Hospital-treated mental and behavioral disorders and risk of Alzheimer's disease: A nationwide nested case-control study

Tapiainen, V.; Hartikainen, Sirpa; Taipale, Heidi; Tiihonen, Jari; Tolppanen, Anna‐Maija

doi:10.1016/j.eurpsy.2017.02.486

Cited by 48 publications

(82 citation statements)

References 43 publications

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“…According to previous reviews, depression in early life might be a risk factor for dementia, and late life onset of depression might be a prodromal symptom [4,27]. Evidence from recent large longitudinal cohorts also supports the importance of age of onset of depressive symptoms [12,[27][28][29]. These studies describe the age of onset of depressive symptomatology as an important component of their dementia risk.…”

Section: Discussionmentioning

confidence: 86%

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Prevalence of Mild Behavioral Impairment and Risk of Dementia in a Psychiatric Outpatient Clinic

Matsuoka

Ismail

Narumoto

2019

JAD

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Background: Mild behavioral impairment (MBI) has been proposed as risk factor for dementia, and for some, an early manifestation of dementia. Objective: We examined the prevalence of MBI in the psychiatric outpatient clinic, and compared the incidence of dementia in MBI with that in other psychiatric diseases. Methods: Retrospective chart review was conducted in 2,853 consecutive outpatients over the age of 50. MBI was diagnosed according to the International Society to Advance Alzheimer's Research and Treatment research diagnostic criteria. The incidence rate of dementia was examined in the patients who were followed up for at least 1 month. Kaplan-Meier survival analyses and Cox proportional hazards regression models were performed to compare the time to onset of dementia between MBI and other psychiatric diseases. Results: The prevalence of MBI was 3.5% and the incidence of dementia was 30.7 cases per 1000 person-years. The hazard ratio (HR) for dementia was higher for MBI than other psychiatric diseases (HR: 8.07, 95% confidence interval: 4.34-15.03, p < 0.001). In MCI patients, the cumulative survival in MCI with affective dysregulation tended to be lower than that in MCI without (p = 0.090). Conclusions: Psychiatric outpatients often meet MBI criteria. MBI, especially the affective dysregulation domain, increases the risk of dementia in this psychiatric outpatient population. Since late-onset psychiatric and behavioral symptoms may be prodromal symptoms of dementia in some, careful observation is needed, and psychiatric clinicians should keep prodromal dementia on their differential diagnosis when assessing those with new onset psychiatric symptomatology in older adults.

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Section: Discussionmentioning

confidence: 86%

“…NPS, especially psychosis, agitation, and aggression, were detected as predictors of progression to severe dementia and death [11]. Moreover, NPS are often identified as early symptoms of dementia [12], but these patients often start out in psychiatric care.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Mild Behavioral Impairment and Risk of Dementia in a Psychiatric Outpatient Clinic

Matsuoka

Ismail

Narumoto

2019

JAD

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“…Further investigation with longitudinal data will be required to explore this interesting finding. The robust longitudinal data suggesting that later life emergence of depression may often be the index manifestation of dementia, sometimes misdiagnosed as major depression, support the need to disentangle "major depression" from the mood and anxiety symptoms in preclinical and prodromal dementia (Almeida et al, 2017;Ismail et al, 2018b;Singh-Manoux et al, 2017;Tapiainen et al, 2017). The major immediate implication of the EFA relates the splitting or reorganization of some of the MBI-C domains.…”

Section: Discussionmentioning

confidence: 98%

Profile of mild behavioral impairment and factor structure of the Mild Behavioral Impairment Checklist in cognitively normal older adults

Creese

Griffiths

Brooker

et al. 2019

Int. Psychogeriatr.

