Behavioral and Psychological Symptoms in Alzheimer’s Disease

Li, Xiaoling; Hu, Nan; Tan, Meng-Shan; Yu, Jin‐Tai; Tan, Lei

doi:10.1155/2014/927804

Cited by 91 publications

(62 citation statements)

References 106 publications

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“…With progressive cognitive and functional decline in AD dementia, the presence of NPS is postulated to represent increased neurodegradation across neural systems. [2][3][4][5] Such NPS have been associated with worse prognosis, accelerated illness progression, increased use of services, and earlier institutionalization. 2 However, variable neuropsychiatric measures and clinical definitions have clouded the true incidence and progression of NPS in patients with AD.…”

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confidence: 99%

“…Overall, they suggest that depression may be a modest risk factor for patients with preclinical dementia. 4,5 Although we used a large sample and frequency matching to minimize confounding variables and adequately detect significant differences between the 2 groups, there remain limitations to the study. The vast majority of participants who developed CDR .0 will exhibit pathology consistent with AD.…”

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confidence: 99%

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“Noncognitive” symptoms of early Alzheimer disease

Masters¹,

Morris²,

Roe³

2015

Neurology

169

117

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Objectives: To observe the natural time course of noncognitive symptoms before the onset of symptomatic Alzheimer disease dementia.Methods: Using the National Alzheimer's Coordinating Center Uniform Data Set from September 2005 to March 2013, data from cognitively normal individuals who were aged 50 years or older at first visit and had subsequent follow-up were analyzed. Survival analyses were used to examine the development of particular symptoms relative to each other on the Neuropsychiatric Inventory Questionnaire (NPI-Q), Functional Activities Questionnaire, and Geriatric Depression Scale, and to compare the development of individual symptoms for persons who did and did not receive a Clinical Dementia Rating (CDR) .0 (indicating abnormal cognition) during the follow-up period.Results: The order of symptom occurrence on the NPI-Q was similar for participants who remained at CDR 0 and for those who received a CDR .0 over the follow-up period, although the time to most NPI-Q symptoms was faster for participants who received a CDR .0 (p , 0.001). With the exception of memory, Geriatric Depression Scale symptoms reported by both CDR groups were similar. Conclusions:We found a significantly earlier presence of positive symptoms on the NPI-Q in cognitively normal patients who subsequently developed CDR .0. Among participants with no depression symptoms at baseline, results suggest that depressive symptoms may increase with aging regardless of incipient dementia. Such findings begin to delineate the noncognitive course of Alzheimer disease dementia in the preclinical stages. Future research must further elucidate the correlation between noncognitive changes and distinct dementia subtypes. The natural course of Alzheimer disease (AD) dementia includes hallmark functional and behavioral deficits in addition to cognitive decline. Alternately termed behavioral and psychological symptoms in dementia or neuropsychiatric symptoms (NPS), this heterogeneous array of noncognitive impairment affects an estimated 90% of patients with AD.1 Earlier studies have shown that with advancing cognitive decline in AD dementia, noncognitive symptoms include apathy, depression, agitation, and aggression, to psychosis. With progressive cognitive and functional decline in AD dementia, the presence of NPS is postulated to represent increased neurodegradation across neural systems.2-5 Such NPS have been associated with worse prognosis, accelerated illness progression, increased use of services, and earlier institutionalization.2 However, variable neuropsychiatric measures and clinical definitions have clouded the true incidence and progression of NPS in patients with AD.While noncognitive outcomes of AD after incident dementia are increasingly characterized, the relative time course of behavioral and functional deficits before onset of cognitive impairment in AD dementia has been rarely studied. Here, we examined the time course of noncognitive symptoms reported on the Functional Activities Questionnaire (FAQ), 6 Geriatric Depression

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confidence: 99%

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confidence: 99%

“Noncognitive” symptoms of early Alzheimer disease

Masters¹,

Morris²,

Roe³

2015

Neurology

169

117

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“…Therefore, it is wise to consider the repetitive pattern of such behavioural problems, which may indicate the underlying neurological discrepancies. Thus, early behavioural typing is recommended for the timely diagnosis or monitoring of the disease condition [135].…”

