Baseline predictors of antipsychotic treatment continuation and response at week 8 in patients with Alzheimer's disease with psychosis or aggressive symptoms: An analysis of the CATIE-AD study

Tomoyuki Nagata, Shinichiro Nakajima, Shunichiro Shinagawa, Eric Plitman, Kazuhiko Nakayama, Ariel Graff-Guerrero, Masaru Mimura

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Abstract

Background/Objective: The aim of the present study was to investigate predictors of atypical antipsychotic (AAP) treatment continuation and response by week 8 in patients with Alzheimer's disease (AD) who have psychotic/aggressive symptoms using the Clinical Antipsychotic Trials of Intervention Effectiveness-Alzheimer's Disease (CATIE-AD) dataset. Methods: Clinical datawas utilized from 421ADoutpatients with psychotic/aggressive symptoms who needed interventional treatment. Logistic regression analyses were performed to examine which baseline sociodemographic and clinical characteristics contributed to treatment 'continuation' and 'response', the latter of which was evaluated by the Clinical Global Impression of Change (CGI-C), Neuropsychiatric Inventory (NPI), and Brief Psychiatric Scale (BPRS). Results: The treatment continuation rate was 48.7%, and CGI-C, NPI, and BPRS response rate by the last observation carried forward method were 42.7%, 48.6%, and 37.5%, respectively. No significant predictor was identified for treatment continuation in the Caucasian patients (n = 331), while better treatment response was predicted by a lower Mini-Mental State Examination score, treatment with risperidone (versus olanzapine and quetiapine), history of diabetes mellitus, healthier physical status, and more severe initial psychotic symptoms. Conclusions: Comparatively high intolerability from AAPs in the short term was confirmed.We found that baseline clinical predictors to treatment response in Caucasian AD patients with psychotic/aggressive symptoms include treatment with risperidone (versus quetiapine and olanzapine), diabetes mellitus, global physical status, cognitive impairment, and psychotic symptoms. Going forward, these findings may help to determine treatment strategies or care plans.

Original languageEnglish
Pages (from-to)263-272
Number of pages10
JournalJournal of Alzheimer's Disease
Volume60
Issue number1
DOIs
Publication statusPublished - 2017

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Keywords

  • Aggression
  • Alzheimer's disease
  • atypical antipsychotic
  • neuropsychiatric symptom
  • psychosis

ASJC Scopus subject areas

  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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