Neuropsychiatric symptom profiles of<scp>community‐dwelling</scp>persons living with dementia: Factor structures revisited

Regier, Natalie G.; Hodgson, Nancy; Gitlin, Laura N.

doi:10.1002/gps.5323

Cited by 19 publications

(23 citation statements)

References 62 publications

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“…Anxiety is not only associated with poor quality of life in people with cognitive impairment, 50,51 but also it is associated with increased caregiver burden among family members. 50,52 In this study, we observed that increased social isolation was related to increased anxiety among people with cognitive impairment.…”

Section: Variance Inflation Factormentioning

confidence: 99%

The relationship between social isolation and anxiety in people with cognitive impairment in the United States

Hwang

Massimo

Aryal

et al. 2022

Int J Geriat Psychiatry

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Objectives Social isolation among older adults with cognitive impairment is understudied. The purpose of this study is to examine the relationship between social isolation and anxiety in people with cognitive impairment in the United States. Methods/Design Secondary data analyses were conducted using the National Social Life, Health, and Aging Project (NSHAP) Wave 2 (2010–2011) dataset which includes a nationally representative sample of American older adults living at home. A total of 1343 people who had probable cognitive impairment measured by a Montreal Cognitive Assessment (MoCA) score of 22 or less were selected. Anxiety was measured using the anxiety measure of Hospital Anxiety and Depression Scale (HADS‐A) and social isolation was measured using Perceived Social Isolation Scale. A weighted multivariable linear regression analysis and weighted F tests were used to examine the relationship between social isolation and anxiety. Results We observed that greater social isolation was related to increased anxiety in people with cognitive impairment (coefficients = 0.7242, t = 2.51, p = 0.015), adjusting for severity of cognitive impairment, race, pain, depression, activities of daily living, and instrumental activities of daily living. Weighted F tests showed that persons with clinically significant anxiety (HADS‐A ≥ 8) had higher levels of loneliness, including feeling a lack of companionship, feeling left out, and greater social isolation. Conclusions The results of our study suggest that people with cognitive impairment can feel social isolation and it may contribute to their anxiety. Health care professionals, family, and friends of people with cognitive impairment should pay greater attention to social isolation of their loved ones.

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Section: Variance Inflation Factormentioning

confidence: 99%

The relationship between social isolation and anxiety in people with cognitive impairment in the United States

Hwang

Massimo

Aryal

et al. 2022

Int J Geriat Psychiatry

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“…Numerous studies have grouped NPSs into subsyndromes [ 13 , 15 , 21 , 27 , 45 , 47 , 50 , 51 ]; however, few studies have examined their distribution based on GDS stage [ 52 ], especially in community-dwelling patients. This grouping by subsyndrome is of great interest from the clinical point of view, especially in a scenario of high frequency consultations, as happens in PC, because it allows simplification of the detection of NPSs and provides a more suitable approach with pharmacological or nonpharmacological measures based on the predominating symptom at any given time [ 53 – 56 ].…”

Section: Discussionmentioning

confidence: 99%

Neuropsychiatric symptoms and subsyndromes in patients with different stages of dementia in primary care follow-up (NeDEM project): a cross-sectional study

et al. 2022

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Background The objective was to describe the prevalence and intensity of neuropsychiatric symptoms (NPSs) isolated and grouped into subsyndromes in patients with dementia in primary care (PC) to analyse their distribution based on stages of dementia and the relationship between them and the intensity of symptoms. Methods Design: Cross-sectional study. Setting and population: Patients with dementia, not institutionalized, in a PC follow-up. Variables: Sociodemographic and clinical variables. Assessment instruments: The frequency and intensity of NPSs were measured with the Neuropsychiatric Inventory (NPI), and the stages of dementia with the Global Deterioration Scale (GDS). Statistical analysis: The number of NPSs per patient, the mean NPI value, and the prevalence and intensity of NPSs isolated and grouped into subsyndromes were calculated, as were their 95% confidence intervals (CIs). The analyses were performed on an overall basis and by GDS scores. To analyse the association between the NPI and GDS scores, multivariate analysis was performed with a generalized linear model. Results Overall, 98.4% (95% CI 94.5;99.8) of the patients presented some type of NPS, with an average of five symptoms per patient. The most frequent symptoms were apathy [69.8% (95% CI 61.1;77.5)], agitation [55.8% (95% CI 46.8;64.5)] and irritability [48.8% (95% CI 39.9;57.8)]. The more intense NPSs were apathy [NPI 3.2 (95% CI 2.5;3.8)] and agitation [NPI 3.2 (95% CI 2.5;4.0)]. For subsyndromes, hyperactivity predominated [86.0% (95% CI 78.8;91.5)], followed by apathy [77.5% (95% CI 69.3;84.4]). By phase of dementia, the most common isolated symptom was apathy (60.7–75.0%). Affective symptoms and irritability predominated in the initial stages, and psychotic symptoms predominated in advanced stages. The mean NPI score was 24.9 (95% CI 21.5;28.4) and increased from 15.6 (95% CI 8.2;23.1) for GDS 3 to 28.9 (95% CI 12.6;45.1) for GDS 7. Patients with in the most advanced stages of dementia presented an NPI score 7.6 (95% CI 6.8;8.3) points higher than the score for mild dementia with adjustment for the other variables. Conclusions A high prevalence of NPSs was found among patients with dementia treated in PC. Symptoms change and increase in intensity as the disease progresses. Scales such as the NPI allow these symptoms to be identified, which may facilitate more stage-appropriate management.

