Neuropsychiatric Symptom Burden across Neurodegenerative Disorders and its Association with Function

Area of Science:

• Neuroscience
• Neurology
• Psychiatry

Background:

• Neuropsychiatric symptoms (NPS) are common in neurodegenerative disorders but their prevalence and functional impact differ across conditions.
• Understanding these variations is crucial for effective patient management and treatment strategies in neurodegenerative diseases.

Purpose of the Study:

• To compare the frequency and severity of NPS across Alzheimer's disease (AD), Cerebrovascular disease (CVD), Parkinson's disease (PD), frontotemporal dementia (FTD), and amyotrophic lateral sclerosis (ALS).
• To investigate the association between NPS burden and functional outcomes (activities of daily living) in these neurodegenerative cohorts.

Main Methods:

• Utilized data from the Ontario Neurodegenerative Disease Research Initiative (ONDRI) including AD, CVD, PD, FTD, and ALS cohorts.
• Compared NPS frequency and severity using generalized estimating equations and ANOVA.
• Assessed the relationship between NPS burden and activities of daily living (ADLs) and instrumental activities of daily living (iADLs) via multivariate linear regression.

Main Results:

• Frontotemporal dementia (FTD) exhibited the highest frequency and severity of NPS compared to all other studied neurodegenerative diseases.
• Significant differences were observed in the association between NPS burden and basic activities of daily living (ADLs) across cohorts, primarily driven by the FTD group.
• No significant differences were found in the association between NPS burden and instrumental activities of daily living (iADLs) across the neurodegenerative disease groups.

Conclusions:

• Neuropsychiatric symptoms are significantly more prevalent and severe in frontotemporal dementia (FTD) than in other common neurodegenerative conditions.
• The relationship between NPS burden and functional impairment varies across neurodegenerative disorders, underscoring the need for tailored clinical interventions.
• Individualized approaches are essential for managing NPS and their functional consequences in patients with diverse neurodegenerative diseases.