Liampas Ioannis, Siokas Vasileios, Stamati Polyxeni, Kyriakoulopoulou Panayiota, Tsouris Zisis, Zoupa Elli, Folia Vasiliki, Lyketsos Constantine G, Dardiotis Efthimios
Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece.
School of Medicine, University of Patras, Patras, Greece.
Int J Geriatr Psychiatry. 2024 Dec;39(12):e70008. doi: 10.1002/gps.70008.
We investigated the association between neuropsychiatric symptoms (NPS) and frontotemporal atrophy (FTA) in older adults without dementia. We hypothesized that the odds of having NPS would be increased in the presence of FTA.
NACC participants ≥ 50 years old with available data on FTA were considered for eligibility. Those with a diagnosis of mild cognitive impairment (MCI) and those who were cognitively unimpaired (CU) were separately analyzed. NPS were quantified on the Neuropsychiatric Inventory Questionnaire. Binary logistic regression models estimated the association (odds ratios and 95% confidence intervals are provided) between FTA and having each of 11 NPS (psychotic symptoms were grouped together) in CU and MCI individuals.
FTA data were available for 3165 participants with MCI and 4051 CU: 207 and 55 had FTA on structural MRI studies, respectively. In the MCI group, the presence of FTA was associated with higher odds of having elation [2.42(1.33-4.40), p = 0.004], aberrant motor behavior [2.43(1.61-3.69), p < 0.001], appetite disorders [2.15(1.52-3.04), p < 0.001], apathy [2.05(1.48-2.85), p < 0.001] and disinhibition [2.02(1.38-2.96), p < 0.001]. The odds of having specific NPS were not significantly elevated in CU individuals with FTA. Of note, the size and direction of the associations were indicative of a potential relationship between FTA and specific NPS (most notably elation, aberrant motor behavior, appetite disorders and anxiety); in light of the small number of CU individuals with FTA we believe this analysis was underpowered and obscured several true associations.
FTA was associated with higher odds of some NPS in older adults with MCI but not with normal cognition.
我们研究了无痴呆症老年人的神经精神症状（NPS）与额颞叶萎缩（FTA）之间的关联。我们假设，存在FTA时出现NPS的几率会增加。
考虑纳入年龄≥50岁且有FTA可用数据的国家阿尔茨海默病协调中心（NACC）参与者。对诊断为轻度认知障碍（MCI）的参与者和认知未受损（CU）的参与者分别进行分析。使用神经精神科问卷对NPS进行量化。二元逻辑回归模型估计了FTA与CU和MCI个体中11种NPS（精神病性症状归为一组）各自出现之间的关联（提供优势比和95%置信区间）。
有3165名MCI参与者和4051名CU参与者有FTA数据：在结构MRI研究中，分别有207名和55名有FTA。在MCI组中，存在FTA与出现欣快[2.42（1.33 - 4.40），p = 0.004]、异常运动行为[2.43（1.61 - 3.69），p < 0.001]、食欲障碍[2.15（1.52 - 3.04），p < 0.001]、冷漠[2.05（1.48 - 2.85），p < 0.001]和脱抑制[2.02（1.38 - 2.96），p < 0.001]的较高几率相关。在有FTA的CU个体中，出现特定NPS的几率没有显著升高。值得注意的是，关联的大小和方向表明FTA与特定NPS（最明显的是欣快、异常运动行为、食欲障碍和焦虑）之间可能存在关系；鉴于有FTA的CU个体数量较少，我们认为该分析的效能不足，掩盖了一些真实的关联。
FTA与MCI老年人中某些NPS的较高几率相关，但与正常认知无关。
