Comparison of behaviors characteristic of autism spectrum disorder behaviors and behavioral and psychiatric symptoms of dementia

Abstract

Background

Similarities exist in behavioral expression of autism spectrum disorder (ASD) and Alzheimer’s disease and related dementias (ADRD). The purpose of this study was to assess presence of behavioral and psychiatric symptoms of dementia (BPSD) and ASD-like behaviors in adults with ADRD.

Methods

Using a cross-sectional design, data from University of Kentucky Alzheimer’s Disease Center participant cohort were used. Hierarchical linear regression was used to assess (1) the relationship between ASD-like behaviors (measured by the Gilliam Autism Rating Scale-Second Edition, GARS-2) and BPSD measured by the Neuropsychiatric Inventory (NPI), and (2) the relationship between ASD-like behaviors and dementia severity (measured by the Clinical Dementia Rating [CDR] sum of boxes), when controlling for BPSD.

Results

Complete data were available for 142 participants. Using α of 0.05, analyses identified ASD behaviors were significantly associated with BPSD severity ratings (r = 0.47; p < 0.001) and dementia severity (r = 0.46; p < 0.001). GARS-2 explained 6.1% (p < 0.001) of variance in CDR sum of boxes when controlling for NPI and other covariates.

Discussion

There is significant overlap in behaviors characteristic of ASD and BPSD as assessed by the NPI and GARS-2, despite the use of these instruments in disparate developmental vs. aging settings. ASD behaviors appear to not be solely present in early childhood as a manifestation of ASD but are also present in older adults with neurodegenerative cognitive impairment. Such associations warrant additional research into causation, assessment, and behavioral interventions to further enable new therapeutic approaches targeting ASD behaviors across the lifespan.

Keywords:

• Alzheimer’s disease
• autism spectrum disorder
• behavioral assessment

Acknowledgements

This study utilized University of Kentucky Alzheimer’s Disease Cohort participants. Funding for the longitudinal cohort is provided by NIH/NIA P30 AG028383. Authors would like to acknowledge Dr. Frederick A. Schmitt for commenting on the development of this manuscript. The first author is funded by NIH T32 AG057461: ‘Training in Translational Research in Alzheimer’s and Related Dementias (TRIAD)’. Researchers acknowledge and thank all participants and their caregivers.

Disclosure statement

The authors have no conflicts of interest to report.

Additional information

Funding

This work was funded by National Institutes of Health.