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ABSTRACTObjectives:In this large population study, we set out to examine the profile of mild behavioral impairment (MBI) by using the Mild Behavioral Impairment Checklist (MBI-C) and to explore its factor structure when employed as a self-reported and informant-rated tool.Design:This was a population-based cohort study.Setting:Participants were recruited from the Platform for Research Online to Investigate Genetics and Cognition in Aging study (https://www.protect-exeter.org.uk).Participants:A total of 5,742 participant-informant dyads participated in the study.Measurements:Both participants and informants completed the MBI-C. The factor structure of the MBI-C was evaluated by exploratory factor analysis.Results:The most common MBI-C items, as rated by self-reported and informants, related to affective dysregulation (mood/anxiety symptoms), being present in 34% and 38% of the sample, respectively. The least common items were those relating to abnormal thoughts and perception (psychotic symptoms) (present in 3% and 6% of the sample, respectively). Only weak correlations were observed between self-reported and informant-reported MBI-C responses. Exploratory factor analysis for both sets of respondent answers indicated that a five-factor solution for the MBI-C was appropriate, reflecting the hypothesized structure of the MBI-C.Conclusion:This is the largest and most detailed report on the frequency of MBI symptoms in a nondementia sample. The full spectrum of MBI symptoms was present in our sample, whether rated by self-reported or informant report. However, we show that the MBI-C performs differently in self-reported versus informant-reported situations, which may have important implications for the use of the questionnaire in clinic and research.

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“…Stroke was defined as ICD‐10 codes I60‐I64. History of schizophrenia, bipolar disorder and depression were defined as ICD‐10 codes (schizophrenia, schizotypal or delusional disorders F20‐29; manic episode, F30; bipolar disorder, F31; depression, F32‐34, F38‐39) at least 5 years before the diagnosis of Alzheimer's disease . Corresponding diagnoses were defined according to ICD‐codes 8 and 9.…”

Section: Methodsmentioning

confidence: 99%

Proton pump inhibitor use and risk of hip fractures among community‐dwelling persons with Alzheimer's disease—a nested case‐control study

Torvinen-Kiiskinen

Tolppanen

Koponen

et al. 2018

Aliment Pharmacol Ther

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Summary Background Hip fractures are a major health concern among older persons with Alzheimer's disease, who usually use many concomitant drugs for several diseases. Evidence of the association between proton pump inhibitor use and risk of hip fracture is contradictory. Aim To investigate whether the long‐term use of proton pump inhibitor is associated with risk of hip fractures among community‐dwelling persons with Alzheimer's disease. Methods In this nested case‐control study, the nationwide MEDALZ data were utilised. Community‐dwelling persons with Alzheimer's disease who encountered incident hip fracture (N = 4818; mean age 84.1) were included as cases. Four controls were matched for each case at the date of hip fracture (N = 19 235; mean age 84.0). The association between hip fracture and duration of current PPI use (ongoing use during 0‐30 days before the index date), and cumulative duration of use during 10 years before was investigated with conditional logistic regression. Results Long‐term or cumulative proton pump inhibitor use was not associated with an increased risk of hip fracture. Current proton pump inhibitor use was associated with an increased risk of hip fracture (adjusted OR 1.12, 95% CI 1.03‐1.22). The risk was increased in short‐term current use (<1 year) (adjusted OR 1.23, 95% CI 1.10‐1.37). Conclusions The increased risk of hip fracture was evident only in short‐term proton pump inhibitor use, but no association was found for long‐term or cumulative use. Thus, our findings do not support previous assumptions that long‐term proton pump inhibitor use would be associated with an increased risk of hip fractures.

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Hospital-treated mental and behavioral disorders and risk of Alzheimer's disease: A nationwide nested case-control study

Cited by 48 publications

References 43 publications

Prevalence of Mild Behavioral Impairment and Risk of Dementia in a Psychiatric Outpatient Clinic

Prevalence of Mild Behavioral Impairment and Risk of Dementia in a Psychiatric Outpatient Clinic

Profile of mild behavioral impairment and factor structure of the Mild Behavioral Impairment Checklist in cognitively normal older adults

Proton pump inhibitor use and risk of hip fractures among community‐dwelling persons with Alzheimer's disease—a nested case‐control study

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