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Neuropsychiatric symptoms differently affect mild cognitive impairment and Alzheimer's disease patients: a
Eugenia Scaricamazza1, Isabella Colonna2, Giulia Maria Sancesario3
1Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.
Abstract:
Alzheimer's disease (AD) is the most common form of dementia characterized by the prevalent memory impairment. Mild cognitive impairment (MCI) may represent the early stage of AD, in particular when MCI patients show biomarkers consistent with AD pathology (MCI due to AD). Neuropsychiatric symptoms (NPS) frequently affect both MCI and AD patients. Cerebrospinal-fluid (CSF) tau and β-amyloid42 (Aβ42) levels are actually considered the most sensitive and specific biomarkers for AD neurodegeneration. In the present retrospective observational study, we evaluated CSF biomarkers and neuropsychological data (also including NPS measured by the neuropsychiatric inventory-NPI) in a population of patients affected by MCI due to AD compared with mild to moderate AD patients. We documented higher NPI scores in MCI compared with AD patients. In particular, sub-items related to sleep, appetite, irritability, depression, and anxiety were higher in MCI than AD. We also found the significant correlation between NPS and CSF AD biomarkers in the whole population of MCI and AD patients. Consistently, t-tau/Aβ42 ratio correlated with NPS in all the MCI and AD patients. These results suggest the more prevalent occurrence of NPS in MCI patients showing AD pathology and converting to dementia than AD patients. Moreover, a more significant degree of AD neurodegeneration, featured by high t-tau/Aβ42 ratio, correlated with more severe NPS, thus supposing that in MCI and AD patients a more extensive AD neurodegeneration is related to more severe behavioral disturbances.
Insights
Neuropsychiatric symptoms like sleep and mood disturbances are more common in early Alzheimer's disease (AD) stages (MCI due to AD) than in later AD. Higher AD biomarker levels correlate with increased symptom severity.
Area of Science:
- Neuroscience
- Neurology
- Geriatrics
Background:
- Alzheimer's disease (AD) is a leading cause of dementia, marked by memory loss.
- Mild cognitive impairment (MCI) can precede AD, especially with AD biomarkers (MCI due to AD).
- Neuropsychiatric symptoms (NPS) are common in both MCI and AD.
Purpose of the Study:
- To compare NPS and cerebrospinal fluid (CSF) AD biomarkers in MCI due to AD versus mild to moderate AD patients.
- To investigate the relationship between NPS severity and AD neurodegeneration markers.
Main Methods:
- Retrospective observational study.
- Evaluation of CSF tau and β-amyloid42 (Aβ42) levels.
- Neuropsychological testing, including the Neuropsychiatric Inventory (NPI).
Main Results:
- MCI due to AD patients exhibited higher NPI scores than AD patients, particularly for sleep, appetite, irritability, depression, and anxiety.
- Significant correlations were found between NPS and CSF AD biomarkers (t-tau/Aβ42 ratio) in both MCI and AD groups.
- Greater AD neurodegeneration (higher t-tau/Aβ42 ratio) was associated with more severe NPS.
Conclusions:
- NPS are more prevalent in MCI due to AD than in established AD.
- AD neurodegeneration severity is linked to the intensity of behavioral disturbances in MCI and AD patients.