Late-onset OCD may indicate dementia risk

Obsessive-compulsive disorder symptoms often occur prior to dementia diagnosis and are frequently accompanied by anxiety, depression and psychosis, according to data presented at the American Academy of Neurology Annual Meeting.

“Sixty-five percent of patients with a [frontotemporal dementia] behavioral variant have perseverative, stereotyped or compulsive/ritualistic behaviors. The relationship between obsessive-compulsive disorder, obsessive-compulsive symptoms and [frontotemporal dementia] has not been well studied,” the researchers wrote.

To assess onset and significance of obsessive-compulsive disorder (OCD) and obsessive-compulsive disorder symptoms in frontotemporal dementia, researchers conducted a meta-analysis of individual patient data from case reports available on PubMed (n = 29) and EMBASE (n = 84). Participants had frontotemporal dementia or frontotemporal lobar degeneration with obsessive-compulsive disorder symptoms or OCD and a mean age of 55.5 years.

Participants had an average Mini Mental State Examination score of 25.9 and average Montreal Cognitive Assessment score of 21.

More than half of participants reported OCD diagnosis.

Approximately 78.3% of participants developed OCD or related symptoms 0 to 27 years before clinical diagnosis of frontotemporal dementia.

OCD and related symptoms occurred concurrently with dementia diagnosis in 17.4% of participants.

Sixty-five percent of the cohort reported additional neuropsychiatric symptoms, of which anxiety, depression and psychosis were the most prevalent.

“[Obsessive-compulsive disorder symptoms] most frequently occur prior to the clinical diagnosis of [frontotemporal dementia] (in 78.3% of cases, 0 to 27 years before) and also co-occur with other psychiatric conditions like anxiety, depression and psychosis. Late-onset [obsessive-compulsive disorder symptoms] can precede frank [frontotemporal dementia], and thus merit further attention as an early marker of [frontotemporal dementia].” – by Amanda Oldt

Reference:

Santibanez RA, et al. Frontotemporal dementia with late-onset obsessive-compulsive symptoms: An individual-patient data meta-analysis. Presented at: American Academy of Neurology Annual Meeting; April 15-21, 2016; Vancouver, British Columbia.

Disclosure: Santibanez reports no relevant financial disclosures. See the study for a full list of relevant financial disclosures.