Effect Of Neuropsychiatric Symptoms Research Articles

Effectiveness of cognitive stimulation therapy (CST) on cognition, quality of life and neuropsychiatric symptoms for patients living with dementia: A meta-analysis

IntroductionMany scholars have explored the effect of cognitive stimulation therapy (CST) on dementia patients, however, due to different experimental designs and insufficient sample sizes, research results are inconsistent. Furthermore, there is a scarcity of high-quality quantitative results. ObjectiveTo assess the effectiveness of CST for improving cognition, quality of life (QoL) and neuropsychiatric symptoms in people with dementia (PwD). MethodsChinese and English databases were searched for randomized controlled trials (RCTs) between establishment of and April 2022, with another search done in May 2022. Finally, 10 studies on the application of CST in PwD for improving cognition, QoL, behavior, language and activities of daily living were reviewed. ResultsBased on the results of the 10 RCTs, CST significantly improved cognitive performance (MMSE: WMD = 1.98, 95% CI: 1.24–2.72, P<0.01), QoL (WMD = 3.12, 95% CI: 2.52–3.72, P<0.01), language (NLT: WMD = 2.71, 95% CI: 1.07–4.35, P<0.01) and activities of daily living (DAD: WMD = 7.27, 95% CI: 0.97–13.56, P<0.01) in PwD. However, no significant improvements in ADAS-Cog (WMD = 0.55, 95% CI: -3.04–4.14, P = 0.76), depression (SMD = -0.12,95% CI: -0.29–0.04, P = 0.15), anxiety (RAID: WMD = -1.05, 95% CI: -3.85–1.75, P = 0.46) or neuropsychiatric symptoms (NPI: WMD = 0.23, 95% CI: -2.62–3.07, P = 0.88) were found. ConclusionCST improved the cognitive ability, QoL, language and activities of daily living of PwD. However, the effect of neuropsychiatric symptoms on PwD requires further exploration.

Association Between Late-Life Neuropsychiatric Symptoms and Cognitive Decline in Relation to White Matter Hyperintensities and Amyloid Burden.

Neuropsychiatric symptoms (NPS) among cognitively normal older adults are increasingly recognized as risk factors for cognitive decline and impairment. However, the underlying mechanisms remain unclear. To examine whether biomarkers of Alzheimer's disease (amyloid burden) and cerebrovascular disease (white matter hyperintensity (WMH) volume) modify the association between NPS and cognitive decline among cognitively unimpaired older adults. Analyses included 193 cognitively unimpaired participants (M age = 70 years) from the BIOCARD study, including 148 with PET amyloid and WMH biomarker data. NPS were measured with Neuropsychiatric Inventory and Geriatric Depression Scale scores. Linear mixed effects models were used to examine the association between baseline NPS and longitudinal cognitive trajectories (M follow-up = 3.05 years), using separate models for global, episodic memory, and executive function cognitive composite scores. In a subset of individuals with biomarker data, we evaluated whether WMH or cortical amyloid burden modified the relationship between NPS and cognitive change (as indicated by the NPS×biomarker×time interactions). Higher baseline NPS were associated with lower executive function scores, but not a faster rate of decline in executive function. NPS symptoms were unrelated to the global or episodic memory composite scores, and there was little evidence of a relationship between NPS symptoms and cognitive change over time. The associations between NPS and cognitive decline did not differ by amyloid or WMH burden, and NPS were unrelated to amyloid and WMH burden. These results suggest that the effect of neuropsychiatric symptoms on executive dysfunction may occur through mechanisms outside of amyloid and cerebrovascular disease.

The Moderating Role of Pain Self-efficacy in the Relationships Among Caregiver Burden and Care Recipient Pain and Neuropsychiatric Symptoms in a Sample of Persons With Dementia.

Past research suggests relationships among dementia caregiver burden and care recipient pain and neuropsychiatric symptoms, but no prior work has examined the influence of pain self-efficacy on these associations. A sample of 502 dementia caregivers completed an online protocol assessing caregiver burden and care recipient neuropsychiatric symptoms, presence of pain, and pain self-efficacy in this cross-sectional, observational study. The indirect effect of neuropsychiatric symptoms on the relationship between pain and caregiver burden was significant. Pain self-efficacy significantly moderated the effect of pain on neuropsychiatric symptoms (P=0.04) and the direct association between pain and caregiver burden (P=0.004), but did not moderate the indirect effect. Future research should explore how pain influences neuropsychiatric symptoms, and whether improvement in pain self-efficacy in dementia care recipients attenuates the influence of pain on neuropsychiatric symptoms and caregiver burden in other samples.

Effect of positive and negative symptoms on schizophrenia related quality of life of hospitalized schizophrenic patients at Sargodha and Lahore: Moderating role of neuropsychiatric symptoms.

