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. 2021 Feb;43(1):213-223.
doi: 10.1007/s11357-020-00304-y. Epub 2021 Jan 9.

Progression of neuropsychiatric symptoms in young-onset versus late-onset Alzheimer's disease

Melisa Gumus  1   2 , Namita Multani  2 , Michael L Mack  3 , Maria Carmela Tartaglia  4   5   6 ; Alzheimer’s Disease Neuroimaging Initiative
Affiliations

Progression of neuropsychiatric symptoms in young-onset versus late-onset Alzheimer's disease

Melisa Gumus et al. Geroscience. 2021 Feb.

Abstract

Young-onset and late-onset Alzheimer's disease has different clinical presentations with late-onset presenting most often with memory deficits while young-onset often presents with a non-amnestic syndrome. However, it is unknown whether there are differences in presentation and progression of neuropsychiatric symptoms in young- versus late-onset Alzheimer's disease. We aimed to investigate differences in the prevalence and severity of neuropsychiatric symptoms in patients with young- and late-onset Alzheimer's disease longitudinally with and without accounting for the effect of medication usage. Sex differences were also considered in these patient groups. We included 126 young-onset and 505 late-onset Alzheimer's disease patients from National Alzheimer's Coordinating Center-Uniform Data Set (NACC-UDS) and Alzheimer's Disease Neuroimaging Initiative (ADNI). We investigated the prevalence and severity of neuropsychiatric symptoms using the Neuropsychiatric Inventory-Questionnaire over 4 visits with 1-year intervals, using a linear mixed-effects model. The prevalence of depression was significantly higher in young-onset than late-onset Alzheimer's disease over a 4-year interval when antidepressant usage was included in our analyses. Our findings suggest that neuropsychiatric symptom profiles of young- and late-onset Alzheimer's disease differ cross-sectionally but also display significant differences in progression.

Keywords: Alzheimer’s disease (AD); Dementia; Late-onset Alzheimer’s disease (LOAD); Neuropsychiatric Inventory–Questionnaire (NPI-Q); Neuropsychiatric symptoms (NPS); Young-onset Alzheimer’s disease (YOAD).

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Prevalence of NPI-Q symptoms in patients with YOAD and LOAD at baseline
Fig. 2
Fig. 2
Prevalence of depression and anxiety in YOAD versus LOAD. Patients with YOAD had higher a depression and b anxiety at the first visit. c The prevalence of depression was not significantly different between YOAD and LOAD males. d Male YOAD patients had significantly higher anxiety than male LOAD. e Female YOAD patients had significantly higher depression than the female LOAD group, but no difference in f Anxiety was observed. Horizontal lines represent 95% confidence intervals
Fig. 3
Fig. 3
Prevalence of NPI-Q symptom in YOAD versus LOAD groups including a depression, b anxiety, c agitation, d hallucinations, e delusions while accounting for medication usage. Comparison of NPI-Q between patients with YOAD versus LOAD for a DEPincANTIDEP, b ANXincANXIOL, c AGIincANTIPSY, d HALincANTIPSY, e DELincANTIPSY. Horizontal lines represent 95% confidence intervals
See this image and copyright information in PMC

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