Prevalence of neuropsychiatric symptoms related to dementia in individuals with Down syndrome

Abstract

AbstractBackgroundNeuropsychiatric symptoms (NPS) are significant manifestations of dementia, with important consequences for patients and caregivers. Despite the established genetic link between Down syndrome (DS) and Alzheimer’s disease (AD), studies investigating NPS in individuals with DS and dementia are scarce. The Neuropsychiatric Inventory (NPI) was developed to identify symptoms of dementia and while it is widely used for the assessment of individuals with dementia in the general population, we have found no studies using the NPI in those with DS. The aim of this study is to characterize NPS in a sample with DS with heterogeneous cognitive profiles using the NPIMethodParticipants (N=92) with DS, ≥30 years of age were assessed with the Cambridge Examination for Mental Disorders of Older People with Down’s Syndrome and Others with Intellectual Disabilities (CAMDEX‐DS). They were classified by a psychiatrist into three categories: AD, prodromal dementia, and stable cognition. Another psychiatrist blinded to the CAMDEX‐DS dementia diagnosis, evaluated the participants using the NPI. Chi‐square tests were used to check for significant differences in frequency of symptoms.ResultThirteen participants (14.1%) had AD, 17 (18.4%) were classified as prodromal dementia and 62 (67.5%) were in the stable cognition group. Prevalence of delusion, depression, anxiety, disinhibition, irritability, appetite abnormalities and total NPI did not differ between groups. Anxiety and irritability were common across all groups (∼50% of the total), while euphoria was not present in any participant. Hallucination, agitation, apathy, aberrant motor behaviour and night‐time behaviour disturbance showed significant difference among the groups (p<0.05), with higher prevalence in the group with AD.ConclusionThe results indicate that individuals with DS and AD have some of the symptoms that are characteristically present among the general population with AD. Future studies are needed to understand if AD in DS is associated with a similar pattern of NPS observed among people with AD in the general population or may follow a specific NPS pattern. The high frequency of some NPS in individuals with DS and stable cognition should be considered in the diagnostic process in order to reduce the odds of generating a false positive.