The purpose of the study was to find out the moderating effect of neuropsychiatric symptoms in the relationship between positive-negative symptoms of schizophrenia with quality of life of schizophrenic patients. This cross-sectional study was conducted at Lahore and Sargodha, Pakistan. Data was collected by administering the Positive and Negative of Schizophrenia Questionnaire, Quality of Life of Schizophrenia Scale and Neuropsychiatry Inventory. SPSS-23 was used for data analysis. The study was completed in one year. The data was collected from September 4, 2017 to November 1, 2018 after 10am. The findings indicated that positive symptoms had significant positive correlation with negative symptoms (p < 0.001) and neuropsychiatric symptoms (p < 0.001) with significant negative correlation with schizophrenia quality of life (p < 0.001). Negative symptoms had significant positive correlation with neuropsychiatric symptoms (p < 0.001) and significant negative correlation with schizophrenia related quality of life (p <0.001). Neuropsychiatric symptoms had significant negative correlation with schizophrenia quality of life (p <0.001) in the study. Moreover, neuropsychiatric symptoms moderated between negative symptoms and schizophrenia related quality of life. In this study, findings suggested that negative symptoms and neuropsychiatric symptoms have positive association with quality of life of schizophrenic patients whereas positive symptoms have inverse relationship. The study also revealed that neuropsychiatric symptoms enhanced the effect of negative symptoms on quality of life of schizophrenic patients.

NEUROPSYCHIATRIC SYMPTOMS AND FUNCTIONAL ACTIVITIES AMONG OLDER ADULTS: THE ROLE OF ETHNICITY AND COGNITIVE STATUS

Little is known about the likelihood of future functional deficits based on current neuropsychiatric symptoms (NPSs). This study seeks to examine the impact of NPSs on functional activities (FAs) by cognitive status and ethnicity. A secondary analysis of the National Alzheimer’s Coordinating Center Uniform Data Set was conducted using ordered logistic regression to examine the effect of NPSs (based on the Neuropsychiatric Inventory Questionnaire [NPI-Q]) on FAs (based on Functional Assessment Questionnaire). Participants had a mean age of 74 (SD: 9.88) and were included if normal cognition was assessed at baseline (n= 13,470). Higher rates of NPSs were associated with higher dependency in almost all FAs. Among NPSs, apathy was the best predictor (p<.05) of FAs for participants in different cognitive groups and ethnicity subsamples. The impact of other NPSs varied. Anxiety and apathy were the best predictors of FAs among participants with cognitive impairment (but not MCI). Among those who eventually developed dementia (n= 6,818), delusions, hallucinations, agitation, depression, irritability, and motor disturbance were significantly associated (p<.05) with future deficits in FAs. Among Hispanics (n=1,095), hallucinations, agitation, apathy, and motor disturbance were significantly associated with dependency in FAs, while for non-Hispanics, all NPSs were associated with dependency in FAs, except elation and nighttime disturbance. Findings suggest as the severity of the NPSs increases, older adults experience higher levels of dependency in FAs. The nature and extent of NPSs’ impact on FAs varied based on cognitive status and ethnicity, suggesting the importance of considering these factors in service provision.

The association between specific neuropsychiatric disturbances in people with Alzheimer's disease and dementia with Lewy bodies and carer distress.

Neuropsychiatric symptoms (NPSs) are identified as important care-recipient variables in terms of the impact on carer distress. The aim of this study was to determine whether specific neuropsychiatric disturbances in people with Alzheimer disease (AD) and dementia with Lewy bodies (DLB) differentially impact carer distress. This was a cross-sectional study of people diagnosed with AD and DLB and their primary carers. The Relatives' Stress Scale (RSS) was used to assess the level of reported distress in carers, and the Neuropsychiatric Inventory (NPI) was used to assess NPSs. The effect of NPSs on carer distress was analyzed using correlation analysis and partial least squares regression. This study included 159 participants diagnosed with AD (n=97) and DLB (n=62) and their primary carers (spouses and adult children). The majority of people diagnosed with dementia were women (64.2%), with a mean age of 75.9years (SD, 7.4) and a mean Mini-Mental State Examination (MMSE) score of 23.5 (SD, 2.9). The main analysis identified apathy as the most important NPS contributing to carer distress. Compared with AD, the explained variance in the DLB group was higher (r2 =37.3 vs r2 =53.7). In addition, more NPSs were considered clinically important in the DLB group. The findings of this study identify apathy as the most important NPS contributing to carer distress among carers of people with AD and DLB. These findings help us identify the support needs of families dealing with dementia.

PT585. Effect of Neuropsychiatric Symptoms on Mortality in Patients with Dementia: differences between Alzheimer’s dementia, subcortical vascular dementia, and frontotemporal dementia

PT585. Effect of Neuropsychiatric Symptoms on Mortality in Patients with Dementia: differences between Alzheimer’s dementia, subcortical vascular dementia, and frontotemporal dementia

Assessing the impact of neuropsychiatric symptoms on distress in professional caregivers

Caregiver burden has been studied extensively in family caregivers of Alzheimer's patients. Behavioral disturbances have been widely reported to be a source of distress and burden for family caregivers. However, the study of the effects of behavioral disturbance on distress for professional caregivers in long-term care facilities has been relatively ignored. This study was conducted to evaluate the effects of neuropsychiatric symptoms among patients with dementia on distress in nursing home caregivers. One hundred and five professional caregiver interviews were done in order to assess distress related to the frequency and severity of neuropsychiatric symptoms in one 125-bed proprietary nursing home staffed according to industry standards. Twelve licensed vocational nurses (LVNs) and 12 certified nurses aids (CNAs) were interviewed regarding 69 nursing home residents using the Neuropsychiatric Inventory-Nursing Home Version (NPI-NH). Agitation and apathy were found to be the two most distressing behaviors for both the LVNs and CNAs, but while the level of distress for the LVNs approaches that reported by family members in other published research, the CNAs report very little overall distress. In summary, professional caregiver distress appears to be a significant problem in LVN caregivers in long-term care settings.