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Psych Congress  

The Natural Progression of Agitation in Alzheimer's Disease/Dementia: A Systematic Literature Review

Milena Anatchkova, PhD; Anne Brooks, BS; Laura Swett, PhD; Ann Hartry, PhD; Ruth Duffy, PhD; Ross Baker, PhD, MBA; Myrlene Aigbogun, MPH
Otsuka Pharmaceutical Development and Commercialization, Inc. and Lundbeck

This poster was presented at the 30th annual  Psych Congress, held Sept. 16-19, 2017, in New Orleans, Louisiana.

BACKGROUND: More than 90% of individuals with Alzheimer's Disease (AD) experience behavioral and neuropsychiatric symptoms (NPS) such as agitation during their illness. Little is known about the natural progression of agitation and its relationship to disease severity in AD/Dementia.

METHODS: A global systematic literature review in Medline and Embase databases assessing clinical, humanistic, and economic burden of agitation in AD/Dementia studies published between 2006-2016 conducted. Studies meeting inclusion criteria for natural progression of agitation/NPS symptoms and severity of disease were summarized.

RESULTS: Seventeen studies evaluated progression of either agitation specifically and/or as a component of NPS. Observation periods ranged from 24 weeks to 6 years. More European studies showed an increase in agitation prevalence over time than US studies (6/9 vs. 1/4) and more US studies showed little or no change in prevalence or frequency over time than European studies (2/4 vs. 1/9). Thirty-four studies assessed the relationship between agitation or overall NPS and AD severity. A majority (74%) of studies indicated a significant positive relationship between agitation or NPS and severity of AD, with additional studies (12%) providing evidence of a trending association.

CONCLUSIONS: Results suggest NPS ratings increase over time, while the proportion of patients with behavioral symptoms increased slightly or remained stable over time. Higher prevalence and severity of agitation over time in EU vs. US may be related to site of care, cultural differences, or possibly under-recognition of symptoms. Studies found a positive relationship in which the prevalence and incidence of agitation increases with disease severity.

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