Peijun Chen1,2, Peter D Guarino3,4, Maurice W Dysken5,6, Muralidhar Pallaki7,8, Sanjay Asthana9,10, Maria D Llorente11,12, Susan Love5,6, Julia E Vertrees13, Gerard D Schellenberg14, Mary Sano15,16. 1. 1 Department of Psychiatry, VISN 10 GRECC, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA. 2. 2 Department of Psychiatry, Geriatric Psychiatry Division, Case Western Reserve University School of Medicine, Cleveland, OH, USA. 3. 3 Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, CT, USA. 4. 4 Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. 5. 5 Minneapolis VA Health Care System, Minneapolis, MN, USA. 6. 6 Department of Psychiatry, Minneapolis, University of Minnesota School of Medicine, MN, USA. 7. 7 Department of Medicine, VISN 10 GRECC, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA. 8. 8 Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA. 9. 9 William S. Middleton Memorial Veterans Hospital, Madison, WI, USA. 10. 10 Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. 11. 11 Washington DC VA Medical Center, Washington, DC, USA. 12. 12 Department of Psychiatry, Georgetown University School of Medicine, Washington, DC, USA. 13. 13 VA Cooperative Studies Program Clinical Research Pharmacy Coordinating Center, New Mexico VA Health Care System, Albuquerque, NM, USA. 14. 14 Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. 15. 15 Bronx Veterans Medical Research Center, New York, NY, USA. 16. 16 Alzheimer's Disease Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Abstract
OBJECTIVES: To assess the prevalence of neuropsychiatric symptoms (NPS) in mild-to-moderate Alzheimer disease (AD) and their association with caregiver burden. METHODS: Secondary analyses of baseline data from the Trial of Vitamin E and Memantine in Alzheimer's Disease (TEAM-AD) (N=613). Neuropsychiatric Inventory were used to measure severity of NPS and caregiver activity survey to measure caregiver burden. RESULTS: A total of 87% of patients displayed at least 1 NPS; 70% displayed clinically meaningful NPS. The most common symptoms were apathy (47%), irritability (44%), agitation (42%), and depression (40%). Those with moderate AD had more severe NPS than those with mild AD ( P = .03). Neuropsychiatric symptoms were significantly associated with caregiver time after adjusting for age, education, cognitive function, and comorbidity ( P-value < .0001) with every point increase in NPS associated with a 10-minute increase in caregiver time. CONCLUSION: Neuropsychiatric symptoms were prevalent in both mild and moderate AD, even in patients receiving treatment with an acetylcholinesterase inhibitors, and were more severe in moderate AD and associated with greater caregiver time.
OBJECTIVES: To assess the prevalence of neuropsychiatric symptoms (NPS) in mild-to-moderate Alzheimer disease (AD) and their association with caregiver burden. METHODS: Secondary analyses of baseline data from the Trial of Vitamin E and Memantine in Alzheimer's Disease (TEAM-AD) (N=613). Neuropsychiatric Inventory were used to measure severity of NPS and caregiver activity survey to measure caregiver burden. RESULTS: A total of 87% of patients displayed at least 1 NPS; 70% displayed clinically meaningful NPS. The most common symptoms were apathy (47%), irritability (44%), agitation (42%), and depression (40%). Those with moderate AD had more severe NPS than those with mild AD ( P = .03). Neuropsychiatric symptoms were significantly associated with caregiver time after adjusting for age, education, cognitive function, and comorbidity ( P-value < .0001) with every point increase in NPS associated with a 10-minute increase in caregiver time. CONCLUSION:Neuropsychiatric symptoms were prevalent in both mild and moderate AD, even in patients receiving treatment with an acetylcholinesterase inhibitors, and were more severe in moderate AD and associated with greater caregiver time.
Authors: Christopher H van Dyck; Amy F T Arnsten; Prasad R Padala; Olga Brawman-Mintzer; Alan J Lerner; Anton P Porsteinsson; Roberta W Scherer; Allan I Levey; Nathan Herrmann; Nimra Jamil; Jacobo E Mintzer; Krista L Lanctôt; Paul B Rosenberg Journal: Am J Geriatr Psychiatry Date: 2020-05-05 Impact factor: 4.105