{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:19:32Z","timestamp":1789175972195,"version":"build-2803163510"},"reference-count":114,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2021,5,4]]},"abstract":"<jats:p>Background: Neuropsychiatric symptoms (NPS) are non-cognitive manifestations common to dementia and other medical conditions, with important consequences for the patient, caregivers, and society. Studies investigating NPS in individuals with Down syndrome (DS) and dementia are scarce. Objective: Characterize NPS and caregiver distress among adults with DS using the Neuropsychiatric Inventory (NPI). Methods: We evaluated 92 individuals with DS (\u226530 years of age), divided by clinical diagnosis: stable cognition, prodromal dementia, and AD. Diagnosis was determined by a psychiatrist using the Cambridge Examination for Mental Disorders of Older People with Down\u2019s Syndrome and Others with Intellectual Disabilities (CAMDEX-DS). NPS and caregiver distress were evaluated by an independent psychiatrist using the NPI, and participants underwent a neuropsychological assessment with Cambridge Cognitive Examination (CAMCOG-DS). Results: Symptom severity differed between-groups for delusion, agitation, apathy, aberrant motor behavior, nighttime behavior disturbance, and total NPI scores, with NPS total score being found to be a predictor of AD in comparison to stable cognition (OR for one-point increase in the NPI\u200a=\u200a1.342, p\u200a=\u200a0.012). Agitation, apathy, nighttime behavior disturbances, and total NPI were associated with CAMCOG-DS, and 62% of caregivers of individuals with AD reported severe distress related to NPS. Caregiver distress was most impacted by symptoms of apathy followed by nighttime behavior, appetite\/eating abnormalities, anxiety, irritability, disinhibition, and depression (R2\u200a=\u200a0.627, F(15,76)\u200a=\u200a8.510, p\u200a&lt;\u200a0.001). Conclusion: NPS are frequent and severe in individuals with DS and AD, contributing to caregiver distress. NPS in DS must be considered of critical relevance demanding management and treatment. Further studies are warranted to understand the biological underpinnings of such symptoms.<\/jats:p>","DOI":"10.3233\/jad-201009","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T14:02:33Z","timestamp":1615903353000},"page":"137-154","source":"Crossref","is-referenced-by-count":15,"title":["Neuropsychiatric Symptoms of Alzheimer\u2019s Disease in Down Syndrome and Its Impact on Caregiver Distress"],"prefix":"10.1177","volume":"81","author":[{"given":"Luciana Mascarenhas","family":"Fonseca","sequence":"first","affiliation":[{"name":"Department of Medical Education and Clinical Science, Washington State University, Spokane, WA, USA"},{"name":"Programa Terceira Idade PROTER, Old Age Research Group, Department and Institute of Psychiatry, University of S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme Prado","family":"Mattar","sequence":"additional","affiliation":[{"name":"Programa Terceira Idade PROTER, Old Age Research Group, Department and Institute of Psychiatry, University of S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenda Guerra","family":"Haddad","sequence":"additional","affiliation":[{"name":"Programa Terceira Idade PROTER, Old Age Research Group, Department and Institute of Psychiatry, University of S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekaterina","family":"Burduli","sequence":"additional","affiliation":[{"name":"College of Nursing, Washington State University, Spokane, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sterling M.","family":"McPherson","sequence":"additional","affiliation":[{"name":"Department of Medical Education and Clinical Science, Washington State University, Spokane, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Maria de Figueiredo Ferreira","family":"Guilhoto","sequence":"additional","affiliation":[{"name":"Institute Jo Clemente, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f4nica Sanches","family":"Yassuda","sequence":"additional","affiliation":[{"name":"School of Arts, Sciences and Humanities, University of S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldo Filho","family":"Busatto","sequence":"additional","affiliation":[{"name":"Programa Terceira Idade PROTER, Old Age Research Group, Department and Institute of Psychiatry, University of S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"},{"name":"Laboratorio de Neuroimagem em Psiquiatria (LIM21, Laboratory of Psychiatric Neuroimaging), Department and Institute of Psychiatry, University of S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassio Machado de Campos","family":"Bottino","sequence":"additional","affiliation":[{"name":"Programa Terceira Idade PROTER, Old Age Research Group, Department and Institute of Psychiatry, University of S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo Queiroz","family":"Hoexter","sequence":"additional","affiliation":[{"name":"Projeto Transtornos do Espectro Obsessivo-Compulsivo PROTOC, Obsessive-Compulsive Spectrum Disorders Program, Department and Institute of Psychiatry, University of S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi Sage","family":"Chaytor","sequence":"additional","affiliation":[{"name":"Department of Medical Education and Clinical Science, Washington State University, Spokane, WA, 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