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Misidentification Subtype of Alzheimer's Disease Psychosis Predicts a Faster Cognitive Decline
The presence of psychosis is associated with a more rapid decline in Alzheimer's disease (AD), but the impact of paranoid (persecutory delusions) and misidentification (misperceptions and/or hallucinations) subtypes of psychosis on the speed of decline in AD is still unclear. We analyzed data o...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6533361/ https://www.ncbi.nlm.nih.gov/pubmed/30779330 http://dx.doi.org/10.1002/psp4.12389 |
Sumario: | The presence of psychosis is associated with a more rapid decline in Alzheimer's disease (AD), but the impact of paranoid (persecutory delusions) and misidentification (misperceptions and/or hallucinations) subtypes of psychosis on the speed of decline in AD is still unclear. We analyzed data on Alzheimer's Disease Neuroimaging Initiative 2 participants with late mild cognitive impairment or AD, and we described individual trajectories of Alzheimer's Disease Assessment Scale–Cognitive Subscale scores using a semimechanistic logistic model with a mixed effects–based approach, which accounted for dropout and adjusted for baseline Mini Mental State Examination scores. The covariate model included psychosis subtypes, age, gender, education, medications, and Apolipoprotein E epsilon 4 (Apo‐e ε4 genotype). We found that the Alzheimer's Disease Assessment Scale–Cognitive Subscale rate of increase was doubled in misidentification (β (r,misid_subtype) = 0.63, P = 0.031) and mixed (both subtypes; β (r,mixed_subtype) = 0.70, P = 0.003) when compared with nonpsychotic (or paranoid) patients, suggesting that the misidentification subtype may represent a distinct AD sub‐phenotype associated with an accelerated pathological process. |
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