Clinical Manifestations.

Area of Science:

• Neurology
• Neuroscience
• Gerontology

Background:

• Neuropsychiatric symptoms (NPS) are common in Alzheimer's disease (AD), affecting disease progression and quality of life.
• Both AD pathology (amyloid, tau) and TDP-43 neuropathology may contribute to NPS.
• The National Alzheimer's Coordinating Center (NACC) database was utilized to investigate these relationships.

Purpose of the Study:

• To explore the associations between NPS and Alzheimer's disease (AD) pathology.
• To investigate the role of TDP-43 neuropathology in NPS.
• To examine the influence of clinical diagnosis on NPS in the context of neuropathology.

Main Methods:

• Analysis of 1391 participants from the NACC database.
• Utilized logistic and linear regression models to assess associations between NPS, clinical diagnosis, and neuropathology.
• Adjusted for age, sex, education, cognitive scores, and APOE e4 status.

Main Results:

• Clinical diagnosis was consistently associated with various NPS domains.
• Both clinical diagnosis and neuropathology significantly correlated with apathy and delusions.
• Interaction effects between neuropathology and clinical diagnosis were observed for apathy and delusions, with clinical diagnosis also impacting NPS severity.

Conclusions:

• Clinical diagnosis plays a significant role in NPS across multiple domains.
• AD and TDP-43 neuropathology, along with demographic factors, have domain-specific effects on NPS, particularly delusions and apathy.
• Pathology and clinical diagnosis appear to have independent effects on NPS, warranting further longitudinal investigation.