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Abstract Details

Associations Between Neuropsychiatric Symptom Burden, Change in Cognitive Status and Survival in Autopsy-confirmed Cohorts of Lewy Body Disease and Alzheimer’s Disease
Movement Disorders
P1 - Poster Session 1 (11:45 AM-12:45 PM)
5-028
To investigate the impact of neuropsychiatric symptom (NPS) burden and cognitive status on survival in pathological cohorts of Lewy body disease (LBD) and Alzheimer’s disease (AD)
Presence of pathological LBD is typically associated with higher NPS burden and poorer survival. Predictors of mortality at dementia diagnosis include age, more depression and worse cognitive status. Predictors of survival during early cognitive changes and relationship to final pathological burden is unknown.
We included 313 initially non-demented cases from the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND) with longitudinal Neuropsychiatric Inventory-Questionnaire (NPI-Q) scores who came to autopsy (mean follow-up duration 6±4 years). Participants were categorized by final Unified Staging System for Lewy Body Disorders (USSLB) (stage-I [n=9], IIA-B [n=32, 16], III [n=59], IV [n=70]); 127 cases had USSLB stage-0, including AD without LB (n=66). We performed Cox regression analyses, adjusting for cognitive status change, age, sex, motor subscale of Unified Parkinson's Disease Rating Scale (UPDRS-III), and Functional Assessment Scale (FAS) from the National Alzheimer’s Coordinating Center.
Individuals with USSLB stages III-IV were younger at first NPI-Q (mean 79±7 years) and at death (mean 85±8 years) (p<0.05). UPDRS-III (mean 23±15) and frequency of mild cognitive impairment (MCI) status (37%) at first NPI-Q were highest for USSLB stage-IV (p<0.05). Total initial NPI-Q score was highest for USSLB stage-IIB (mean 3.6±3.4), followed by stage-IV (3.3±3.4) and III (2.9±3.7) (p<0.05). While nighttime behaviors were most frequent/severe in stage-IIB, hallucinations were most prominent in stage-IV (p<0.05). When analyzing survival across all cases irrespective of underlying pathology, higher first available total NPI-Q, progression to dementia, age and UPDRS-III at first NPI-Q were predictive of worse survival (p<0.05).
Cognitive progression to dementia (not MCI), higher initial NPI-Q scores, older age, and poorer baseline motor function, were associated with worse survival across pathological cases of LBD and AD.
Authors/Disclosures
Shannon Y. Chiu, MD, MSc (Mayo Clinic Arizona)
PRESENTER
Dr. Chiu has received research support from NIH.
Cecilia Tremblay (Banner Sun Health Research Institute) Cecilia Tremblay has nothing to disclose.
Nan Zhang Nan Zhang has nothing to disclose.
Charles H. Adler, MD, PhD, FAAN (Mayo Clinic Arizona) Dr. Adler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Adler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Avion. Dr. Adler has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for CND Life Sci. Dr. Adler has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Jazz. Dr. Adler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Precon. Dr. Adler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurocrine. The institution of Dr. Adler has received research support from NIH. The institution of Dr. Adler has received research support from Michael J. Fox Foundation. The institution of Dr. Adler has received research support from Arizona Biomedical Research Commission. Dr. Adler has received publishing royalties from a publication relating to health care.
Holly A. Shill, MD, FAAN (Barrow Neurology Clinics) Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sage Biogen. Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for KeifeRx. Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Praxis Precision Medicine. Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Fasikl Inc. Dr. Shill has received personal compensation in the range of $0-$499 for serving as a Consultant for Boston Scientific. Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Tanabe Pharma America.
Shyamal Mehta, MD, PhD, FAAN (Mayo Clinic, Arizona) Dr. Mehta has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Adamas Pharma. Dr. Mehta has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott. Dr. Mehta has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for CNS Ratings.
Erika Driver-Dunckley, MD, FAAN Dr. Driver-Dunckley has nothing to disclose.
David Shprecher, DO, FAAN (Banner Sun Health Research Institute) Dr. Shprecher has received personal compensation for serving as an employee of Banner Health. Dr. Shprecher has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amneal. Dr. Shprecher has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanders+Parks. Dr. Shprecher has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurocrine. Dr. Shprecher has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Shprecher has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kyowa Kirin. Dr. Shprecher has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medplace. The institution of Dr. Shprecher has received research support from MJFF. The institution of Dr. Shprecher has received research support from Cognition Therapeutics. The institution of Dr. Shprecher has received research support from Biogen. The institution of Dr. Shprecher has received research support from Neuraly. The institution of Dr. Shprecher has received research support from Jazz Pharmaceuticals. The institution of Dr. Shprecher has received research support from Sanofi Aventis. The institution of Dr. Shprecher has received research support from Annovis. The institution of Dr. Shprecher has received research support from Neurocrine. The institution of Dr. Shprecher has received research support from Teva. The institution of Dr. Shprecher has received research support from Nuvelution. The institution of Dr. Shprecher has received research support from EIP Pharma. Dr. Shprecher has received personal compensation in the range of $500-$4,999 for serving as a Speaker with International Parkinson's and MDS. Dr. Shprecher has received personal compensation in the range of $5,000-$9,999 for serving as a Speaker with Parkinson's Movement Disorder Alliance.
Christine Belden Christine Belden has nothing to disclose.
Geidy Serrano Geidy Serrano has nothing to disclose.
Thomas Beach (Banner Sun Health Research Institute) Thomas Beach has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Vivid Genomics. Thomas Beach has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche Diagnostics. The institution of Thomas Beach has received research support from National Institutes of Health. The institution of Thomas Beach has received research support from Michael J Fox Foundation . The institution of Thomas Beach has received research support from State of Arizona.
Alireza Atri, MD, PhD (Banner Sun Health Research Institute) Dr. Atri has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Prothena. Dr. Atri has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eisai. Dr. Atri has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novo Nordisk. Dr. Atri has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Atri has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Atri has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Life Molecular Imaging. Dr. Atri has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novo Nordisk. Dr. Atri has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche/Genentech. Dr. Atri has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lunbeck. Dr. Atri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ONO. Dr. Atri has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Axsome. Dr. Atri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AriBio. Dr. Atri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Vaxxinity. The institution of Dr. Atri has received research support from National Institute of Aging (NIA). The institution of Dr. Atri has received research support from AZ Department of Health Services. The institution of Dr. Atri has received research support from Gates Ventures. The institution of Dr. Atri has received research support from Multiple companies, universities & consortia for contracted clinical trials to institution. The institution of Dr. Atri has received research support from Washington University in St. Louis. The institution of Dr. Atri has received research support from Foundation for NIH. The institution of Dr. Atri has received research support from ACTC/NIH. Dr. Atri has received publishing royalties from a publication relating to health care.
Parichita Choudhury, MD (Banner Sun Health Research Institute) The institution of Dr. Choudhury has received research support from Lewy Body Dementia Association. The institution of Dr. Choudhury has received research support from Arizona Alzheimer's Consortium.