Neuropsychiatric Symptoms and Risk of Progression to Alzheimer's Disease Among Mild Cognitive Impairment Subjects.
Aged
Aged, 80 and over
Aggression
/ psychology
Alzheimer Disease
/ diagnosis
Apathy
/ physiology
Cognition
/ physiology
Cognitive Dysfunction
/ diagnosis
Delusions
/ diagnosis
Disease Progression
Female
Humans
Longitudinal Studies
Male
Neuropsychological Tests
Psychomotor Agitation
/ diagnosis
Risk Factors
Symptom Assessment
Alzheimer’s disease
dementia
mild cognitive impairment
neuropsychiatric
symptoms
Journal
Journal of Alzheimer's disease : JAD
ISSN: 1875-8908
Titre abrégé: J Alzheimers Dis
Pays: Netherlands
ID NLM: 9814863
Informations de publication
Date de publication:
2019
2019
Historique:
pubmed:
28
5
2019
medline:
17
9
2020
entrez:
26
5
2019
Statut:
ppublish
Résumé
Neuropsychiatric symptoms (NPS) are prevalent in mild cognitive impairment (MCI), but we do not know much about their role in progression to dementia. To investigate NPS and the risk of progression to probable Alzheimer's disease dementia (AD) among subjects with MCI. 96 MCI participants were followed for 4 years. Progression to probable AD was defined by the change of CDR total score from 0.5 to ≥1, reviewed by an expert consensus panel. NPS were determined using the Neuropsychiatric Inventory (NPI) 12-items. This study analyzed prognostic value of each NPI item and 5 sub-syndromes of NPS (apathy, psychosis, affective, hyperactivity, and vegetative) for prediction of progression to probable AD. A Cox proportional hazard model was used; hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with time dependent variable to compare the incidence of progression considering presence/absence of any NPS or sub-syndromes throughout the study. The presence of symptoms "agitation/aggression", "delusions", and "aberrant motor behavior" significantly increased the risk of probable AD (HR = 3.9; 95% CI = 1.9-8.2; HR = 13.9; 95% CI = 4.1-48.9; HR = 4.3; 95% CI = 1.7-10.3, respectively). The presence of sub-syndromes "psychosis" and "hyperactivity" were also predictors of progression (HR = 14.0; 95% CI = 4.4-44.5; HR = 2.0; 95% CI = 1.1-3.7, respectively). These results did not change after adjusting by potential confounders. Presence of delusions, agitation/aggression, and aberrant motor behavior is predictor of progression to probable AD.
Sections du résumé
BACKGROUND
Neuropsychiatric symptoms (NPS) are prevalent in mild cognitive impairment (MCI), but we do not know much about their role in progression to dementia.
OBJECTIVE
To investigate NPS and the risk of progression to probable Alzheimer's disease dementia (AD) among subjects with MCI.
METHODS
96 MCI participants were followed for 4 years. Progression to probable AD was defined by the change of CDR total score from 0.5 to ≥1, reviewed by an expert consensus panel. NPS were determined using the Neuropsychiatric Inventory (NPI) 12-items. This study analyzed prognostic value of each NPI item and 5 sub-syndromes of NPS (apathy, psychosis, affective, hyperactivity, and vegetative) for prediction of progression to probable AD. A Cox proportional hazard model was used; hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with time dependent variable to compare the incidence of progression considering presence/absence of any NPS or sub-syndromes throughout the study.
RESULTS
The presence of symptoms "agitation/aggression", "delusions", and "aberrant motor behavior" significantly increased the risk of probable AD (HR = 3.9; 95% CI = 1.9-8.2; HR = 13.9; 95% CI = 4.1-48.9; HR = 4.3; 95% CI = 1.7-10.3, respectively). The presence of sub-syndromes "psychosis" and "hyperactivity" were also predictors of progression (HR = 14.0; 95% CI = 4.4-44.5; HR = 2.0; 95% CI = 1.1-3.7, respectively). These results did not change after adjusting by potential confounders.
CONCLUSION
Presence of delusions, agitation/aggression, and aberrant motor behavior is predictor of progression to probable AD.
Identifiants
pubmed: 31127783
pii: JAD190025
doi: 10.3233/JAD-190025
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM