Neuropsychiatric symptoms as risk factors of dementia in a Mexican population: A 10/66 Dementia Research Group study

Abstract

IntroductionCognitive and/or memory impairment are the main clinical markers currently used to identify subjects at risk of developing dementia. This study aimed to explore the relationship between the presence of neuropsychiatric symptoms and dementia incidence.MethodsWe analyzed the association between neuropsychiatric symptoms and incident dementia in a cohort of 1355 Mexican older adults from the general population over 3 years of follow-up, modeling cumulative incidence ratios using Poisson models.ResultsFive neuropsychiatric symptoms were associated with incident dementia: delusions, hallucinations, anxiety, aberrant motor behavior, and depression. The simultaneous presence of two symptoms had a relative risk, adjusted for mild cognitive impairment, diabetes, indicators of cognitive function, and sociodemographic factors, of 1.9 (95% confidence interval, 1.2–2.9), whereas the presence of three to five, similarly adjusted, had a relative risk of 3.0 (95% confidence interval, 1.9–4.8).DiscussionNeuropsychiatric symptoms are common in predementia states and may independently contribute as risk factors for developing dementia.

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

“…Dementia incidence in the current study was 30.7 cases per 1000 person-years. This is similar to a previous study reporting that dementia incidence was 32.5 cases per 1000 person-years in people over 65 years old from the general population [26]. Most patients developed AD in the current study.…”

Clinically significant anxiety as a risk factor for dementia in the elderly community

“…The few studies of anxiety as a risk factor for dementia have produced conflicting results. Several studies suggest that anxiety is a risk factor for dementia (8,9,14) while three other investigations estimate that dementia risk is increased by 48-70% in those with anxiety symptoms (11)(12)(13). However, de Bruijn et al (10) found no association of either anxiety symptoms or anxiety disorder.…”

“…The relationship between anxiety and dementia has received recent attention (8)(9)(10)(11)(12)(13), but the nature of this relationship (true association or reverse causation) remains unclear. The few studies of anxiety as a risk factor for dementia have produced conflicting results.…”

“…These inconsistencies may reflect variations in factors such as the length of observation, follow-up attrition rate, potentially modifying variables controlled for, or method of assessing either anxiety or dementia. With the exception of de Bruijn et al (10), who used DSM-IV diagnostic criteria to identify anxiety disorder in one sample, others used only scales and questionnaires (8,(10)(11)(12)(13), and none used methods recommended specifically for use in the elderly (15).…”

Updated Information on Some Cognitive Disorders

“…Three months ago, some investigators documented the association between the presence of hallucinations, delusions, anxiety, depression, and abnormal motor behavior, with the risk of developing incident dementia, independent of other known risk factors, including MCI in the future, a simple, low-cost strategy for screening population groups at dementia risk, particularly in environments with limited access to specialized services and very sophisticated resources [37][38][39][40].…”