-DS
• Beneficiário: Luciana Mascarenhas Fonseca
• Modalidade de apoio: Bolsas no Brasil - Doutorado Direto
• Processo FAPESP: 16/22123-5 - Proposta de estágio de pesquisa em demência, Síndrome de Down e neuroimagem no Departamento de Psiquiatria da Universidade de Cambridge
• Beneficiário: Luciana Mascarenhas Fonseca
• Modalidade de apoio: Bolsas no Exterior - Estágio de Pesquisa - Doutorado Direto