Elizabeth K Rhodus1, Justin Barber1, Erin L Abner1,2, Shoshana H Bardach1,3, Allison Gibson1,4, Gregory A Jicha1,5,6. 1. Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA. 2. Department of Epidemiology, University of Kentucky, Lexington, KY, USA. 3. Graduate Center for Gerontology, University of Kentucky, Lexington, KY, USA. 4. College of Social Work, University of Kentucky, Lexington, KY, USA. 5. Department of Behavioral Science, University of Kentucky, Lexington, KY, USA. 6. Department of Neurology, University of Kentucky, Lexington, KY, USA.
Abstract
BACKGROUND: Similarities exist in behavioral expression of autism spectrum disorder (ASD) and Alzheimer's disease and related dementias (ADRD). The purpose of this study was to assess presence of behavioral and psychiatric symptoms of dementia (BPSD) and ASD-like behaviors in adults with ADRD. METHODS: Using a cross-sectional design, data from University of Kentucky Alzheimer's Disease Center participant cohort were used. Hierarchical linear regression was used to assess (1) the relationship between ASD-like behaviors (measured by the Gilliam Autism Rating Scale-Second Edition, GARS-2) and BPSD measured by the Neuropsychiatric Inventory (NPI), and (2) the relationship between ASD-like behaviors and dementia severity (measured by the Clinical Dementia Rating [CDR] sum of boxes), when controlling for BPSD. RESULTS: Complete data were available for 142 participants. Using α of 0.05, analyses identified ASD behaviors were significantly associated with BPSD severity ratings (r = 0.47; p < 0.001) and dementia severity (r = 0.46; p < 0.001). GARS-2 explained 6.1% (p < 0.001) of variance in CDR sum of boxes when controlling for NPI and other covariates. DISCUSSION: There is significant overlap in behaviors characteristic of ASD and BPSD as assessed by the NPI and GARS-2, despite the use of these instruments in disparate developmental vs. aging settings. ASD behaviors appear to not be solely present in early childhood as a manifestation of ASD but are also present in older adults with neurodegenerative cognitive impairment. Such associations warrant additional research into causation, assessment, and behavioral interventions to further enable new therapeutic approaches targeting ASD behaviors across the lifespan.
BACKGROUND: Similarities exist in behavioral expression of autism spectrum disorder (ASD) and Alzheimer's disease and related dementias (ADRD). The purpose of this study was to assess presence of behavioral and psychiatric symptoms of dementia (BPSD) and ASD-like behaviors in adults with ADRD. METHODS: Using a cross-sectional design, data from University of Kentucky Alzheimer's Disease Center participant cohort were used. Hierarchical linear regression was used to assess (1) the relationship between ASD-like behaviors (measured by the Gilliam Autism Rating Scale-Second Edition, GARS-2) and BPSD measured by the Neuropsychiatric Inventory (NPI), and (2) the relationship between ASD-like behaviors and dementia severity (measured by the Clinical Dementia Rating [CDR] sum of boxes), when controlling for BPSD. RESULTS: Complete data were available for 142 participants. Using α of 0.05, analyses identified ASD behaviors were significantly associated with BPSD severity ratings (r = 0.47; p < 0.001) and dementia severity (r = 0.46; p < 0.001). GARS-2 explained 6.1% (p < 0.001) of variance in CDR sum of boxes when controlling for NPI and other covariates. DISCUSSION: There is significant overlap in behaviors characteristic of ASD and BPSD as assessed by the NPI and GARS-2, despite the use of these instruments in disparate developmental vs. aging settings. ASD behaviors appear to not be solely present in early childhood as a manifestation of ASD but are also present in older adults with neurodegenerative cognitive impairment. Such associations warrant additional research into causation, assessment, and behavioral interventions to further enable new therapeutic approaches targeting ASD behaviors across the lifespan.
Authors: Frederick A Schmitt; Peter T Nelson; Erin Abner; Stephen Scheff; Gregory A Jicha; Charles Smith; Gregory Cooper; Marta Mendiondo; Deborah D Danner; Linda J Van Eldik; Allison Caban-Holt; Mark A Lovell; Richard J Kryscio Journal: Curr Alzheimer Res Date: 2012-07 Impact factor: 3.498
Authors: Sarah A Khan; Shahida A Khan; A R Narendra; Gohar Mushtaq; Solafa A Zahran; Shahzad Khan; Mohammad A Kamal Journal: CNS Neurol Disord Drug Targets Date: 2016 Impact factor: 4.388
Authors: Abigail Bangerter; Nikolay V Manyakov; David Lewin; Matthew Boice; Andrew Skalkin; Shyla Jagannatha; Meenakshi Chatterjee; Geraldine Dawson; Matthew S Goodwin; Robert Hendren; Bennett Leventhal; Frederick Shic; Seth Ness; Gahan Pandina Journal: JMIR Ment Health Date: 2019-03-26