Cognitive and Neuropsychiatric Symptom Differences in Early Stages of Alzheimer’s Disease: Kuopio ALSOVA Study

Hallikainen, Ilona; Koivisto, Anne M.; Paajanen, Teemu; Hiltunen, Asta; Karppi, Pertti; Vanhanen, Matti; Välimäki, Tarja; Herukka, Sanna‐Kaisa; Hänninen, Tuomo

doi:10.1159/000338231

Cited by 15 publications

(16 citation statements)

References 73 publications

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“…This study utilized data collected as part of the ALSOVA study, a prospective, five year, rehabilitation study, conducted by the Department of Neurology, University of Eastern Finland [ 3 , 18 ]. The primary aim of the ALSOVA study was to evaluate whether an early psychosocial rehabilitation intervention, combining education and support for persons with very mild (Clinical dementia rating, CDR 0.5) or mild (CDR 1) AD and their caregivers, could postpone institutionalization of the person with AD.…”

Section: Methodsmentioning

confidence: 99%

Depressive Symptoms Are Associated with Analgesic Use in People with Alzheimer’s Disease: Kuopio ALSOVA Study

Gilmartin¹,

Väätäinen

Törmälehto

et al. 2015

PLoS ONE

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Neuropsychiatric symptoms of Alzheimer’s disease (AD) such as depression may be associated with pain, which according to the literature may be inadequately recognized and managed in this population. This study aimed to identify the factors associated with analgesic use in persons with AD; in particular, how AD severity, functional status, neuropsychiatric symptoms of AD, co-morbidities and somatic symptoms are associated with analgesic use. 236 community-dwelling persons with very mild or mild AD at baseline, and their caregivers, were interviewed over five years as part of the prospective ALSOVA study. Generalized Estimating Equations (GEEs) were used to estimate unadjusted and adjusted odds ratios (ORs) for the factors associated with analgesic use over a five year follow-up. The proportion of persons with AD using any analgesic was low (13.6%) at baseline and remained relatively constant during the follow-up (15.3% at Year 5). Over time, the most prevalent analgesic changed from non-steroidal anti-inflammatories (8.1% of persons with AD at Year 1) to acetaminophen (11.1% at Year 5). Depressive symptoms (measured by the Beck Depression Inventory, BDI) were independently associated with analgesic use, after effects of age, gender, education, AD severity, comorbidities and somatic symptoms were taken into account. For every one unit increase in BDI, the odds of analgesic use increased by 4% (OR = 1.04, 95% confidence interval CI = 1.02-1.07). Caregiver depressive symptoms were not statistically significantly associated with analgesic use of the person with AD. Depressive symptoms were significantly associated with analgesic use during the five year follow-up period. Possible explanations warranting investigation are that persons with AD may express depressive symptoms as painful somatic complaints, or untreated pain may cause depressive symptoms. Greater awareness of the association between depressive symptoms and analgesic use may lead to safer and more effective prescribing for these conditions.

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Section: Methodsmentioning

confidence: 99%

Depressive Symptoms Are Associated with Analgesic Use in People with Alzheimer’s Disease: Kuopio ALSOVA Study

Gilmartin¹,

Väätäinen

Törmälehto

et al. 2015

PLoS ONE

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“…Although all studies assessed mild dementia, some studies were more precise in their categorisations and included only an MMSE range of 18À23 (Hodges & Patterson, 1995;. However, some studies included scores ranging from 18 to 30 (Jones, Livner, & Backman, 2006) or from 16 to 30 (excluded from this review: Hallikainen et al, 2012). A large spectrum of cognitive deficit can influence the results, because some PwD are affected to a greater degree than others.…”

Section: Aging and Mental Health 13mentioning

confidence: 99%

Understanding the cognitive underpinnings of functional impairments in early dementia: a review

Giebel

Challis

Montaldi

2015

Aging & Mental Health

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“…In addition, NPS such as depression, apathy, and agitation seem to already be common in early stages of AD and can have an impact on the well-being of both patients and caregivers. Cognitive performance has been consistently associated with functional ability 38. In cognitive impairment and dementia, both functional ability and behavior are significantly correlated with caregiver burden, although the strength of association is more than two times higher for behavioral changes 39…”

Section: Nps In Dementia Stages Of Alzheimer’s Disease and Frontotempmentioning

confidence: 99%

Behavioral symptoms related to cognitive impairment

Dillon¹,

Serrano²,

Castro³

et al. 2013

NDT

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Neuropsychiatric symptoms (NPS) are core features of Alzheimer’s disease and related dementias. On one hand, behavioral symptoms in patients with mild cognitive impairment (MCI) can indicate an increased risk of progressing to dementia. On the other hand, mild behavioral impairment (MBI) in patients who usually have normal cognition indicates an increased risk of developing dementia. Whatever the cause, all dementias carry a high rate of NPI. These symptoms can be observed at any stage of the disease, may fluctuate over its course, are a leading cause of stress and overload for caregivers, and increase rates of hospitalization and early institutionalization for patients with dementia. The clinician should be able to promptly recognize NPI through the use of instruments capable of measuring their frequency and severity to support diagnosis, and to help monitor the treatment of behavioral symptoms. The aims of this review are to describe and update the construct ‘MBI’ and to revise the reported NPS related to prodromal stages of dementia (MCI and MBI) and dementia stages of Alzheimer’s disease and frontotemporal lobar degeneration.

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Cognitive and Neuropsychiatric Symptom Differences in Early Stages of Alzheimer’s Disease: Kuopio ALSOVA Study

Cited by 15 publications

References 73 publications

Depressive Symptoms Are Associated with Analgesic Use in People with Alzheimer’s Disease: Kuopio ALSOVA Study

Depressive Symptoms Are Associated with Analgesic Use in People with Alzheimer’s Disease: Kuopio ALSOVA Study

Understanding the cognitive underpinnings of functional impairments in early dementia: a review

Behavioral symptoms related to cognitive impairment

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