BPSD Patterns in Patients With Severe Neuropsychiatric Disturbances: Insight From the RECAGE Study

Emmanuel Cognat; Séverine Sabia; Alexandra Fayel; Matthieu Lilamand; Ron Handels; Sara Fascendini; Sverre Bergh; Giovanni B Frisoni; Andrea Fabbo; Magdalina Tsolaki; Lutz Frölich; Oliver Peters; Paola Merlo; Alfonso Ciccone; Patrizia Mecocci; Julien Dumurgier; Carlo A Defanti; Jacques Hugon; Claire Paquet

doi:10.1016/j.jagp.2023.03.014

BPSD Patterns in Patients With Severe Neuropsychiatric Disturbances: Insight From the RECAGE Study

Am J Geriatr Psychiatry. 2023 Aug;31(8):633-639. doi: 10.1016/j.jagp.2023.03.014. Epub 2023 Apr 23.

Authors

Emmanuel Cognat¹, Séverine Sabia², Alexandra Fayel³, Matthieu Lilamand⁴, Ron Handels⁵, Sara Fascendini⁶, Sverre Bergh⁷, Giovanni B Frisoni⁸, Andrea Fabbo⁹, Magdalina Tsolaki¹⁰, Lutz Frölich¹¹, Oliver Peters¹², Paola Merlo¹³, Alfonso Ciccone¹⁴, Patrizia Mecocci¹⁵, Julien Dumurgier¹⁶, Carlo A Defanti⁶, Jacques Hugon¹⁷, Claire Paquet¹⁷

Affiliations

¹ Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Cognitive Neurology Center (EC, AF, ML, JD, JH, CP), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France. Electronic address: emmanuel.cognat@aphp.fr.
² Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Université Paris Cité (SS, JD), Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France.
³ Université Paris Cité (SS, JD), Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France.
⁴ Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Cognitive Neurology Center (EC, AF, ML, JD, JH, CP), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France; Department of Geriatry (ML), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France.
⁵ Alzheimer Centre Limburg (RH), School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
⁶ Fondazione Europea di Ricerca Biomedica (FERB Onlus) (SF), Gazzaniga, Italy.
⁷ The Research Centre for Age-related Functional Decline and Disease (SB), Innlandet Hospital Trust, Ottestad, Norway; The Norwegian National Centre for Aging and Health (SB), Vestfold Hospital Trust, Tønsberg, Norway.
⁸ Memory Clinic (GBF), Geneva University Hospitals, Geneva, Switzerland; Laboratory of Neuroimaging of Aging (LANVIE) (GBF), University of Geneva, Geneva, Switzerland.
⁹ Geriatric Service-Cognitive Disorders and Dementia (AF), Department of Primary Care, Health Authority and Services of Modena, Modena, Italy.
¹⁰ Greek Association of Alzheimer's Disease and Related Disorders (GAADRD) (MT), Thessaloniki, Hellas, Macedonia Greece; First Department of Neurology, School of Medicine (MT), Aristotle University of Thessaloniki (AUTh), Hellas, Macedonia Greece.
¹¹ Department of Geriatric Psychiatry (LF), Central Institute of Mental Health; Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.
¹² Department of Psychiatry (OP), Charité Universitätsmedizin Berlin, Berlin, Germany; German Center for Neurodegenerative Diseases (DZNE) (OP), Berlin, Germany.
¹³ Neurological Unit (PM), U.V.A. Centre, Humanitas Gavazzeni, Bergamo, Italy.
¹⁴ Department of Neurology with neurosurgical activity and stroke unit (AC), ASST di Mantova, Mantova, Italy.
¹⁵ Section of Gerontology and Geriatrics (PM), Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Clinical Geriatrics (PM), NVS Department, Karolinska Institutet, Stockholm, Sweden.
¹⁶ Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Cognitive Neurology Center (EC, AF, ML, JD, JH, CP), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France; Université Paris Cité (SS, JD), Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France.
¹⁷ Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Cognitive Neurology Center (EC, AF, ML, JD, JH, CP), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France.

PMID: 37183097
DOI: 10.1016/j.jagp.2023.03.014

Abstract

Objective: Behavioral and psychological symptoms of dementia (BPSD) profiles vary depending on etiology in patients with mild-to-moderate BPSD. It is not known if similar differences exist in patients with severe BPSD.

Methods: We analyzed data collected at baseline in 398 patients with severe BPSD (NPI ≥ 32) and defined diagnosis of dementia (Alzheimer's disease [AD] 297; frontotemporal dementia [FTD] 39; Lewy body disease/Parkinsonian dementia [LBD/PD] 31; and vascular dementia [VD] 31) included in the European multicenter cohort RECAGE.

Results: Mean total NPI was 52.11 (18.55). LBD/PD patients demonstrated more hallucinations, more anxiety and more delusions than patients with other dementia. FTD patients had less delusions and more disinhibition than patients with other neurodegenerative disorders. These profiles overlapped partially with those reported in the literature in patients with less severe symptoms.

Conclusion: Patients with severe BPSD display different and specific profiles of neuropsychiatric symptoms depending on dementia etiology.

Keywords: Agitation; Alzheimer's disease; Lewy body dementia; clinical profile; frontotemporal dementia; neuropsychiatric inventory.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Alzheimer Disease* / psychology
Dementia, Vascular* / complications
Frontotemporal Dementia* / complications
Frontotemporal Dementia* / diagnosis
Humans
Lewy Body Disease* / psychology
Psychiatric Status Rating Scales