The persistence of neuropsychiatric symptoms in dementia: the Cache County Study

Steinberg, Martin; Tschanz, Jo Ann T.; Corcoran, Christopher; Steffens, David C.; Norton, Maria C.; Lyketsos, Constantine G.; Breitner, John C.S.

doi:10.1002/gps.1025

Cited by 152 publications

(147 citation statements)

References 19 publications

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“…Elation never occurred in more than 1% of participants during any visit. In this regard, our finding of the most and least commonly occurring symptoms in dementia are similar to those of our earlier studies of prevalence, incidence and persistence (Lyketos et al, 2000;Steinberg et al, 2003;Steinberg et al, 2004) as well as to those of the MAAstrict Study of BEhavior in Dementia (MAASBED) study (Aalten et al, 2005). Symptom severity was consistently highest for apathy.…”

Section: Discussionsupporting

confidence: 90%

“…Meanwhile, lower five-year period prevalences were seen for elation (6%), and disinhibition (31%). This suggests that the relative rarity of these symptoms in our prior point prevalence and 18-month incidence and persistence studies (Lyketsos et al, 2000;Steinberg et al, 2003;Steinberg et al, 2004) is indeed a valid finding.…”

Section: Discussionmentioning

confidence: 53%

“…Neuropsychiatric symptoms affect nearly all dementia patients over the course of their illness (Tariot et al, 1995;Steinberg et al, 2004;Aalten et al, 2005). They have been associated with patient and caregiver distress (Rabins et al, 1999;Tan et al, 2005;Shin et al, 2005;Steele et al, 1990).…”

Section: Introductionmentioning

confidence: 99%

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Point and 5‐year period prevalence of neuropsychiatric symptoms in dementia: the Cache County Study

Steinberg

Shao

Zandi

et al. 2007

Int J Geriat Psychiatry

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629

437

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 53%

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Point and 5‐year period prevalence of neuropsychiatric symptoms in dementia: the Cache County Study

Steinberg

Shao

Zandi

et al. 2007

Int J Geriat Psychiatry

Self Cite

629

437

View full text Add to dashboard Cite

show abstract

“…Higher scores indicate greater symptom frequency/severity. Symptoms were considered clinically relevant if the domain score was ≥4 [8,34].…”

Section: Methodsmentioning

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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“…78 Sensitivity to change was demonstrated in a few trials. [163][164][165][166] Informed other ratings on the CSDD in patients with dementia were shown to have higher sensitivity for correctly diagnosing depression than other depression scales, including the BDI, the Ham-D, and the GDS (all modified for caregiver rating). 97 Although there is limited data on the reliability, validity, and sensitivity of the CSDD in nondemented elderly patients, 162,167 it has also been recommended as a useful scale for screening older adults for a diagnosis of depression.…”

Section: Depression In Non-pd Patientsmentioning

confidence: 99%

Depression rating scales in Parkinson's disease: Critique and recommendations

Schrag¹,

Barone²,

Brown³

et al. 2007

Movement Disorders

592

348

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Depression is a common comorbid condition in Parkinson's disease (PD) and a major contributor to poor quality of life and disability. However, depression can be difficult to assess in patients with PD due to overlapping symptoms and difficulties in the assessment of depression in cognitively impaired patients. As several rating scales have been used to assess depression in PD (dPD), the Movement Disorder Society commissioned a task force to assess their clinimetric properties and make clinical recommendations regarding their use. A systematic literature review was conducted to explore the use of depression scales in PD and determine which scales should be selected for this review. The scales reviewed were the Beck Depression Inventory (BDI), Hamilton Depression Scale (Ham-D), Hospital Anxiety and Depression Scale (HADS), Zung Self-Rating Depression Scale (SDS), Geriatric Depression Scale (GDS), Montgomery-Asberg Depression Rating Scale (MADRS), Unified Parkinson's Disease Rating Scale (UPDRS) Part I, Cornell Scale for the Assessment of Depression in Dementia (CSDD), and the Center for Epidemiologic Studies Depression Scale (CES-D). Seven clinical researchers with clinical and research experience in the assessment of dPD were assigned to review the scales using a structured format. The most appropriate scale is dependent on the clinical or research goal. However, observer-rated scales are preferred if the study or clinical situation permits. For screening purposes, the HAM-D, BDI, HADS, MADRS, and GDS are valid in dPD. The CES-D and CSDD are alternative instruments that need validation in dPD. For measurement of severity of depressive symptoms, the Ham-D, MADRS, BDI, and SDS scales are recommended. Further studies are needed to validate the CSDD, which could be particularly useful for the assessment of severity of dPD in patients with comorbid dementia. To account for overlapping motor and nonmotor symptoms of depression, adjusted instrument cutoff scores may be needed for dPD, and scales to assess severity of motor symptoms (e.g., UPDRS) should also be included to help adjust for confounding factors. The HADS and the GDS include limited motor symptom assessment and may, therefore, be most useful in rating depression severity across a range of PD severity; however, these scales appear insensitive in severe depression. The complex and time-consuming task of developing a new scale to measure depression specifically for patients with PD is currently not warranted.

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The persistence of neuropsychiatric symptoms in dementia: the Cache County Study

Abstract: Neuropsychiatric symptoms in dementia overall were highly persistent. Among those in whom symptoms did persist, symptom severity a year and a half later appeared to be comparable.

Cited by 152 publications

References 19 publications

Point and 5‐year period prevalence of neuropsychiatric symptoms in dementia: the Cache County Study

Point and 5‐year period prevalence of neuropsychiatric symptoms in dementia: the Cache County Study

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

Depression rating scales in Parkinson's disease: Critique and recommendations

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