Impact of Modifiable Risk Factors and APOE on Neuropsychiatric Symptoms in Alzheimer’s Disease
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BACKGROUND
Neuropsychiatric symptoms (NPS) are prevalent and debilitating in Alzheimer’s disease (AD). Existing pharmacologic treatments are often ineffective and associated with serious adverse events. Identifying modifiable risk factors (MRFs) is critical for prevention and treatment.
METHODS
Capitalizing on data from 14,497 individuals with AD from the National Alzheimer’s Coordinating Center (NACC) database, we examined longitudinal associations between modifiable risk factors, APOE genotype and NPI-Q-assessed NPS using Cox proportional hazards models adjusted for demographics.
RESULTS
Diabetes, alcohol consumption, smoking, and TBI were associated with an increased risk of specific NPS in AD. APOEε4 carrier status was linked to multiple NPS, showing a dose-response relationship. Education, LDL-C, and corrective lenses were protective; hypertension showed no associations.
CONCLUSION
These findings strongly suggest that individual MRFs are associated with specific NPS in line with a complex etiology underlying these symptoms. Early detection and management of vascular, lifestyle and sensory factors could reduce NPS.
