The impact of neuropsychiatric symptoms (NPS) on cognitive performance has been extensively reported, and this impact was better defined in the aging population. Yet a potential impact of NPS on brain morphology, cognitive performance and interactions between them in a longitudinal setting, as well as the potential of using these values as prediction of conversion – have remained questionable. We studied 156 participants with mild cognitive impairment (MCI) from the Alzheimer’s Disease Neuroimaging Initiative database who maintained the same level of cognitive performance after a 4-year follow-up and compared them to 119 MCI participants who converted to dementia. Additionally, we assessed the same analysis in 170 healthy controls who remained healthy at follow-up. Compared to 15 controls who converted to MCI. Their neuropsychological, neuropsychiatric, and brain morphology data underwent statistical analyses of 1) baseline comparison between the groups; (2) analysis of covariance model controlling for age, sex, education, and MMSE score, to specify the cognitive performance and brain structures that distinguish the two subgroups, and 3) used the significant ANCOVA variables to construct a binary logistic regression model that generates a probability equation for a given individual to convert to a lower cognitive performance state.Results showed that MCI who converted to AD in comparison to those who did not convert, exhibited a higher NPS prevalence, a lower cognitive performance and a higher number of involved brain structures. Furthermore, agitation, memory and the volumes of inferior temporal, hippocampal and amygdala sizes were significant predictors of MCI to AD conversion.
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