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“…Numerous studies have grouped NPSs into subsyndromes (13,15,21,27,45,47,50,51); however, few studies have examined their distribution based on GDS stage (52), especially in community-dwelling patients. This grouping by subsyndrome is of great interest from the clinical point of view, especially in a scenario of high frequency consultations, as happens in PC, because it allows simpli cation of the detection of NPSs and provides a more suitable approach with pharmacological or nonpharmacological measures based on the predominating symptom at any given time (53)(54)(55)(56).…”

Section: Discussionmentioning

confidence: 99%

Neuropsychiatric symptoms and subsyndromes in patients with different stages of dementia in primary care follow-up (NeDEM project): a cross-sectional study.

García-Martín¹,

Hoyos-Alonso²,

Ariza-Cardiel³

et al. 2021

Preprint

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BackgroundThe objective was to describe the prevalence and intensity of Neuropsychiatric symptoms (NPSs) isolated and grouped into subsyndromes in patients with dementia in primary care (PC), to analyse their distribution based on stages of dementia and the relationship between them and the intensity of symptoms.MethodsDesign: Cross-sectional study. Setting and population: Patients with dementia, not institutionalized, in PC follow-up. Variables: Sociodemographic and clinical. Assessment instruments: The frequency and intensity of NPSs were measured with the Neuropsychiatric Inventory (NPI), and the stages of dementia with the Global Deterioration Scale (GDS). Statistical analysis: The number of NPSs per patient, mean NPI value, and prevalence and intensity of NPSs isolated and grouped into subsyndromes were calculated, as were their 95% CIs. The analyses were performed on an overall basis and by GDS. To analyse the association between NPI and GDS, multivariate analysis was performed with a generalized linear model.Results98.4% (95% CI 94.5;99.8) of the patients presented some type of NPS, with an average of five symptoms per patient. The most frequent symptoms were apathy [69.8% (95% CI 61.1;77.5)], agitation [55.8% (95% CI 46.8;64.5)] and irritability [48.8% (95% CI 39.9;57.8)]. The NPSs with greater intensity were apathy [NPI 3.2 (95% CI 2.5;3.8)] and agitation [NPI 3.2 (95% CI 2.5;4.0)]. For subsyndromes, hyperactivity predominated [86.0% (95% CI 78.8;91.5)], followed by apathy [77.5% (95% CI 69.3;84.4]). By phase of dementia, the most common isolated symptom was apathy (60.7%-75.0%). Affective symptoms and irritability predominated in the initial stages, and psychotic symptoms predominated in advanced stages. The mean NPI score was 24.9 (95% CI 21.5;28.4) and increased from 15.6 (95% CI 8.2;23.1) for GDS 3 to 28.9 (95% CI 12.6;45.1) for GDS 7. Patients with in the most advanced stages of dementia presented an NPI score of 7.6 (95% CI 6.8;8.3) points higher than mild dementia, adjusted for the other variables.ConclusionsThere is a high prevalence of NPSs in patients with dementia treated in PC. Symptoms change and increase in intensity as the disease progresses. Scales such as the NPI allow these symptoms to be identified, which could facilitate more stage-appropriate management.

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Neuropsychiatric symptom profiles ofcommunity‐dwellingpersons living with dementia: Factor structures revisited

Cited by 19 publications

References 62 publications

The relationship between social isolation and anxiety in people with cognitive impairment in the United States

The relationship between social isolation and anxiety in people with cognitive impairment in the United States

Neuropsychiatric symptoms and subsyndromes in patients with different stages of dementia in primary care follow-up (NeDEM project): a cross-sectional study

Neuropsychiatric symptoms and subsyndromes in patients with different stages of dementia in primary care follow-up (NeDEM project): a cross-sectional study.

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