INS NYC 2024 Program

Poster	Poster Session 06 Program Schedule 02/15/2024 04:00 pm - 05:15 pm Room: Majestic Complex (Posters 61-120) Poster Session 06: Aging \| MCI \| Neurodegenerative Disease - PART 2 Final Abstract #71 Behavioral and Neuropsychiatric Differences Between Two Atypical Alzheimer’s Disease Variants: Posterior Cortical Atrophy and Logopenic Progressive Aphasia Carling Robinson, Mayo Clinic, Rochester, United States Tia Coleman, Mayo Clinic, Rochester, United States Marina Buciuc, Medical University of South Carolina, Charleston, United States Neha Atulkumar Singh, Mayo Clinic, Rochester, United States Nha Trang Thu Pham, Mayo Clinic, Rochester, United States Mary Machulda, Mayo Clinic, Rochester, United States Jonathan Graff-Radford, Mayo Clinic, Rochester, United States Jennifer Whitwell, Mayo Clinic, Rochester, United States Keith Josephs, Mayo Clinic, Rochester, United States Category: Dementia (Alzheimer's Disease) Keyword 1: neuropsychiatry Objective: To characterize the behavioral and neuropsychiatric profiles and activities of daily living (ADLs) in patients with Posterior Cortical Atrophy (PCA) and Logopenic Progressive Aphasia (LPA) and compare presence/absence and severity of symptoms between syndromes. Participants and Methods: The Neurodegenerative Research Group at Mayo Clinic Rochester recruited 78 patients with atypical AD (46 with PCA; 32 with LPA) from 2016 – 2023 as part of a longitudinal study. All patients were evaluated by a behavioral neurologist and met clinical criteria for either PCA or LPA. Patients also completed the Neuropsychiatric Inventory Questionnaire (NPI-Q) and Cambridge Behavioral Inventory-Revised (CBI-R) at baseline and additional visits 1 – 3 years later. Mann-Whitney U and Fisher’s Exact Tests assessed for differences in symptoms between the two syndromes with significance set at p ≤ 0.01. To eliminate demographic differences as confounders, we reanalyzed the groups after matching on age of onset, age at baseline evaluation, and disease duration. We also searched patient medical records for use of anti-depressant, anti-anxiety, anti-psychotic, sleep aid, and anticholinesterase inhibitor medications after the baseline evaluation. Results: PCA patients were younger at age of onset (p=.006), time of baseline evaluation (p=.02), and had longer disease duration (p=.01). Neuropsychiatric symptoms were common in PCA and LPA, although more common and severe in PCA. On the NPI-Q at baseline, the most common symptoms in the PCA group were depression/dysphoria, anxiety, and agitation/aggression, and the most common symptoms in the LPA group were anxiety, depression/dysphoria, and irritability/lability. PCA had higher severity on the NPI-Q total score (p=.01) and depression subscore (p=.01) compared to LPA. Baseline total CBI-R severity scores were also higher in PCA than LPA (p=0.001), with PCA having worse scores in all 10 CBI-R categories. Longitudinally, there was no difference between groups on the NPI-Q. However, on the CBI-R, PCA had faster rates of worsening on self-grooming (p=.01) and self-dressing (p=.01) compared to LPA. All NPI-Q and CBI-R significant differences between PCA and LPA remained in our subsamples that were matched by age and disease duration except NPI-Q depression; restless/agitation; and indifferent to friends/family. In the PCA group, 45.7% were on antidepressants, 28.3% anti-anxiety medications, 21.7% anti-psychotic medications, none taking a sleep aid, and 39.1% were on anti-cholinesterase inhibitors. In the LPA group, 43.8% of patients were taking antidepressants, 46.9% anti-anxiety medications, 18.8% antipsychotic medications, 3.1% sleep aids, and 68.8% anti-cholinesterase inhibitors. There were no significant differences in the proportion of patients taking any of these medications. Conclusions: Behavioral and neuropsychiatric symptoms are common in PCA and LPA although these symptoms are more common and severe in PCA. These findings are clinically relevant given that both PCA and LPA patients experienced neuropsychiatric symptoms which might improve with pharmacological interventions and/or additional modes of therapy that focus on cognitive rehabilitation and adjustment to disability. Further, our results are pertinent to patient care and prognosis given that PCA patients had higher frequencies and severity of depression at baseline and had faster rates of worsening over time on tasks pertaining to self-care which will lead to different care challenges.

