背景:与非西班牙裔白人(NHW)个体相比,阿尔茨海默病(AD)在非洲裔美国人(AA)和西班牙裔白人(HIW)中更为普遍。同样,神经精神症状(NPS)因AD人群而异。这可能是社会文化和遗传祖先差异的结果。然而,这些NPS对不同组AD的影响尚不清楚。
方法:自我声明AA,HIW,和NHW个体被确定为正在进行的AD遗传学研究的一部分。包括在临床痴呆等级(CDR)量表(CDR)上得分高于0.5的参与者。神经精神量表(NPI-Q)结果的小组相似性和差异性(NPI-Q总分,NPI-Q项目)在控制性别和CDR阶段后,使用单变量ANOVA和事后比较进行评估。
结果:我们的样本包括498名参与者(26%AA;30%HIW;44%NHW)。总的来说,NPI-Q总分在我们组间差异显著,HIW的NPI-Q总分最高,以及通过CDR测量的AD阶段。我们发现不同性别的NPI-Q总分没有显着差异。有六个NPI-Q项目在所有组中的患病率相当,六个项目在组间有显著差异(焦虑,冷漠,抑郁症,解除抑制,兴高采烈,和易怒)。Further,在HIW组中,在多个NPI-Q项目中,波多黎各人和古巴裔美国人之间存在差异。最后,六个NPI-Q项目在AD的后期阶段更为普遍,包括躁动,食欲,幻觉,易怒,电机扰动,和夜间行为。
结论:我们确定了HIW之间NPS的差异,AA,和NHW个人。最引人注目的是HIW核动力源的高负担,特别是情绪和焦虑症状。我们建议NPS差异可能代表了社会文化影响对症状表现以及源于祖先背景的潜在遗传因素的影响。考虑到AD和NPS之间的复杂关系,辨别NPS的存在以确保适当的干预是至关重要的。
Alzheimer disease (AD) is more prevalent in African American (AA) and Hispanic White (HIW) compared to Non-Hispanic White (NHW) individuals. Similarly, neuropsychiatric symptoms (NPS) vary by population in AD. This is likely the result of both sociocultural and genetic ancestral differences. However, the impact of these NPS on AD in different groups is not well understood.
Self-declared AA, HIW, and NHW individuals were ascertained as part of ongoing AD genetics studies. Participants who scored higher than 0.5 on the Clinical Dementia Rating (CDR) Scale (CDR) were included. Group similarities and differences on Neuropsychiatric Inventory Questionnaire (NPI-Q) outcomes (NPI-Q total score, NPI-Q items) were evaluated using univariate ANOVAs and post hoc comparisons after controlling for sex and CDR stage.
Our sample consisted of 498 participants (26% AA; 30% HIW; 44% NHW). Overall, NPI-Q total scores differed significantly between our groups, with HIW having the highest NPI-Q total scores, and by AD stage as measured by CDR. We found no significant difference in NPI-Q total score by sex. There were six NPI-Q items with comparable prevalence in all groups and six items that significantly differed between the groups (Anxiety, Apathy, Depression, Disinhibition, Elation, and Irritability). Further, within the HIW group, differences were found between Puerto Rican and Cuban American Hispanics across several NPI-Q items. Finally, Six NPI-Q items were more prevalent in the later stages of AD including Agitation, Appetite, Hallucinations, Irritability, Motor Disturbance, and Nighttime Behavior.
We identified differences in NPS among HIW, AA, and NHW individuals. Most striking was the high burden of NPS in HIW, particularly for mood and anxiety symptoms. We suggest that NPS differences may represent the impact of sociocultural influences on symptom presentation as well as potential genetic factors rooted in ancestral background. Given the complex relationship between AD and NPS it is crucial to discern the presence of NPS to ensure appropriate interventions.