Neuropsychiatric Symptom Burden across Neurodegenerative Disorders and its Association with Function

ONDRI Investigators, Daniel Kapustin, Shadi Zarei, Wei Wang, Malcolm A Binns, Paula M McLaughlin, Agessandro Abrahao, Sandra E Black, Michael Borrie, David Breen, Leanna Casaubon, Dar Dowlatshahi, Elizabeth Finger, Corinne E Fischer, Andrew Frank, Morris Freedman, David Grimes, Ayman Hassan, Mandar Jog, Donna KwanAnthony Lang, Brian Levine, Jennifer Mandzia, Connie Marras, Mario Masellis, Joseph B Orange, Stephen Pasternak, Alicia Peltsch, Bruce G Pollock, Tarek K Rajji, Angela Roberts, Demetrios Sahlas, Gustavo Saposnik, Dallas Seitz, Christen Shoesmith, Alisia Southwell, Thomas D L Steeves, Kelly Sunderland, Richard H Swartz, Brian Tan, David F Tang-Wai, Maria Carmela Tartaglia, Angela Troyer, John Turnbull, Lorne Zinman, Sanjeev Kumar

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: Neuropsychiatric symptoms (NPS) are prevalent in neurodegenerative disorders, however, their frequency and impact on function across different disorders is not well understood. We compared the frequency and severity of NPS across Alzheimer's disease (AD) (either with mild cognitive impairment or dementia), Cerebrovascular disease (CVD), Parkinson's disease (PD), frontotemporal dementia (FTD), and amyotrophic lateral sclerosis (ALS), and explored the association between NPS burden and function.

METHODS: We obtained data from Ontario Neurodegenerative Disease Research Initiative (ONDRI) that included following cohorts: AD ( N  = 111), CVD ( N  = 148), PD ( N  = 136), FTD ( N  = 50) and ALS ( N  = 36). We compared the frequency and severity of individual NPS (assessed by the neuropsychiatric inventory questionnaire) across cohorts using generalized estimating equations and analysis of variance. Second, we assessed the relationship of NPS burden with instrumental (iADLs) and basic (ADLs) activities of living across cohorts using multivariate linear regression while adjusting for relevant demographic and clinical covariates.

RESULTS: Frequency of NPS varied across cohorts (χ 2 (4)  = 34.4, p < .001), with post-hoc tests showing that FTD had the greatest frequency as compared to all other cohorts. The FTD cohort also had the greatest severity of NPS ( H (4)  = 34.5, p < .001). Further, there were differences among cohorts in terms of the association between NPS burden and ADLs ( F (4,461)  = 3.1, p  = 0.02). Post-hoc comparisons suggested that this finding was driven by the FTD group, however, the differences did not remain significant following Bonferroni correction. There were no differences among cohorts in terms of the association between NPS burden and IADLs.

CONCLUSIONS: NPS frequency and severity are markedly greater in FTD as compared to other neurodegenerative diseases. Further, NPS burden appears to be associated differently with function across neurodegenerative disorders, highlighting the need for individualized clinical interventions.

Original languageEnglish
Pages (from-to)7067437221147443
Journal The Canadian Journal of Psychiatry (CJP)
Early online date13 Jan 2023
Publication statusE-pub ahead of print - 13 Jan 2023


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