Conference Coverage

ADHD Associated With the Development of Specific Neuropsychiatric Symptoms in Patients With Cognitive Impairment

Anthony Calabro, MA

In a recent study presented at the Alzheimer's Association International Conference 2024 in Philadelphia, PA, researchers determined that a higher genetic risk for attention-deficit/hyperactivity disorder (ADHD) could potentially be a risk factor for the development of neuropsychiatric symptoms—specifically hyperactive and apathy indications—in those with cognitive impairment (CI).

Although it is well-understood that there is an association between an increased genetic risk for ADHD and a more severe Alzheimer disease (AD) presentation, Leffa and colleagues set out to determine whether ADHD predisposes individuals to the development of neuropsychiatric symptoms as well.

The researchers used data from the Alzheimer's Disease Neuroimaging Initiative to determine any associations between ADHD polygenic risk scores (ADHD-PRS) and the development of neuropsychiatric symptoms in patients with CI (including those with mild CI and AD), who also had brain amyloidosis at baseline.

>> Research Summary: Relationship Between Neuropsychiatric Symptoms in Patients With Alzheimer Disease and Functional Decline

Leffa and colleagues also analyzed the association between the genetic risk for depression, bipolar disorder (BD), schizophrenia, and autism spectrum disorder (ASD) with the development of neuropsychiatric symptoms using the Neuropsychiatric Inventory and the Neuropsychiatric Inventory Questionnaire. They divided neuropsychiatric symptoms into four groups:

  • hyperactive (agitation, disinhibition, irritability, and aberrant motor behavior)
  • psychosis (delusions, hallucinations, and night-time behavior disturbances)
  • apathy (apathy and appetite and eating abnormalities)
  • affective (depression and anxiety)

The mean age of the 852 patients in the study was 73 years. Of the total study participants, 636 patients (74.1%) had mild CI. According to the results of the study, ADHD-PRS was associated with a higher risk of developing hyperactive (HR = 1.41; 95% CI, 1.04 to 1.89) and apathy (HR = 1.34; 95% CI, 1.01 to 1.77) symptoms, but not psychosis (HR = 1.04; 95% CI, 0.78 to 1.41) or affective (HR = 0.97; 95%, CI 0.72 to 1.32) symptoms. The results also showed no association between the genetic risk for depression, BD, schizophrenia, or ASD with any neuropsychiatric syndrome.

“Findings indicate that a higher genetic risk for ADHD may be a risk factor for the development of hyperactive and apathy symptoms in CI individuals,” the researchers concluded. “These effects were specific for ADHD and were not observed for other prevalent psychiatric disorders. Clinically, our results contribute to the literature that highlights the need for tailored assessments for CI individuals with ADHD histories.”

 

Reference:
Leffa DT, Bellaver B, Povala G, et al. Attention-deficit/hyperactivity disorder impacts the development of neuropsychiatric symptoms in Alzheimer’s disease. Presented at: Alzheimer's Association International Conference; July 28-August 1, 2024; Philadelphia, PA. Accessed August 12, 2024. https://aaic.alz.org/about/overview.asp