Occurrence of neuropsychiatric symptoms and psychiatric disorders in mild Alzheimer's disease and mild cognitive impairment subtypes

Iulio, Fulvia Di; Palmer, Katie; Blundo, Carlo; Casini, Arianna; Gianni, Walter; Caltagirone, Carlo; Spalletta, Gianfranco

doi:10.1017/s1041610210000281

Cited by 119 publications

(88 citation statements)

References 41 publications

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“…Our study identified a high frequency and severity of depression in the very early stage (CDR = 0.5) of dementia patients, similar to previous findings 23 . It is possible that symptoms are associated with pathological changes in regions of the brain associated with its pathogenesis.…”

Section: Discussionsupporting

confidence: 92%

Severity and prevalence of behavioral and psychological symptoms among patients of different dementia stages in Taiwan

Huang

Wang

Liao

2017

Arch. Clin. Psychiatry (São Paulo)

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Background: To better understand the trends of behavioral and psychological symptoms of dementia (BPSD) over the disease progression is important to provide psychoeducation for dementia caregivers. Objective: This study examined the severity and occurrence of BPSD across the various degrees of the disease. Methods: This study was a cross-sectional design. Patients (N = 276) who had dementia from July 2001 to October 2008 were surveyed and assessed for dementia stage, using the clinical dementia rating scale (CDR). BPSD was evaluated using the Neuropsychiatric Inventory (NPI). We examined the differences between the severities and occurrence of the individual's BPSD among various CDR stages with the Kruskal-Wallis test and Chi-square test. Results: Delusion (p = 0.01), agitation/aggression (p = 0.033), apathy/indifference (p = 0.009), aberrant motor behavior (p < 0.001), nighttime behavior disturbances (p < 0.001), and eating abnormalities (p = 0.001) were significantly different among stages of dementia. The severity of BPSD became exacerbated over the course of the disease, and was highest in moderate (CDR = 2) or severe (CDR = 3) dementia. The occurrence of BPSD was highest when the CDR equaled 2 (97.5%). Discussion: The association of global (or certain) BPSD, across different stages of dementia, is a non-linear relationship. These findings suggest the importance of taking into account clinical dementia stage for managing BPSD.

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Section: Discussionsupporting

confidence: 92%

Severity and prevalence of behavioral and psychological symptoms among patients of different dementia stages in Taiwan

Huang

Wang

Liao

2017

Arch. Clin. Psychiatry (São Paulo)

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“…[73][74][75] There is a growing tendency to admit that neuropsychiatric symptoms may accelerate the transitional state from MCI to dementia. 74,75 These symptoms could confer a higher risk for dementia even among cognitively preserved persons. 73 Accordingly, neuropsychiatric symptoms now tend to be incorporated into any comprehensive clinical examination of individuals with MCI.…”

Section: Neuropsychiatric Symptoms and Risk Of Cognitive Declinementioning

confidence: 99%

Mild cognitive impairment (part 1): clinical characteristics and predictors of dementia

Forlenza

Diniz

Stella

et al. 2013

Rev. Bras. Psiquiatr.

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Objective: To critically review and evaluate existing knowledge on the conceptual limits and clinical usefulness of the diagnosis of mild cognitive impairment (MCI) and the neuropsychological assessment and short-and long-term prognosis thereof. Methods: We conducted a systematic search of the PubMed and Web of Science electronic databases, limited to articles published in English between 1999 and 2012. Based on the search terms mild cognitive impairment or MCI and epidemiology or diagnosis, we retrieved 1,698 articles, of which 248 were critically eligible (cross-sectional and longitudinal studies); the abstracts of the remaining 1,450 articles were also reviewed. Results: A critical review on the MCI construct is provided, including conceptual and diagnostic aspects; epidemiological relevance; clinical assessment; prognosis; and outcome. The distinct definitions of cognitive impairment, MCI included, yield clinically heterogeneous groups of individuals. Those who will eventually progress to dementia may present with symptoms consistent with the definition of MCI; conversely, individuals with MCI may remain stable or return to normal cognitive function. Conclusion: On clinical grounds, the cross-sectional diagnosis of MCI has limited prognostic relevance. The characterization of persistent and/or progressive cognitive deficits over time is a better approach for identification of cases at the pre-dementia stages, particularly if these cognitive abnormalities are consistent with the natural history of incipient Alzheimer's disease.

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“…Most of the studies on NPS to date have focused on highly selective clinical samples recruited from tertiary care centers [12,[23][24][25] or as subsamples of population-based cohorts [4,7,8,14,19,26]. This means that there is a gap in our knowledge about the spectrum of NPS occurring in the population across different cognitive phenotypes, disorders, outcomes, and status.…”

Section: Introductionmentioning

confidence: 99%

Neuropsychiatric Symptoms and Cognitive Impairment: Understanding the Importance of Co-Morbid Symptoms

Mortby

Burns

Eramudugolla

et al. 2017

JAD

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Abstract.Background: Neuropsychiatric symptoms (NPS) are common in older adults with cognitive impairment, yet little is known about population-based prevalence and clinical implications of co-morbid symptom presentation across the spectrum from normal cognition to dementia. Objective: To characterize the prevalence of NPS and explore the clinical implications of co-morbid symptom presentation. Methods: Cross-sectional study of 1,417 older adults (aged 73-79) with dementia (n = 40); with mild cognitive impairment (MCI; n = 133); who are 'cognitively normal, but-at-risk' (CN-AR; n = 397); and who are cognitively normal (n = 847). NPS were assessed by the Neuropsychiatric Inventory. Cluster analyses were conducted using a latent class analysis (LCA). Results: NPS are highly prevalent across the cognitive function spectrum (30.8%-80%). NPS were associated with a 3-fold increased risk of dementia, a 2-fold increased risk of MCI, and a 1.5-times increased risk of CN-AR. Each additional co-morbid symptom was associated with an additional 1.5-times increased risk of dementia, but not MCI or CN-AR. LCA revealed four distinctive sub-populations: 1) frontal/low comorbidity; 2) high prevalence/high comorbidity; 3) affective/low comorbidity; and 4) sleep/low comorbidity. Conclusion: Our findings confirm previous reports on the prevalence of NPS in community-based samples and are consistent with the profiles of NPS domain characteristics of MCI and dementia. Number of co-morbid NPS and not symptom clusters are associated with increased risk of dementia. Understanding such patterns will help inform our understanding of mild behavioral disorders and assist with clinical assessment.

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Occurrence of neuropsychiatric symptoms and psychiatric disorders in mild Alzheimer's disease and mild cognitive impairment subtypes

Abstract: Clinicians should consider the relevance of neuropsychiatric disorders and symptoms in patients with cognitive disturbances, and incorporate a thorough psychiatric examination in the evaluation of patients.

Cited by 119 publications

References 41 publications

Severity and prevalence of behavioral and psychological symptoms among patients of different dementia stages in Taiwan

Severity and prevalence of behavioral and psychological symptoms among patients of different dementia stages in Taiwan

Mild cognitive impairment (part 1): clinical characteristics and predictors of dementia

Neuropsychiatric Symptoms and Cognitive Impairment: Understanding the Importance of Co-Morbid Symptoms

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