Baseline neuropsychiatric symptoms and psychotropic medication use midway through data collection of the Longitudinal Early‐ Onset Alzheimer’s Disease Study (LEADS) Cohort
Angelina J Polsinelli, Ryan J Wonderlin, Dustin B. Hammers, Alex Pena Garcia, Ani Eloyan, Alexander Taurone, Maryanne Thangarajah, Laurel Beckett, Sujuan Gao, Sophia Wang, Kala Kirby, Paige E. Logan, Paul S. S Aisen, Jeff L. Dage, Tatiana M. Foroud, Percy Griffin, Leo Iaccarino, Joel H. Kramer, Robert A. Koeppe, Walter A. Kukull, Renaud La Joie, Nidhi S Mundada, Melissa E. Murray, Kelly N. H. Nudelman, David N. Soleimani‐Meigooni, Malia C. Rumbaugh, Arthur W. Toga, Alexandra Touroutoglou, Prashanthi Vemuri, Alireza Atri, Gregory S. Day, Ranjan Duara, Neill R Graff‐Radford, Lawrence S. Honig, David T. Jones, Joseph C. Masdeu, Mario F. Mendez, Erik S. Musiek, Chiadi Onyike, Meghan C. Riddle, Emily J Rogalski, Stephen Salloway, Sharon Sha, Raymond Scott Turner, Thomas S. Wingo, David Wolk, Kyle B. Womack, Maria C. Carrillo, Brad C. Dickerson, Gil D. Rabinovici, Liana G. Apostolova- Psychiatry and Mental health
- Cellular and Molecular Neuroscience
- Geriatrics and Gerontology
- Neurology (clinical)
- Developmental Neuroscience
- Health Policy
- Epidemiology
Abstract
Background
We examined neuropsychiatric symptoms (NPS) and psychotropic medication use at the midway point of data collection of the Longitudinal Early‐onset Alzheimer’s Disease Study (LEADS). We compared amyloid‐positive early‐onset Alzheimer’s disease (EOAD) participants and amyloid‐negative early‐onset non‐Alzheimer’s disease [EOnonAD]) participants across NPS domains and psychotropic medication categories.
Method
282 participants enrolled in LEADS were compared across diagnostic groups – amyloid‐positive EOAD (n = 212) and amyloid‐negative EOnonAD (n = 70). All participants were between ages 40 and 64 at baseline. NPS were measured with the Neuropsychiatric Inventory – Questionnaire (NPI‐Q) and Geriatric Depression Scale – Short Form (GDS‐SF). Medications were categorized into psychotropic category (e.g., antidepressants, antipsychotics, benzodiazepines). Groups were compared on NPI‐Q using binary logistic regression adjusting for sex and disease severity, on GDS‐SF using linear regression adjusting for sex and disease severity, and on psychotropic medication use using Chi square or Fisher’s exact test.
Result
Demographic data are presented in Table 1. Average total NPI‐Q score was higher in EOnonAD than EOAD (p = .002, ŋp 2 = .03). Regardless of diagnostic group, informants endorsed Affective behaviors most frequently (76.2%). EOAD informants endorsed fewer Distress‐Tension behaviors (p = .02, OR = .498) and Impulse Control behaviors (p = .01, OR = .438). EOAD informants also endorsed apathy (p < .001, OR = .316), irritability (p = .02, OR = .498), and disinhibition (p = .04, OR = .476) at lower frequency than EOnonAD. GDS‐SF showed that the EOnonAD participants self‐reported more symptoms of depression than the EOAD group (p = .002, ŋp 2 = .03). (Table 2A). A minority of participants, regardless of diagnostic group, reported psychotropic medication use (35%). There was higher use in EOnonAD (38%) than EOAD (24%) (p = .03, Cohen W = .14) (Table 2B).
Conclusion
NPS burden and psychotropic medication use were higher in EOnonAD than EOAD participants, despite EOnonAD being less severely impaired. LEADS continues to collect data. Future studies will examine etiologies that may be larger drivers of NPS than AD neuropathology, mediators (e.g., race, ethnicity) in the association between NPS and diagnostic group classication, compare NPS in EOAD vs. LOAD, and examine longitudinal changes in neuropsychiatric profiles.