Behavioral and Psychological Symptoms of Dementia in Different Dementia Disorders: A Large-Scale Study of 10,000 Individuals

Schwertner, Emilia; Pereira, Joana B.; Xu, Hong; Sečník, Juraj; Winblad, Bengt; Eriksdotter, Maria; Nägga, Katarina; Religa, Dorota

doi:10.3233/jad-215198

Cited by 64 publications

(42 citation statements)

References 53 publications

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“…A Swedish registry study on cognitive disorders and dementia revealed that individuals with VaD had a higher risk of apathy, but a lower risk of agitation or aggression, anxiety, and aberrant motor behavior. Agitation and aggression are more relevant to mixed-type dementia than to VaD [ 86 ]. A study conducted at three major medical centers in Taiwan enrolled 97 patients with BPSD.…”

Section: Resultsmentioning

confidence: 99%

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Clinical Trials of New Drugs for Vascular Cognitive Impairment and Vascular Dementia

Linh

Hsieh

Huang

et al. 2022

IJMS

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Population aging has challenged the treatment of cognitive impairment or dementia. Vascular dementia is the second leading cause of dementia after Alzheimer’s disease. Cognitive consequences after ischemic brain injury have been recognized as a preferred target for therapeutic strategies, prompting the search for potential agents. The keyword “vascular dementia” was used to search ClinicalTrials.gov to determine agents represented in phases I, II, III, and IV. The agents were classified on the basis of their mechanisms. Of the 17 randomized controlled trials meeting our inclusion criteria, 9 were completed in the past 10 years, and 8 are ongoing or in the planning stages. We also identified one trial in phase I, nine in phase II, six in phase III, and one in phase IV. Fewer trials of new drugs for improving cognition or ameliorating the behavioral and psychological symptoms of dementia target vascular dementia than Alzheimer’s dementia. Drug trials on vascular dementia overlap with drug trials targeting functional outcomes in cerebrovascular disease. International pharmaceutical companies’ investment in new drugs targeting VCI and vascular dementia remains insufficient.

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Section: Resultsmentioning

confidence: 99%

“…Sodium benzoate treatment improved cognitive function (in terms of ADAS-cog scores) only in women with later-phase dementia (15). Sodium benzoate exerted antipsychotic properties in patients with schizophrenia [ 86 ]. However, it did not mitigate psychotic symptoms in patients with dementia.…”

Section: Resultsmentioning

confidence: 99%

Clinical Trials of New Drugs for Vascular Cognitive Impairment and Vascular Dementia

Linh

Hsieh

Huang

et al. 2022

IJMS

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“…Although dementia is defined largely by memory and cognitive decline which results in the loss of the ability to function independently, behavioral and psychological symptoms in dementia (BPSD) play a large role in a patient's overall functional level [1]. Significant BPSD are more the rule than the exception, as >90% of people with dementia develop BPSD during the disease course [2,3]. BPSD encompass a wide array of symptoms and include aggression, agitation, hyperactivity, compulsions, disinhibition, anxiety, depression and dysphoria, euphoria delusions, and hallucinations.…”

Section: Introductionmentioning

confidence: 99%

Unique Transcriptional Signatures Correlate with Behavioral and Psychological Symptom Domains in Alzheimer’s Disease

Dong¹,

Fisher²,

Dunn³

et al. 2023

Preprint

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Despite the significant burden, cost, and worse prognosis of Alzheimer’s Disease (AD) with Behavioral and Psychological Symptoms of Dementia (BPSD), little is known about the molecular causes of these symptoms. Using antemortem assessments of BPSD in AD, we demonstrate that individual BPSD can be grouped into 4 domain factors in our sample: Affective, Apathy, Agitation, and Psychosis. Then, we performed a transcriptome-wide analysis for each domain utilizing bulk RNA-seq of post-mortem Anterior Cingulate Cortex (ACC) tissue. Though all 4 domains are associated with a predominantly downregulated pattern of hundreds of DEGs, most DEGs are unique to each domain, with only 22 DEGs being common to all BPSD domains, including TIMP1. Weighted Gene Co-Expression Network Analysis (WGCNA) yielded multiple transcriptional modules that were shared between BPSD domains or unique to each domain, and NetDecoder was used to analyze context-dependent information flow through the biological network. For the agitation domain, we found that all DEGs and a highly correlated transcriptional module were functionally enriched for ECM-related genes including TIMP1, TAGLN, and FLNA. Another unique transcriptional module also associated with the agitation domain was enriched with genes involved in post-synaptic signaling, including DRD1, PDE1B, CAMK4, and GABRA4. By comparing context-dependent changes in DEGs between cases and control networks, ESR1 and PARK2 were implicated as two high impact genes associated with agitation that mediated significant information flow through the biological network. Overall, our work establishes unique targets for future study of the biological mechanisms of BPSD and resultant drug development.

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“…Unfortunately, it has been found that a surprising number of individuals living with dementia do not receive any post-diagnosis support beyond the information they received at diagnosis (2). Indeed, in addition to the symptom of cognitive decline, individuals with dementia frequently manifest behavioral and psychological disturbances like agitation, depression, anxiety, apathy, and delusions, among others (3)(4)(5). It is estimated that 80-90% of patients with dementia develop behavioral and psychological symptoms of dementia (BPSD) during their illness (6).…”

Section: Introduction Rationalementioning

confidence: 99%

Non-pharmacological interventions for behavioral and psychological symptoms of dementia: A systematic review and network meta-analysis protocol

Yin

Zhang

et al. 2022

Front. Psychiatry

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IntroductionDementia patients often experience behavioral and psychological symptoms (BPSD), which severely affect their quality of life and activities of daily living. Non-pharmacological interventions are effective in treating BPSD, according to multiple clinical trials and systematic reviews. However, the optimal non-pharmacological treatment remains controversial. Therefore, the study aims to evaluate and compare multiple non-pharmacological methods for treating BPSD in order to identify the optimal non-pharmacological intervention.ObjectiveThis study aims to perform a systematic review and network meta-analysis of evidence on non-pharmacological interventions in the treatment of BPSD, which may potentially guide future research and clinical decisions.MethodsIn order to select potentially relevant randomized controlled trials (RCTs), 10 academic databases and 3 clinical trial registries will be systematically searched from inception until the 1 October 2022. Two researchers will independently extract information from eligible articles. The primary outcome is the severity of BPSD. Herein, Pairwise and Bayesian network meta-analyses will be conducted utilizing STATA 15.0 and ADDIS 1.16.8. Evidence quality will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).ResultsResults from this study will be published in peer-reviewed journals or conference reports.DiscussionIn this study, we aim to comparatively assess the efficacy of various non-pharmacological treatments for BPSD. Findings from this review will help clinicians to make evidence-based treatment decisions.Systematic review registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42022352095].

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Behavioral and Psychological Symptoms of Dementia in Different Dementia Disorders: A Large-Scale Study of 10,000 Individuals

Cited by 64 publications

References 53 publications

Clinical Trials of New Drugs for Vascular Cognitive Impairment and Vascular Dementia

Clinical Trials of New Drugs for Vascular Cognitive Impairment and Vascular Dementia

Unique Transcriptional Signatures Correlate with Behavioral and Psychological Symptom Domains in Alzheimer’s Disease

Non-pharmacological interventions for behavioral and psychological symptoms of dementia: A systematic review and network meta-analysis protocol

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