Section: Necessity Of Behavioural Typing For Neurological Disease Diamentioning

confidence: 99%

Neurochemicals, Behaviours and Psychiatric Perspectives of Neurological Diseases

Choudhury¹,

Sahu²,

Ramanujam³

et al. 2018

Neuropsychiatry

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Structural changes in different regions of the brain have become clinically relevant and regarded as the signature phenomenon for neurological diseases. Morphological changes in brain are also associated with neuronal and neurochemical alterations. Studies have showed that minute changes in neurochemical levels may have marked impact on the psychobehaviour of the subject. Several neurological disease profiles have been reported with such specific psychobehavioural expression. However, application of behavioural abnormalities as possible disease progress markers has not been considered and emphasised much. Reports suggested that-the subjects, who have already entered into the terminal stage of the disease, used to show cardinal behavioural signs for a specific disease profile. However, psychological expressions are comparatively early expressive. As most of the neurodegenerative disorders are unidirectional and progressive by nature, therapeutic intervention at the right time is essential for attaining the desired outcome. Moreover, early diagnosis can aid in managing the disease progression also. Psychobehavioural analysis could meet the expected outcome of disease diagnosis if implemented properly and timely. In the present review, we have amalgamated the reported behavioural anomalies with the supportive background from neurochemical basis. Further, we have concluded that behaviour centric studies could be a potential diagnostic tool for the early diagnosis of major neurological diseases such as Alzheimer disease, Parkinson's disease, Amyotrophic lateral sclerosis (ALS), Bipolar disorder, Schizophrenia, Impulse control disorder (ICD) and Obsessive-compulsive disorder (OCD).

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“…Despite rigorous research and study, the actual cause and underlying molecular mechanisms of neurodegeneration seems to be equivocal. Globally, Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS), Amyotrophic lateral sclerosis (ALS) are among most common pathological outcomes of neurodegeneration [5][6][7][8]. Besides age and…”

Section: Introductionmentioning

confidence: 99%

Effect and Disease Indicative Role of Inflammation in Neurodegenerative Pathology: A Mechanistic Crosstalk of Promise and Dilemma

Choudhury¹,

Chakraborty²,

Banerjee³

et al. 2018

Neuropsychiatry

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The pathobiology of neuronal cell loss due to various endogenous or exogenous influences is clinically termed as neurodegeneration. Neurodegeneration has been reported to be the major contributor to aging and central nervous system diseases. Apart from aging and endogenous involvement, neurodegeneration also has been reported from viral infection and prion diseases. Studies have shown that, chronic degeneration of neuronal cells initiate the pathology of Alzheimer's disease-the most prevalent neurodegenerative disorder in the world. Similar neurodegenerative pathology is also evident in Parkinson's disease, multiple sclerosis, and Amyotrophic Lateral Sclerosis. Neurodegeneration negatively affects the mental and physical functioning of the patient. Intriguingly, the involvement of inflammation has been linked as the most crucial entity in the mechanistic progress of neurodegeneration. Moreover, recent data also have shown that inflammatory biomarkers can prognosticate the silent progress of neurodegeneration through low-cost diagnostic approach. Mainly, Th17 and MDSCs are the particular immune cells, which have been reported to assist adequately to get a detailed insight into the underlying pathological process in neurodegeneration. Similarly, depression and dementia are also having a crucial association with pro-inflammatory cytokines, which in chronic spectrum indicates the degenerative pathology. Together, available literatures are depicting a direct association between neuroinflammation and neurodegeneration. In the present review, we have summed up all the neuropathologies in light of inflammation and emphasized the possible diagnostic measures by using inflammatory cells and mediators as biomarkers for neurodegenerative diseases.

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Behavioral and Psychological Symptoms in Alzheimer’s Disease

Cited by 91 publications

References 106 publications

“Noncognitive” symptoms of early Alzheimer disease

“Noncognitive” symptoms of early Alzheimer disease

Neurochemicals, Behaviours and Psychiatric Perspectives of Neurological Diseases

Effect and Disease Indicative Role of Inflammation in Neurodegenerative Pathology: A Mechanistic Crosstalk of Promise and Dilemma

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