Poster

02/15/2024
04:00 pm - 05:15 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 06: Aging | MCI | Neurodegenerative Disease - PART 2

Final Abstract #71

Behavioral and Neuropsychiatric Differences Between Two Atypical Alzheimer’s Disease Variants: Posterior Cortical Atrophy and Logopenic Progressive Aphasia

Carling Robinson, Mayo Clinic, Rochester, United States
Tia Coleman, Mayo Clinic, Rochester, United States
Marina Buciuc, Medical University of South Carolina, Charleston, United States
Neha Atulkumar Singh, Mayo Clinic, Rochester, United States
Nha Trang Thu Pham, Mayo Clinic, Rochester, United States
Mary Machulda, Mayo Clinic, Rochester, United States
Jonathan Graff-Radford, Mayo Clinic, Rochester, United States
Jennifer Whitwell, Mayo Clinic, Rochester, United States
Keith Josephs, Mayo Clinic, Rochester, United States

Category: Dementia (Alzheimer's Disease)

Keyword 1: neuropsychiatry

Objective:

To characterize the behavioral and neuropsychiatric profiles and activities of daily living (ADLs) in patients with Posterior Cortical Atrophy (PCA) and Logopenic Progressive Aphasia (LPA) and compare presence/absence and severity of symptoms between syndromes.

Participants and Methods:

The Neurodegenerative Research Group at Mayo Clinic Rochester recruited 78 patients with atypical AD (46 with PCA; 32 with LPA) from 2016 – 2023 as part of a longitudinal study. All patients were evaluated by a behavioral neurologist and met clinical criteria for either PCA or LPA. Patients also completed the Neuropsychiatric Inventory Questionnaire (NPI-Q) and Cambridge Behavioral Inventory-Revised (CBI-R) at baseline and additional visits 1 – 3 years later. Mann-Whitney U and Fisher’s Exact Tests assessed for differences in symptoms between the two syndromes with significance set at p ≤ 0.01. To eliminate demographic differences as confounders, we reanalyzed the groups after matching on age of onset, age at baseline evaluation, and disease duration. We also searched patient medical records for use of anti-depressant, anti-anxiety, anti-psychotic, sleep aid, and anticholinesterase inhibitor medications after the baseline evaluation.

Results:

PCA patients were younger at age of onset (p=.006), time of baseline evaluation (p=.02), and had longer disease duration (p=.01). Neuropsychiatric symptoms were common in PCA and LPA, although more common and severe in PCA. On the NPI-Q at baseline, the most common symptoms in the PCA group were depression/dysphoria, anxiety, and agitation/aggression, and the most common symptoms in the LPA group were anxiety, depression/dysphoria, and irritability/lability. PCA had higher severity on the NPI-Q total score (p=.01) and depression subscore (p=.01) compared to LPA. Baseline total CBI-R severity scores were also higher in PCA than LPA (p=0.001), with PCA having worse scores in all 10 CBI-R categories. Longitudinally, there was no difference between groups on the NPI-Q. However, on the CBI-R, PCA had faster rates of worsening on self-grooming (p=.01) and self-dressing (p=.01) compared to LPA. All NPI-Q and CBI-R significant differences between PCA and LPA remained in our subsamples that were matched by age and disease duration except NPI-Q depression; restless/agitation; and indifferent to friends/family. In the PCA group, 45.7% were on antidepressants, 28.3% anti-anxiety medications, 21.7% anti-psychotic medications, none taking a sleep aid, and 39.1% were on anti-cholinesterase inhibitors. In the LPA group, 43.8% of patients were taking antidepressants, 46.9% anti-anxiety medications, 18.8% antipsychotic medications, 3.1% sleep aids, and 68.8% anti-cholinesterase inhibitors. There were no significant differences in the proportion of patients taking any of these medications.

Conclusions:

Behavioral and neuropsychiatric symptoms are common in PCA and LPA although these symptoms are more common and severe in PCA. These findings are clinically relevant given that both PCA and LPA patients experienced neuropsychiatric symptoms which might improve with pharmacological interventions and/or additional modes of therapy that focus on cognitive rehabilitation and adjustment to disability. Further, our results are pertinent to patient care and prognosis given that PCA patients had higher frequencies and severity of depression at baseline and had faster rates of worsening over time on tasks pertaining to self-care which will lead to different care challenges.