The use of neuropsychiatric symptoms as biomarkers for a prodromal state among an electronic medical record cohort of neurodegenerative disorders

Background Neuropsychiatric symptoms including anxiety, depression, psychosis, hallucinations, delusions, agitation, as well as sleep disturbances are associated with the development of dementia. We aim to show how they may be utilized as biomarkers of a prodromal state of neurodegenerative disorders. Method A cohort of Alzheimer’s disease (AD) and Dementia with Lewy body (DLB) patients was created using EPIC electronic medical record software. Data was compiled and analyzed using Microsoft Excel program. Result In our cohort of 5,784 AD patients, 1,721 (29.8%) held a diagnosis of anxiety, 2,727 (47.2%) depression, 2,231 (38.6%) psychosis, 165 (2.9%) hallucinations, 144 (2.5%) delusions, 376 (6.5%) agitation, and 1,242 (21.5%) sleep disturbance. Of 355 DLB patients, 110 (31.0%) had anxiety, 165 (46.5%) depression, 183 (51.6%) psychosis, 81 (22.8%) hallucinations, 18 (5.1%) delusions, 34 (9.6%) agitation, and 95 (26.8%) sleep disturbance. Of 81 patients with diagnoses of both AD and DLB, 36 (44.4%) had anxiety, 45 (55.6%) depression, 57 (70.4%) psychosis, 18 (22.2%) hallucinations, 7 (8.6%) delusions, 7 (8.6%) agitation, and 27 (33.3%) sleep disturbance. Many patients in the cohort held more than one neuropsychiatric diagnosis. Conclusion Neuropsychiatric symptoms have been shown to precede the onset of neurodegenerative disorders, including AD and DLB, by years to decades. Our study aims to demonstrate the use of neuropsychiatric symptoms as biomarkers for the future development of neurodegenerative disease.