Neuropsychiatric or behavioral and psychological symptoms of dementia (BPSD): focus on prevalence and natural history in Alzheimer’s disease and frontotemporal dementia
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Neuropsychiatric or behavioral and psychological symptoms of dementia (BPSD) represent a heterogeneous group of non-cognitive symptoms that are virtually present in all patients during the course of their disease. The aim of this study is to examine the prevalence and natural history of BPSD in a large cohort of patients with behavioral variant of frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) in three stages: (i) pre-T0 (before the onset of the disease); (ii) T0 or manifested disease (from the onset to 5 years); (iii) T1 or advanced (from 5 years onwards). Six hundred seventy-four clinical records of patients with bvFTD and 1925 with AD, from 2006 to 2018, were studied. Symptoms have been extracted from Neuropsychiatric Inventory (NPI) and from a checklist of BPSD for all periods observed. In our population, BPSD affect up to 90% of all dementia subjects over the course of their illness. BPSD profiles of the two dementia groups were similar but not identical. The most represented symptoms were apathy, irritability/affective lability, and agitation/aggression. Considering the order of appearance of neuropsychiatric symptoms in AD and bvFTD, mood disorders (depression, anxiety) come first than the other BPSD, with the same prevalence. This means that they could be an important “red flag” in detection of dementia. With the increase of disease severity, aberrant motor behavior and wandering were significantly more present in both groups. Differences between BPSD in AD and bvFTD resulted only in prevalence: Systematically, in bvFTD, all the symptoms were more represented than in AD, except for hallucinations, depression, anxiety, and irritability. Given their high frequency and impact on management and overall health care resources, BPSD should not be underestimated and considered as an additional important diagnostic and therapeutic target both in patients with AD and bvFTD.
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Neuropsychiatric symptoms changed over time, with symptoms of depression and anxiety in preclinical and prodromal phases, followed by delusions, hallucinations and euphoria in the symptomatic phase.
“Similarly, neuropsychiatric symptoms showed to change over time, with symptoms of depression and anxiety in preclinical and prodromal phases, followed by delusions, hallucinations and euphoria in the symptomatic phase (Laganà et al., 2022).”
From The pursuit for markers of disease progression in behavioral variant frontotemporal dementia: a scoping review to optimize outcome measures for clinical trials (2024) · cites this paper as Laganà et al., 2022
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- Authors
- Laganà, V., Bruno, F., Altomari, N., Bruni, G., Smirne, N., Curcio, S., Mirabelli, M., Colao, R., Puccio, G., Frangipane, F., Cupidi, C., Torchia, G., Muraca, G., Malvaso, A., Addesi, D., Montesanto, A., Di Lorenzo, R., Bruni, A. C., & Maletta, R.
- Affiliations
- University of Calabria (IT)
- Fondazione Istituto G. Giglio di Cefalù (IT)
- IRCCS Ospedale San Raffaele (IT)
- Corresponding author
- Laganà, Valentina
- Bruno, Francesco
- ORCID
- Venue
- Frontiers in Neurology
- Publisher
- Frontiers Media SA
- Published
- 2022-06-24
- Volume
- 13
- Pages
- 832199-832199
- ISSN
- 1664-2295 (ISSN-L)
- PMC
- PMC9263122
- OpenAlex
- W4283398372
- Cited by
- 105
- References
- 59
- Citations by year
- 2026: 31 · 2025: 30 · 2024: 14 · 2023: 26 · 2022: 4
- FWCI
- 12.06
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Neurology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Archive of Doctoral Theses and Digital Collections (University of Calabria) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Keywords
- behavioral and psychological symptoms of dementia, Alzheimer's disease, behavioral variant frontotemporal dementia, prevalence, natural history (disease), apathy, irritability, agitation, wandering, aberrant motor behavior, mood disorders, dementia detection, Neuropsychiatric Inventory
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