Demographics, Symptoms, Psychotropic Use, and Caregiver Distress in Patients With Early vs Late Onset Dementia

David R Lee; Tahmineh Romero; Katherine Sy Serrano; Michelle Panlilio; Abel Rojas-Parra; Lauren Matsuno; Mario F Mendez; Christine Willinger; David B Reuben

doi:10.1016/j.jagp.2024.03.009

Demographics, Symptoms, Psychotropic Use, and Caregiver Distress in Patients With Early vs Late Onset Dementia

Am J Geriatr Psychiatry. 2024 Aug;32(8):944-954. doi: 10.1016/j.jagp.2024.03.009. Epub 2024 Mar 22.

Authors

David R Lee¹, Tahmineh Romero², Katherine Sy Serrano³, Michelle Panlilio⁴, Abel Rojas-Parra⁵, Lauren Matsuno⁴, Mario F Mendez⁶, Christine Willinger⁴, David B Reuben³

Affiliations

¹ Multicampus Program in Geriatric Medicine and Gerontology, Division of Geriatrics, David Geffen School of Medicine at UCLA, University of California (DRL, KS, DBR), Los Angeles, CA. Electronic address: drlee@mednet.ucla.edu.
² Department of Medicine Statistics Core (TR), David Geffen School of Medicine, University of California, Los Angeles, CA.
³ Multicampus Program in Geriatric Medicine and Gerontology, Division of Geriatrics, David Geffen School of Medicine at UCLA, University of California (DRL, KS, DBR), Los Angeles, CA.
⁴ Department of Medicine (MP, LM, CW), David Geffen School of Medicine, University of California, Los Angeles, CA.
⁵ Department of Geriatric Medicine (ARP), Clinica Sierra Vista, Bakersfield, CA.
⁶ Department of Neurology, Department of Psychiatry and Behavioral Sciences (MFM), David Geffen School of Medicine, University of California Los Angeles (UCLA), Neurology Service, Neurobehavior Unit, V.A. Greater Los Angeles Healthcare System, Los Angeles, CA.

PMID: 38600005
DOI: 10.1016/j.jagp.2024.03.009

Abstract

Background: Understanding experiences and challenges faced by persons living with Early-Onset Dementia (EOD) compared to individuals diagnosed with Late-Onset Dementia (LOD) is important for the development of targeted interventions.

Objective: Describe differences in sociodemographic, neuropsychiatric behavioral symptoms, caregiver characteristics, and psychotropic use.

Design, setting, participants: Cross-sectional, retrospective study including 908 UCLA Alzheimer's Dementia Care Program participants (177 with EOD and 731 with LOD).

Measurements: Onset of dementia was determined using age at program enrollment, with EOD defined as age <65 years and LOD defined as age >80 years. Sociodemographic and clinical characteristics were measured once at enrollment. Behavioral symptoms were measured using the Neuropsychiatric Inventory Questionnaire (NPI-Q) severity score and caregiver distress was measured using the NPI-Q distress score. Medications included antipsychotic, antidepressant, benzodiazepines and other hypnotics, antiepileptics, and dementia medications.

Results: EOD compared to LOD participants were more likely men, college graduates, married, live alone, and have fewer comorbidities. EOD caregivers were more often spouses (56% vs 26%, p <0.01), whereas LOD caregivers were more often children (57% vs 10%, p <0.01). EOD was associated with lower odds of being above the median (worse) NPI-Q severity (adjusted odds ratio [aOR], 0.58; 95% CI 0.35-0.96) and NPI-Q distress scores (aOR, 0.53; 95% CI 0.31-0.88). Psychotropic use did not differ between groups though symptoms were greater for LOD compared to EOD.

Conclusion: Persons with EOD compared to LOD had sociodemographic differences, less health conditions, and fewer neuropsychiatric symptoms. Future policies could prioritize counseling for EOD patients and families, along with programs to support spousal caregivers of persons with EOD.

Keywords: Caregiver distress; Early onset dementia; Neuropsychiatric symptoms; Psychotropic medications.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Age of Onset*
Aged
Aged, 80 and over
Caregivers* / psychology
Cross-Sectional Studies
Dementia* / epidemiology
Female
Humans
Male
Middle Aged
Psychological Distress
Psychotropic Drugs* / therapeutic use
Retrospective Studies

Substances

Psychotropic Drugs