Neuropsychiatric Symptoms Among Hispanics: Results of the Maracaibo Aging Study

Abstract

Background: Neuropsychiatric symptoms play an important role in diagnosing and clinical follow-up of cognitive impairment and dementia. Objective: We investigated the relationship between neuropsychiatric symptoms, cognitive impairment, and dementia in Hispanics. Methods: We included 529 participants (age ≥40 years) from the Maracaibo Aging Study with standardized neuropsychiatric assessments, including the Neuropsychiatric Inventory (NPI). Based on the Clinical Dementia Rating and the Mini-Mental State Examination scores, participants’ cognitive status was categorized into normal cognition, mild/moderate, and severe cognitive impairment. Diagnosis of dementia was established in a consensus conference. Statistical analyses included multivariable logistic regression models and area under the curve (AUC). Results: The mean age of participants was 59.3 years, and 71.8%were women. The proportion of dementia was 6.8%. Disturbed sleep, anxiety, and depression were the most common neuropsychiatric symptoms in the study sample. In crude analyses, the proportions of hallucinations, aberrant motor behavior, agitation/aggression, apathy, delusions, irritability, eating disturbance, depression, and euphoria were differently distributed among cognitive status groups (p < 0.05). After accounting for confounders, aberrant motor behavior and agitation/aggression remained significantly associated with cognitive impairment and dementia (p < 0.05). The inclusion of the NPI domains significantly improved the AUC to discriminate severe cognitive impairment and dementia above of a basic model that included sex, age, education, alcohol, obesity, serum glucose, total cholesterol, hypertension, and stroke. Conclusion: Neuropsychiatric symptoms are associated with severe cognitive impairment and dementia. The addition of NPI items to the global cognitive assessment might help early detection of dementia in primary care settings.

Prevalence and impact of neuropsychiatric symptoms in normal aging and neurodegenerative syndromes: A population‐based study from Latin America

“…In addition, we found a relatively high frequency of NPSs in the control group, which may be explained by the advanced age of the sample. This finding is consistent with previous reports in similar age groups 10,22,23 . In addition, there is the potential of early/prodromal NPSs in “healthy individuals” due to underlying pathology but not yet meeting clinical diagnosis criteria.…”

“…This finding is consistent with previous reports in similar age groups. 10,22,23 In addition, there is the potential of early/prodromal NPSs in "healthy individuals" due to underlying pathology but not yet meeting clinical diagnosis criteria.…”

“…AD and PD are the most common neurodegenerative diseases in LatAm, and the region will face a significant increase in the burden of these diseases in the next decade 18–21 . However, NPSs in dementia and parkinsonism have rarely been studied in LatAm populations 22–25 . No study has assessed the prevalence of NPSs in dementia and parkinsonism in a large population‐based study from multiple countries in LatAm and using the same methodology.…”

“…[18][19][20][21] However, NPSs in dementia and parkinsonism have rarely been studied in LatAm populations. [22][23][24][25] No study has assessed the prevalence of NPSs in dementia and parkinsonism in a large population-based study from multiple countries in LatAm and using the same methodology. Furthermore, although there are known racial disparities in dementia and parkinsonism, little is known regarding NPSs across all races/ethnicities.…”

Translational Research and Drug Discovery for Neurodegeneration: Challenges for Latin America

“…Several studies make a notable contribution to the current literature gaps about dementia and related risk factors in Hispanics living in developing countries. The extensive work of Gil et al [16] and Castro et al [17] highlights the relationship between neuropsychiatric symptoms and cognitive impairment and dementia, including biomarkers of depressive symptoms, in population-based studies of older Hispanics in Maracaibo City, Venezuela. Castillo-Mendieta et al [18] report the potential of plasma biomarkers of neuropathological signs of AD as a cost-effective approach to identifying individuals at risk for AD in a sample of Mexican AD patients.…”