Cognitive correlates of neuropsychiatric syndromes measured over time in patients with Alzheimer's disease
Travis Seidl, Jennifer N
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Previous research has demonstrated an association between the emotional and behavioral symptoms of dementia, known as neuropsychiatric symptoms, and cognitive and functional decline among patients with Alzheimer’s disease (AD). The present study aimed to identify baseline associations, as well as relationships over time, between neuropsychiatric symptoms and cognitive and functional performance. Participants were 288 AD patients enrolled in the Alzheimer’s Disease and Memory Disorders Center (ADMDC) at Baylor College of Medicine. An exploratory factor analysis of a measure of neuropsychiatric symptoms, the Neuropsychiatric Inventory-Questionnaire (NPI-Q), indicated a two-factor structure consisting of Negative/Oppositional and Anxiety/Restlessness factors. At an initial evaluation, regression analyses revealed significant associations between greater total severity of neuropsychiatric symptoms and poorer performance on measures of overall dementia severity, immediate verbal recall, and basic and instrumental activities of daily living (ADLs). Greater severity of Anxiety/Restlessness symptoms was associated with poorer performance on measures of overall dementia severity, executive functioning, visuospatial functioning, and basic and instrumental ADLs. The Negative/Oppositional factor was not related to cognition or functioning. Greater initial neuropsychiatric symptom severity was also associated with worsening overall dementia severity over time. Worsening severity of neuropsychiatric symptoms over time, and particularly worsening of Anxiety/Restlessness symptoms, were related to worsening overall dementia severity over time, as well as a deceleration of overall dementia severity progression. In summary, neuropsychiatric symptoms (particularly Anxiety/Restlessness symptoms) were related to cognition, everyday functioning, and decline over time. Proper assessment and treatment of these symptoms is essential for improving cognition and functioning in AD patients.