SOCIO DEMOGRAPHIC, CLINICAL CHARACTERISTICS AND TREATMENTS OF ALZHEIMER'S DISEASE PATIENTS WITH PSYCHOTIC SYMPTOMS _ MEMORA COHORT
Author(s)
Melanie Chartier, MSc1, Virginie Dauphinot, PhD2, Frederic Gervais, PharmaD, MSc3, FRANCOIS-EMERY COTTE, MA, MPH, PharmD, PhD4, Caroline Guilmet, PharmaD5, Astrid Morle, PharmaD6, Antoine Garnier-Crussard, MCU-PH, MD PhD, MSc7.
1HEOR Manager, Bristol Myers Squibb, Rueil Malmaison, France, 2Clinical and Research Memory Centre of Lyon, Lyon Institute for Aging, Hospices Civils de Lyon, Lyon, France, 3Hospices Civils de Lyon, Villeurbanne, France, Villeurbanne, France, 4Bristol Myers Squibb, RUEIL MALMAISON, France, 5BMS, Reuil-Malmaison, France, 6Medical, Bristol Myers Squibb, Rueil-Malmaison, France, 7Clinical and Research Memory Centre of Lyon, Lyon Institute for Aging, Hospices Civils de Lyon, Villeurbanne, France.
1HEOR Manager, Bristol Myers Squibb, Rueil Malmaison, France, 2Clinical and Research Memory Centre of Lyon, Lyon Institute for Aging, Hospices Civils de Lyon, Lyon, France, 3Hospices Civils de Lyon, Villeurbanne, France, Villeurbanne, France, 4Bristol Myers Squibb, RUEIL MALMAISON, France, 5BMS, Reuil-Malmaison, France, 6Medical, Bristol Myers Squibb, Rueil-Malmaison, France, 7Clinical and Research Memory Centre of Lyon, Lyon Institute for Aging, Hospices Civils de Lyon, Villeurbanne, France.
OBJECTIVES: Psychotic symptoms (hallucinations and delusions) are frequent in Alzheimer’s disease (AD) and associated with worse outcomes. This study described patients’ characteristics, treatments, caregiver burden and nursing home placement (NHP) among AD patients with psychotic symptoms in the MEMORA cohort.
METHODS: This descriptive retrospective study was conducted using data from the MEMORA real-world cohort (Lyon Memory Centers, 2014-2022) linked to the French claims database (SNDS). Psychotic symptoms were assessed using the Neuropsychiatric Inventory (NPI). We defined three populations: P1, AD patients with a NPI assessment; P2, AD patients with any psychotic symptoms (hallucinations (H) and/or delusions (D) ; severity NPI subscore H+D ≥1); and P3, a subset of P2 with more severe symptoms (H+D ≥6). We summarized neuropsychiatric symptoms disorders (NPI), cognitive impairment (MMSE), functional limitation (Lawton’s IADL), caregiver burden (mini-Zarit), treatments within ±90 days, and 1-year NHP.
RESULTS: Among 3,391 AD patients with an NPI assessment (P1; 62.1% women; mean age 81.7 years), 1,224 (36.1%) had psychotic symptoms (P2) including 739 (21.8%) with more severe symptoms (P3). Mean MMSE was lower in patients with psychotic symptoms (P2, MMSE14.8 ±6.3 and P3, MMSE14.0 ±6.3) vs. in all patients (P1, MMSE 17.5 ±6.4)), as were IADL scores. Mean mini-Zarit score was higher in P2 and P3 (4.1 ±1.7; 4.4±1.7) vs. P1 (3.3 ±1.8). Antipsychotic use was higher in P2 and P3 than in P1 (25.1%; 41.8% vs. 11.8%), as was anxiolytic use (46.5% ; 63.1% vs. 30.1%). The1-year NHP rate was higher in P2 and P3 than in P1 (34.8% ;46.4% vs.19.6%).
CONCLUSIONS: Alzheimer’s disease patients with psychotic symptoms, especially those with more severe symptoms, seem to exhibit higher caregiver burden, more frequent antipsychotics use, and higher nursing home placement rates, highlighting the unmet need for targeted, well-tolerated treatments specifically addressing psychotic symptoms.
METHODS: This descriptive retrospective study was conducted using data from the MEMORA real-world cohort (Lyon Memory Centers, 2014-2022) linked to the French claims database (SNDS). Psychotic symptoms were assessed using the Neuropsychiatric Inventory (NPI). We defined three populations: P1, AD patients with a NPI assessment; P2, AD patients with any psychotic symptoms (hallucinations (H) and/or delusions (D) ; severity NPI subscore H+D ≥1); and P3, a subset of P2 with more severe symptoms (H+D ≥6). We summarized neuropsychiatric symptoms disorders (NPI), cognitive impairment (MMSE), functional limitation (Lawton’s IADL), caregiver burden (mini-Zarit), treatments within ±90 days, and 1-year NHP.
RESULTS: Among 3,391 AD patients with an NPI assessment (P1; 62.1% women; mean age 81.7 years), 1,224 (36.1%) had psychotic symptoms (P2) including 739 (21.8%) with more severe symptoms (P3). Mean MMSE was lower in patients with psychotic symptoms (P2, MMSE14.8 ±6.3 and P3, MMSE14.0 ±6.3) vs. in all patients (P1, MMSE 17.5 ±6.4)), as were IADL scores. Mean mini-Zarit score was higher in P2 and P3 (4.1 ±1.7; 4.4±1.7) vs. P1 (3.3 ±1.8). Antipsychotic use was higher in P2 and P3 than in P1 (25.1%; 41.8% vs. 11.8%), as was anxiolytic use (46.5% ; 63.1% vs. 30.1%). The1-year NHP rate was higher in P2 and P3 than in P1 (34.8% ;46.4% vs.19.6%).
CONCLUSIONS: Alzheimer’s disease patients with psychotic symptoms, especially those with more severe symptoms, seem to exhibit higher caregiver burden, more frequent antipsychotics use, and higher nursing home placement rates, highlighting the unmet need for targeted, well-tolerated treatments specifically addressing psychotic symptoms.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH180
Topic
Clinical Outcomes, Epidemiology & Public Health
Disease
Geriatrics, Mental Health (including addiction), Neurological Disorders