THE ASSOCIATION BETWEEN NEUROPSYCHIATRIC SYMPTOMS, APOE ε4 AND PROGRESSION OF ALZHEIMER'S DISEASE

Abstract

The progression of Alzheimer disease is very difficult to predict. Whether neuropsychiatric symptoms, APOE ε4 may play a role is still unknown. From 2012 to 2015, we prospectively followed 492 patients with probable AD from the memory clinic of Taipei Veterans General Hospital for median of 3 years. All patients underwent standard assessments, including brain magnetic resonance imaging or computed tomography, neuropsychological tests, neuropsychiatry inventory (NPI-Q) and related blood tests. A logistic regression analysis was performed to investigate the relationship between change of clinical dementia rating scale-sum of boxes (CDR-SOB) and age, gender, education, APOE ε4 allele and various neuropsychiatric symptoms. Of all the participants, 306 (62.1%) completed the initial examinations and 2 times of follow-up. Among 306 patients, 222 (73%) showed CDR-SOB decline. We observed initial neuropsychiatric symptom of agitation (OR = 1.24; 95% CI = 1.03–1.419, p = 0.021) and APOE ε4 (OR = 1.83; 95% CI = 1.10–3.04, p = 0.019) both related to CDR-SOB decline. Baseline agitation and APOE ε4 significantly associated with clinical progression of Alzheimer disease.