{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:47:36Z","timestamp":1777394856636,"version":"3.51.4"},"reference-count":50,"publisher":"SAGE Publications","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2020,12,8]]},"abstract":"<jats:p>Background: Comprehensive clinicopathological studies of neuropsychiatric symptoms (NPS) in dementia are lacking. Objective: To describe the pathological correlations of NPS in a sample of institutionalized people with dementia. Methods: We studied 59 people who were consecutively admitted to a nursing home and donated their brain. Correlations between pathological variables and NPS upon admission (n\u200a=\u200a59) and at one-year follow-up assessment (n\u200a=\u200a46) were explored and confirmed using bivariate and multivariate statistical methods. Results: Mean (SD) age at admission was 83.2 (6.4) years and mean (SD) age at demise was 85.4 (6.6); 73% of the subjects were female and 98% presented advanced dementia. The most frequent etiological diagnosis was Alzheimer\u2019s disease (AD; 74.6% clinical diagnosis, 67.8% pathological diagnosis). The pathological diagnosis of AD was associated with aggression (\u03b2 est 0.31), depression (\u03b2 est 0.31), anxiety (\u03b2 est 0.38), and irritability (\u03b2 est 0.28). Tau stage correlated with aggressive symptoms (\u03b2 est 0.32) and anxiety (\u03b2est 0.33). Coexistence of AD and Lewy body pathology was associated with depression (\u03b2 est 0.32), while argyrophilic grains were associated with eating symptoms (\u03b2 est 0.29). Predictive models were achieved for apathy, including cognitive performance, basal ganglia ischemic lesions, and sex as predictors (R2 0.38) and for sleep disorders, including pathological diagnosis of AD and age at demise (R2 0.18) (all p-values &lt;0.05, unadjusted). Conclusion: AD was the main pathological substrate of NPS in our sample of very elderly people with advanced dementia. However, correlations were mild, supporting a model of focal\/asymmetric rather than diffuse brain damage, along with relevance of environmental and other personal factors, in the genesis of those symptoms.<\/jats:p>","DOI":"10.3233\/jad-200600","type":"journal-article","created":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T10:22:55Z","timestamp":1605262975000},"page":"1731-1741","source":"Crossref","is-referenced-by-count":15,"title":["Pathological Correlations of Neuropsychiatric Symptoms in Institutionalized People with Dementia"],"prefix":"10.1177","volume":"78","author":[{"given":"Ester","family":"Esteban de Antonio","sequence":"first","affiliation":[{"name":"Neurology Service, University Hospital Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"L\u00f3pez-\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Psychiatry Department, University Hospital 12 de Octubre, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"R\u00e1bano","sequence":"additional","affiliation":[{"name":"Alzheimer\u2019s Center Reina Sof\u00eda Foundation - CIEN Foundation and CIBERNED, Carlos III Institute of Health, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Ag\u00fcera-Ortiz","sequence":"additional","affiliation":[{"name":"Psychiatry Department, University Hospital 12 de Octubre, Madrid, Spain"},{"name":"CIBERSAM, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"S\u00e1nchez-Soblechero","sequence":"additional","affiliation":[{"name":"Neurology Service, University Hospital Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Amaya","sequence":"additional","affiliation":[{"name":"Neurology Service, University Hospital Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sof\u00eda","family":"Portela","sequence":"additional","affiliation":[{"name":"Neurology Service, University Hospital Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"C\u00e1tedra","sequence":"additional","affiliation":[{"name":"Neurology Service, University Hospital Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Olazar\u00e1n","sequence":"additional","affiliation":[{"name":"Neurology Service, University Hospital Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"Memory Disorders Unit, HM Hospitals, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"key":"10.3233\/JAD-200600_ref1","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1097\/JGP.0b013e3181d5745d","article-title":"Caregiver burden in Alzheimer disease: Cross-sectional and longitudinal patient correlates","volume":"18","author":"Mohamed","year":"2010","journal-title":"Am J Geriatr Psychiatry"},{"key":"10.3233\/JAD-200600_ref2","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s00401-011-0821-3","article-title":"Clinicopathological correlates of behavioral and psychological symptoms of dementia","volume":"122","author":"Casanova","year":"2011","journal-title":"Acta Neuropathol"},{"key":"10.3233\/JAD-200600_ref3","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1192\/bjp.174.1.39","article-title":"Natural history of behavioural changes and psychiatric symptoms in Alzheimer\u2019s disease: A longitudinal study","volume":"174","author":"Hope","year":"1999","journal-title":"Br J Psychiatry"},{"key":"10.3233\/JAD-200600_ref4","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.3233\/JAD-2010-101215","article-title":"Grouping and trajectories of neuropsychiatric symptoms in patients with Alzheimer\u2019s disease. 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