Cerebral Amyloid Angiopathy Is Associated With Emotional Dysregulation, Impulse Dyscontrol, and Apathy

Background Cerebral amyloid angiopathy (CAA) causes cognitive decline, but it is not known whether it is associated with neuropsychiatric symptoms (NPS). Methods and Results Participants with CAA, mild cognitive impairment, mild dementia due to Alzheimer's disease, and normal cognition were rec...

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Autores principales:	Eric E. Smith, Stephanie Crites, Meng Wang, Anna Charlton, Angela Zwiers, Ramnik Sekhon, Tolulope Sajobi, Richard Camicioli, Cheryl R. McCreary, Richard Frayne, Zahinoor Ismail
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	Alzheimer's disease anxiety apathy cerebral amyloid angiopathy depression intracerebral hemorrhage Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/ea130f2b41c74b018104683a64297c1b
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spelling	oai:doaj.org-article:ea130f2b41c74b018104683a64297c1b2021-11-16T10:22:43ZCerebral Amyloid Angiopathy Is Associated With Emotional Dysregulation, Impulse Dyscontrol, and Apathy10.1161/JAHA.121.0220892047-9980https://doaj.org/article/ea130f2b41c74b018104683a64297c1b2021-11-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.121.022089https://doaj.org/toc/2047-9980Background Cerebral amyloid angiopathy (CAA) causes cognitive decline, but it is not known whether it is associated with neuropsychiatric symptoms (NPS). Methods and Results Participants with CAA, mild cognitive impairment, mild dementia due to Alzheimer's disease, and normal cognition were recruited from stroke and dementia clinics and community advertising. NPS were captured using the Neuropsychiatric Inventory Questionnaire short form. The number and total severity (number multiplied by severity of each symptom [mild, moderate, or severe]) of NPS were analyzed using generalized linear regression with a negative binomial link and multiple linear regression, adjusting for age, sex, and education. A total of 109 participants (43 with CAA, 15 with Alzheimer's disease, 28 with mild cognitive impairment, and 23 with normal cognition) (mean age 71.1 [SD=7.6]; 53.2% male) were included. The most frequent NPS in CAA were depression/dysphoria (48.8%), irritability/lability (37.2%), agitation/aggression (37.2%), apathy/indifference (34.9%), and anxiety (32.6%). In adjusted models, patients with CAA had 3.2 times (95% CI, 1.7–6.0) more NPS symptoms and 3.1 units (95% CI, 1.0–5.1) higher expected severity score. The number of NPS was similar to patients with mild cognitive impairment (3.2 times higher than controls) but less than in patients with Alzheimer's disease dementia (4.1 times higher than controls). Within patients with CAA, there were 1.20 times (95% CI, 1.01–1.32) more NPS per 1% increase in white matter hyperintensity as a percentage of intracranial volume. Conclusions NPS are common in CAA, with a similar prevalence as in mild cognitive impairment. The association of the total number of NPS with higher white matter hyperintensity volume suggests that white matter damage may underlie some of these symptoms.Eric E. SmithStephanie CritesMeng WangAnna CharltonAngela ZwiersRamnik SekhonTolulope SajobiRichard CamicioliCheryl R. McCrearyRichard FrayneZahinoor IsmailWileyarticleAlzheimer's diseaseanxietyapathycerebral amyloid angiopathydepressionintracerebral hemorrhageDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 22 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Alzheimer's disease anxiety apathy cerebral amyloid angiopathy depression intracerebral hemorrhage Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Alzheimer's disease anxiety apathy cerebral amyloid angiopathy depression intracerebral hemorrhage Diseases of the circulatory (Cardiovascular) system RC666-701 Eric E. Smith Stephanie Crites Meng Wang Anna Charlton Angela Zwiers Ramnik Sekhon Tolulope Sajobi Richard Camicioli Cheryl R. McCreary Richard Frayne Zahinoor Ismail Cerebral Amyloid Angiopathy Is Associated With Emotional Dysregulation, Impulse Dyscontrol, and Apathy
description	Background Cerebral amyloid angiopathy (CAA) causes cognitive decline, but it is not known whether it is associated with neuropsychiatric symptoms (NPS). Methods and Results Participants with CAA, mild cognitive impairment, mild dementia due to Alzheimer's disease, and normal cognition were recruited from stroke and dementia clinics and community advertising. NPS were captured using the Neuropsychiatric Inventory Questionnaire short form. The number and total severity (number multiplied by severity of each symptom [mild, moderate, or severe]) of NPS were analyzed using generalized linear regression with a negative binomial link and multiple linear regression, adjusting for age, sex, and education. A total of 109 participants (43 with CAA, 15 with Alzheimer's disease, 28 with mild cognitive impairment, and 23 with normal cognition) (mean age 71.1 [SD=7.6]; 53.2% male) were included. The most frequent NPS in CAA were depression/dysphoria (48.8%), irritability/lability (37.2%), agitation/aggression (37.2%), apathy/indifference (34.9%), and anxiety (32.6%). In adjusted models, patients with CAA had 3.2 times (95% CI, 1.7–6.0) more NPS symptoms and 3.1 units (95% CI, 1.0–5.1) higher expected severity score. The number of NPS was similar to patients with mild cognitive impairment (3.2 times higher than controls) but less than in patients with Alzheimer's disease dementia (4.1 times higher than controls). Within patients with CAA, there were 1.20 times (95% CI, 1.01–1.32) more NPS per 1% increase in white matter hyperintensity as a percentage of intracranial volume. Conclusions NPS are common in CAA, with a similar prevalence as in mild cognitive impairment. The association of the total number of NPS with higher white matter hyperintensity volume suggests that white matter damage may underlie some of these symptoms.
format	article
author	Eric E. Smith Stephanie Crites Meng Wang Anna Charlton Angela Zwiers Ramnik Sekhon Tolulope Sajobi Richard Camicioli Cheryl R. McCreary Richard Frayne Zahinoor Ismail
author_facet	Eric E. Smith Stephanie Crites Meng Wang Anna Charlton Angela Zwiers Ramnik Sekhon Tolulope Sajobi Richard Camicioli Cheryl R. McCreary Richard Frayne Zahinoor Ismail
author_sort	Eric E. Smith
title	Cerebral Amyloid Angiopathy Is Associated With Emotional Dysregulation, Impulse Dyscontrol, and Apathy
title_short	Cerebral Amyloid Angiopathy Is Associated With Emotional Dysregulation, Impulse Dyscontrol, and Apathy
title_full	Cerebral Amyloid Angiopathy Is Associated With Emotional Dysregulation, Impulse Dyscontrol, and Apathy
title_fullStr	Cerebral Amyloid Angiopathy Is Associated With Emotional Dysregulation, Impulse Dyscontrol, and Apathy
title_full_unstemmed	Cerebral Amyloid Angiopathy Is Associated With Emotional Dysregulation, Impulse Dyscontrol, and Apathy
title_sort	cerebral amyloid angiopathy is associated with emotional dysregulation, impulse dyscontrol, and apathy
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/ea130f2b41c74b018104683a64297c1b
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Cerebral Amyloid Angiopathy Is Associated With Emotional Dysregulation, Impulse Dyscontrol, and Apathy

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