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 Kwan; Anthony 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

doi:10.1177/07067437221147443

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

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Abstract / Description of output

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 language	English
Pages (from-to)	7067437221147443
Journal	The Canadian Journal of Psychiatry (CJP)
Early online date	13 Jan 2023
DOIs	https://doi.org/10.1177/07067437221147443
Publication status	E-pub ahead of print - 13 Jan 2023

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07067437221147443Final published version, 1.32 MBLicence: Creative Commons: Attribution (CC-BY)

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ONDRI Investigators, Kapustin, D., Zarei, S., Wang, W., Binns, M. A., McLaughlin, P. M., Abrahao, A., Black, S. E., Borrie, M., Breen, D., Casaubon, L., Dowlatshahi, D., Finger, E., Fischer, C. E., Frank, A., Freedman, M., Grimes, D., Hassan, A., Jog, M., ... Kumar, S. (2023). Neuropsychiatric Symptom Burden across Neurodegenerative Disorders and its Association with Function. The Canadian Journal of Psychiatry (CJP), 7067437221147443. Advance online publication. https://doi.org/10.1177/07067437221147443

@article{525aab4517054e59963e105aa4fcfea0,

title = "Neuropsychiatric Symptom Burden across Neurodegenerative Disorders and its Association with Function",

abstract = "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.",

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

note = "Funding Information: This research was conducted with support from the Ontario Neurodegenerative Disease Research Initiative through the Ontario Brain Institute, an independent non-profit corporation, funded partially by the Ontario government. The opinions, results and conclusions are those of the authors and no endorsement by the Ontario Brain Institute is intended or should be inferred. Matching funds provided by participating hospital and research institute foundations, including the Baycrest Foundation, Bruy{\`e}re Research Institute, Centre for Addiction and Mental Health Foundation, London Health Sciences Foundation, McMaster University Faculty of Health Sciences, Ottawa Brain and Mind Research Institute, Queen's University Faculty of Health Sciences, Providence Care (Kingston), Sunnybrook Health Sciences Foundation, St. Michael's Hospital, the Thunder Bay Regional Health Sciences Centre, the University of Ottawa Faculty of Medicine, and the Windsor/Essex County ALS Association. This study was also funded in part by an Academic Scholars Award from the Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto to SK. Publisher Copyright: {\textcopyright} The Author(s) 2023.",

year = "2023",

month = jan,

day = "13",

doi = "10.1177/07067437221147443",

language = "English",

pages = "7067437221147443",

journal = " The Canadian Journal of Psychiatry (CJP)",

issn = "0706-7437",

publisher = "Canadian Psychiatric Association",

}

ONDRI Investigators, Kapustin, D, Zarei, S, Wang, W, Binns, MA, McLaughlin, PM, Abrahao, A, Black, SE, Borrie, M, Breen, D, Casaubon, L, Dowlatshahi, D, Finger, E, Fischer, CE, Frank, A, Freedman, M, Grimes, D, Hassan, A, Jog, M, Kwan, D, Lang, A, Levine, B, Mandzia, J, Marras, C, Masellis, M, Orange, JB, Pasternak, S, Peltsch, A, Pollock, BG, Rajji, TK, Roberts, A, Sahlas, D, Saposnik, G, Seitz, D, Shoesmith, C, Southwell, A, Steeves, TDL, Sunderland, K, Swartz, RH, Tan, B, Tang-Wai, DF, Tartaglia, MC, Troyer, A, Turnbull, J, Zinman, L & Kumar, S 2023, 'Neuropsychiatric Symptom Burden across Neurodegenerative Disorders and its Association with Function', The Canadian Journal of Psychiatry (CJP), pp. 7067437221147443. https://doi.org/10.1177/07067437221147443

TY - JOUR

T1 - Neuropsychiatric Symptom Burden across Neurodegenerative Disorders and its Association with Function

AU - ONDRI Investigators

AU - Kapustin, Daniel

AU - Zarei, Shadi

AU - Wang, Wei

AU - Binns, Malcolm A

AU - McLaughlin, Paula M

AU - Abrahao, Agessandro

AU - Black, Sandra E

AU - Borrie, Michael

AU - Breen, David

AU - Casaubon, Leanna

AU - Dowlatshahi, Dar

AU - Finger, Elizabeth

AU - Fischer, Corinne E

AU - Frank, Andrew

AU - Freedman, Morris

AU - Grimes, David

AU - Hassan, Ayman

AU - Jog, Mandar

AU - Kwan, Donna

AU - Lang, Anthony

AU - Levine, Brian

AU - Mandzia, Jennifer

AU - Marras, Connie

AU - Masellis, Mario

AU - Orange, Joseph B

AU - Pasternak, Stephen

AU - Peltsch, Alicia

AU - Pollock, Bruce G

AU - Rajji, Tarek K

AU - Roberts, Angela

AU - Sahlas, Demetrios

AU - Saposnik, Gustavo

AU - Seitz, Dallas

AU - Shoesmith, Christen

AU - Southwell, Alisia

AU - Steeves, Thomas D L

AU - Sunderland, Kelly

AU - Swartz, Richard H

AU - Tan, Brian

AU - Tang-Wai, David F

AU - Tartaglia, Maria Carmela

AU - Troyer, Angela

AU - Turnbull, John

AU - Zinman, Lorne

AU - Kumar, Sanjeev

N1 - Funding Information: This research was conducted with support from the Ontario Neurodegenerative Disease Research Initiative through the Ontario Brain Institute, an independent non-profit corporation, funded partially by the Ontario government. The opinions, results and conclusions are those of the authors and no endorsement by the Ontario Brain Institute is intended or should be inferred. Matching funds provided by participating hospital and research institute foundations, including the Baycrest Foundation, Bruyère Research Institute, Centre for Addiction and Mental Health Foundation, London Health Sciences Foundation, McMaster University Faculty of Health Sciences, Ottawa Brain and Mind Research Institute, Queen's University Faculty of Health Sciences, Providence Care (Kingston), Sunnybrook Health Sciences Foundation, St. Michael's Hospital, the Thunder Bay Regional Health Sciences Centre, the University of Ottawa Faculty of Medicine, and the Windsor/Essex County ALS Association. This study was also funded in part by an Academic Scholars Award from the Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto to SK. Publisher Copyright: © The Author(s) 2023.

PY - 2023/1/13

Y1 - 2023/1/13

N2 - 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.

AB - 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.

U2 - 10.1177/07067437221147443

DO - 10.1177/07067437221147443

M3 - Article

C2 - 36637224

SN - 0706-7437

SP - 7067437221147443

JO - The Canadian Journal of Psychiatry (CJP)

JF - The Canadian Journal of Psychiatry (CJP)

ER -

Neuropsychiatric Symptom Burden across Neurodegenerative Disorders and its Association with Function

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