Association between Neuropsychiatric Improvement and Neurocognitive Change in Alzheimer's Disease: Analysis of the CATIE-AD Study

Tomoyuki Nagata, Shunichiro Shinagawa, Shinichiro Nakajima, Masaru Mimura, Masahiro Shigeta

Research output: Contribution to journalArticle

Abstract

BACKGROUND/OBJECTIVE: To assess associations between improvements in neuropsychiatric symptoms (NPS) and neurocognitive change in patients with Alzheimer's disease (AD) during treatment using the Clinical Antipsychotic Trials of Intervention Effectiveness-Alzheimer Disease (CATIE-AD) dataset.

METHODS: AD outpatients with NPS who needed pharmacological treatment (n = 421) were followed up with antipsychotics, citalopram, or placebo for up to 36 weeks (mean±SD = 252±52 days). The study aim was to investigate associations between improvement in each NPS evaluating scale (by Clinical Global Impression of Change [CGI-C], Neuropsychiatric Inventory [NPI], or Brief Psychiatric Scale [BPRS]) at endpoint (week 36 or early termination [ET], n = 340) and neurocognitive change (change score in the Mini-Mental State Examination [MMSE] between endpoint and baseline during the treatment). Multiple logistic regression analyses were performed on the associations between each NPS improvement and neurocognitive change as well as socio-clinico-demographic variables of interest.

RESULTS: At endpoint, NPS improvement rates were 76.1%, 70.8%, and 58.1% in CGI-C, NPI, and BPRS, respectively, while MMSE score change was -2.3±3.8. NPS improvement was significantly related to more severe psychotic symptoms at baseline and preserved levels of neurocognition (smaller MMSE score change) among several variables.

CONCLUSIONS: Our findings suggested that neurocognitive preservation may be associated with attaining optimal benefits from any treatment against NPSs in a longitudinal treatment course of patients with AD.

Original languageEnglish
Pages (from-to)139-148
Number of pages10
JournalJournal of Alzheimer's disease : JAD
Volume66
Issue number1
DOIs
Publication statusPublished - 2018 Jan 1

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Antipsychotic Agents
Alzheimer Disease
Clinical Trials
Psychiatry
Therapeutics
Equipment and Supplies
Citalopram
Outpatients
Logistic Models
Placebos
Regression Analysis
Demography
Pharmacology

Keywords

  • Alzheimer’s disease
  • antipsychotic
  • CATIE-AD
  • neurocognitive impairment
  • neuropsychiatric symptom

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Association between Neuropsychiatric Improvement and Neurocognitive Change in Alzheimer's Disease : Analysis of the CATIE-AD Study. / Nagata, Tomoyuki; Shinagawa, Shunichiro; Nakajima, Shinichiro; Mimura, Masaru; Shigeta, Masahiro.

In: Journal of Alzheimer's disease : JAD, Vol. 66, No. 1, 01.01.2018, p. 139-148.

Research output: Contribution to journalArticle

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