Frequency of neuropsychiatric symptoms in Hispanics with Alzheimer's disease

Poster Presentations: P4 P4-139

FREQUENCY OF NEUROPSYCHIATRIC SYMPTOMS IN HISPANICS WITH ALZHEIMER’S DISEASE

Ricardo Salazar1, Walter Shuham2, Donald Royall3, 1The University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States; 2UTHSCSA, San Antonio, Texas, United States; 3UTHSCSA Psychiatry, San Antonio, Texas, United States. Contact e-mail: salazarr1@ uthscsa.edu Background: Previous studies show that problem behavior, as measured by the Neuropsychiatric Inventory (NPI) differentiates Mild Cognitive Impairment (MCI) from both dementia cases and normal controls. This implies a clinical and possibly a biological continuum which may help identify populations at risk for developing dementia. Data from the Texas Alzheimer‘s Research and Care Consortium (TARCC) may help confirm MCI as an intermediate state between normal cognitive functioning and dementia, and identify differences between MCI’s presentation in Hispanic and non-Hispanic populations. The aim of this study was t o examine moderating effects of ethnicity on the neuropsychiatric profile of MCI, and compare MCI to both normal controls and patients with Alzheimer‘s Disease (AD) in the TARCC population. Methods: Visit 1 data from n¼ 2189 TARCC participants [975 cases of Alzheimer‘s disease (AD), 339 Mild Cognitive Impairment (MCI) cases, and 875 normal controls (NC)] were included in the analyses. The frequency of NPI-Q affected domains and NPI-Q total scores were compared across the three groups while controlling for age, education, Mini-Mental State Exam (MMSE), Clinical Dementia Rating-Sum of Boxes (CDRSUM), and Geriatric Depression Scores (GDS). Statistical analysis using multivariate analysis of variance (MANOVA) was performed on Statistica version 10 for windows. Results: Both NPI-Q total and NPI-Q domain subscores differed significantly across the three diagnostic groups (p <0.001). Interaction analyses stratified by ethnicity identified a significant difference in the frequency of NPI-Q affected domains and total NPI-Q scores between Hispanic and Non-Hispanic subjects among AD cases only (both p ¼ 0.004), but not among those with NC and MCI (all p > 0.05). There were no significant cross ethnic interactions by stage of disease in gender, CDRSUM or IADL scores. Conclusions: NPI-Q has repeatedly proven to be a reliable indicator of problem behaviors. The current analysis indicates that it may also be used to stage and monitor AD progression. Ethnic differences in neuropsychiatric symptoms of subjects with AD, but not MCI, indicate that the presentation of dementia, but also possibly its etiology, may differ between these two populations. This could have significant impacts on the treatment and understanding of dementia within the Hispanic population. P4-140

NORMAL PRESSURE HYDROCEPHALUS: TREATABLE DEMENTIA, MISSED DIAGNOSIS— THE LAUNCESTON PREVALENCE STUDY

George Razay1, Melissa Wimmer1, 1Launceston General Hospital, Launceston, Australia. Contact e-mail: [email protected] Background: Normal Pressure Hydrocephalus (NPH) is one of the few treatable forms of dementia, but it is notoriously difficult to diagnose in the elderly. It is often treated by the insertion of ventriculo-peritoneal shunt with significant improvement in the cognitive, gait and urinary functioning. Most studies suggest the condition is rare but there are few studies addressing the prevalence of the condition. We have, therefore, investigated the prevalence of NPH amongst patients with cognitive impairment attending the Memory Disorders Clinic in Launceston. Methods: Three hundreds and fifty five consecutive patients were recruited from the Memory Disorders Clinic at the Launceston General Hospital since 2010. The diagnosis of NPH was based on the presence of memory impairment or dementia, and/or balance/gait disorder and the presence of prominent ventricles regardless of cerebral atrophy on MRI of the brain. All patients with NPH were investigated by CSF Flow Study. Results: One hundred and sixty four men and 191 women participated in the study, mean age 73 years (range 32-95 years), mean MMSE score 23 (range 0-30). 190 (54%) patients were diagnosed with mild cognitive impairment, of whom 54 (28%) had underly-

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ing anxiety and depression, 23 (12%) had NPH and 9 (5%) had Parkinsonism.165 (46%) were diagnosed with dementia, of whom 77 (47%) had Alzheimer’s disease, 33 (20%) had NPH, 20 (12%) had mixed dementia, 9 (5%) had vascular dementia and 26 (16%) were diagnosed with other forms of dementia including Parkinsonism, Lewy Body Disease, Gertsmann Syndrome, and Frontal Lobe Dementia. Conclusions: NPH is probably more common than previously thought. This is important because many patients without shunting might be condemned for years of disabilities and institutionalisation. P4-141

PERFORMANCE OF THE DIFFERENT PROPOSED CRITERIA FOR THE DIAGNOSIS OF MILD COGNITIVE IMPAIRMENT AND ALZHEIMER’S DISEASE: DATA FROM THE AUSTRALIAN IMAGING, BIOMARKERS AND LIFESTYLE STUDY OF AGING

Yi-Hsuan Chen1, Cassandra Szoeke2, Michael Woodward3, 1Austin Health, Melbourne, Australia, Melbourne, Victoria, Australia; 2National Ageing Research Institute Inc., Melbourne, Australia; 3Austin Health, Heidelberg West, Australia. Contact e-mail: [email protected] Background: To apply the diagnostic criteria proposed by the National Institute on Aging and the Alzheimer’s Association (NIA-AA), the International Working Group for New Research Criteria for the Diagnosis of Alzheimer’s Disease (IWG), and the DSM-5 to the AIBL baseline study population. The AIBL study participants were classified into different diagnostic groups using the AIBL criteria at baseline (Ellis et al, International