Merilee A. Teylan (United States of America)
National Alzheimer's Coordinating Center, University of Washington Department of EpidemiologyAuthor Of 1 Presentation
PSYCHOSIS IN ALZHEIMER’S DISEASE NEUROPATHOLOGY IS ASSOCIATED WITH SPECIFIC BRAIN MRI ATROPHY, COGNITIVE AND NEUROPATHOLOGICAL CHANGES
Abstract
Aims
Psychosis in Alzheimer’s Disease (AD) is prevalent and indicates poor prognosis. However, the neuropathological, cognitive and atrophy patterns underlying these symptoms have not been fully elucidated.
Methods
We studied 154 patients with AD neuropathological change/primary age-related tauopathy (ADNC/PART) and ante-mortem volumetric brain magnetic resonance imaging (MRI). Presence of psychosis was determined using the Neuropsychiatric Inventory Questionnaire. Clinical Dementia Rating Sum-of-boxes (CDR-SB) was longitudinally compared between groups with a follow-up of 3000 days using mixed-effects multiple linear regression. Neuropsychological tests at the time of MRI and brain regional volumes were cross-sectionally compared.
Results
Psychosis was associated with lower age of death, higher longitudinal CDR-SB scores, multi-domain cognitive deficits, neuritic plaque and Lewy Body pathology (LB) and temporal and cingulate regional atrophy. Division according to the presence of LB showed differential patterns of AD-typical pathology, cognitive deficits and regional atrophy.
Conclusions
Psychosis in ADNC/PART is clinically valuable and heterogeneous with subgroup patterns of neuropathology, cognition and regional atrophy. Further research into the underlying pathophysiology may enhance development of targeted therapies.