PhD in Nursing Science Program

The Relationship of Neuropsychiatric Symptoms with Functional Status in Huntington’s Disease

Dissertation under the direction of Professor Sheila H. Ridner

Huntington’s disease (HD) is a rare, neurodegenerative disease characterized by motor, cognitive, and neuropsychiatric dysfunction. Neuropsychiatric symptoms are common and bothersome in HD patients, but evidence to inform treatment for these symptoms is lacking. Functional status is a commonly used outcome in HD research, but little is known about the relationship between neuropsychiatric symptoms and functional status in HD. This dissertation aimed to describe the effects of neuropsychiatric symptoms on functional status using quantitative and qualitative methods. Simple and multiple regression analyses were used to examine the effects of total neuropsychiatric symptoms on two functional status measures. Neuropsychiatric symptoms were not statistically significantly associated with either functional status score on simple or multiple regression. Conversely, in qualitative interviews, HD patients and caregivers reported that neuropsychiatric symptoms have significant effects on functional status, particularly with social withdrawal. This suggests that existing instruments do not measure functional status holistically. This study also confirms the importance of identification and treatment for neuropsychiatric symptoms in HD. Future research should focus on development of holistic functional status measures and interventions to treat neuropsychiatric symptoms.