Neuropsychiatric symptoms as predictors of clinical course in neurodegeneration : a longitudinal study

Q2Q2Artículo original1-15Background: To study the extent to which neuropsychiatric symptoms (NPS) influence the cognitive and functional decline in frontotemporal degeneration (FTD) and Alzheimer’s disease (AD). Methods: We assessed the progression of NPS and their influence on cognitive and functional progression in a group of FTD (n = 36) and AD patients (n = 47) at two different stages of the disease (2.5 years). A standardized scale was used to assess NPS—the Columbia University Scale for Psychopathology in Alzheimer’s Disease (CUSPAD)—which tracks different symptoms including depression, psychotic symptoms, as well as sleep and conduct problems. In addition, in a subsample of patients (AD n = 14 and FTD n = 14), we analyzed another group of NPS by using the Neuropsychiatric Inventory (NPI). Cognitive declines were tracked by using the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE), while functionality was tracked by using the Lawton scale and the Barthel Index. Results: The presence of NPS impacts cognitive and functional decline in both groups of patients 2.5 years after disease onset. However, we observed a dissociable profile of the affectation of NPS in each group. In the AD group, results indicate that the progression of depressive symptoms and sleep problems predict cognitive and functional decline. In contrast, the progression of a mixed group of NPS, including conduct problems and delusions, predicts cognitive and functional decline in FTD. Conclusion: The presence of NPS has a critical impact on the prediction of cognitive decline in FTD and AD patients after 2.5 years of disease progression. Our results demonstrate the importance of assessing different types of NPS in neurodegenerative disorders which, in turn, predict disease progression. Future studies should assess the role of NPS in predicting different neurocognitive pathways and in neurodegeneration

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Los buenos resultados obtenidos por los servicios de atención domiciliaria del Centro de Memoria y Cognition Intellectus del Hospital Universitario San Ignacio planteó la necesidad de entender su éxito La atención domiciliaria se define como un conjunto de actividades biopsicosociales a realizar en el domicilio para detectar, atender, y monitorear los problemas de salud y sociales del individuo y su familia y mejorar su calidad de vida 1 para conocer el entorno en el que se desarrolla el paciente, identificar factores nocivos y los positivos pueden ser reforzados El traslado del personal de salud al domicilio del paciente cambia el tradicional escenario generando cambios en el tipo de relación y comunicación entre los distintos actores Este estudio profundiza en las relaciones entre los actores (paciente mayor, familiares/cuidadores) de estos servicios, sus roles y el rol del medio ambiente( 2The good results obtained by the home care services of the Center for Memory and Cognition Intellectus of the University Hospital San Ignacio raised the need to understand its success Home care is defined as a set of biopsychosocial activities to be carried out at home to detect, attend to, and monitor the health and social problems of the individual and their family and improve their quality of life 1 to learn about the environment in which develops the patient, to identify harmful factors and positive ones can be reinforced Shifting health personnel to the patient's home changes the traditional scenario generating changes in the type of relationship and communication between the various actors This study deepens in the relationships between the actors ( elder patient, relatives/caregivers)of this services, their roles and the role of the environment( 2https://orcid.org/0000-0003-3221-222Xhttps://scholar.google.com/citations?user=WDp1QG8AAAAJ&hl=eshttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=000067144