Neuropsychiatric Symptoms in Patients with the Main Etiological Types of Mild Neurocognitive Disorders: A Hospital-Based Case–Control Study

Abstract

BackgroundThe diagnostic construct of mild neurocognitive disorders (MNCDs) is substantially congruent with previously proposed criteria for mild cognitive impairment (MCI). MNCD/MCI is associated with neuropsychiatric symptoms (NPS). Previous studies have examined the prevalence of NPS in amnestic and non-amnestic MCI subtypes; however, no studies exist for etiological types of MNCD. We aimed to estimate the prevalence of NPS in patients with MNCD due to Alzheimer’s disease (MNCD-AD) and subcortical vascular MNCD (ScVMNCD) and to determine whether NPS would expand these MNCD phenotypes.MethodsThe sample comprised 70 patients with MNCD-AD, 70 patients with ScVMNCD, and 55 cognitively normal elderly persons (CNEP). The diagnosis of MNCD-AD was made according to DSM-5 criteria for possible MNCD-AD. ScVMNCD patients fulfilled the DSM-5 criteria of the probable vascular MNCD and the diagnostic criteria for subcortical vascular MCI according to Frisoni et al. (1). The prevalence of NPS was based on the neuropsychiatric inventory. The statistical analyses included parametric and non-parametric tests, multivariate regression, and Spearman’s correlation coefficient.ResultsAbout 69.1% of CNEP, 97.1% of MNCD-AD, and 100% of ScVMNCD patients had one or more NPS. The prevalence of NPS in both MNCD groups was significantly higher than that in CNEP. The most prevalent NPS that had significant differential diagnostic value in separating MNCD-AD from ScVMNCD, as well as MNCD from CNEP, were anxiety (81.43%) and irritability (67.14%) in MNCD-AD and depression (81.43%) in ScVMNCD. In both MNCD groups, we observed significant (p < 0.05) correlations between all distinguishing NPS and the differential cognitive disturbances: the amnestic syndrome in MNCD-AD and executive dysfunction in ScVMNCD.ConclusionNPS occur in the majority of persons with MNCD-AD and ScVMNCD. Anxiety and irritability are the most prevalent NPS in MNCD-AD, as well as depression in ScVMNCD. The amnestic–anxious–irritable syndrome can be the main phenotype in MNCD-AD, on the other hand, the dysexecutive–depressive syndrome can be considered as the most prevalent clinical manifestation in ScVMNCD. Obtained data may be used for clinical differentiation of MNCD-AD and ScVMNCD patients.

Retention and impairment of neurocognitive functions in mild cognitive impairment and Alzheimer’s disease with a comprehensive neuropsychological test

“…In 2013, the concept of mild neurocognitive disorders (mild NCD) and major neurocognitive disorders due to Alzheimer's disease (major NCD due to AD) was defined in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM‐5) 22 . Diagnostic criteria of mild NCD are largely consistent with the previously proposed nosological entity for MCI, 23 and major NCD is mostly synonymous with dementia 24 . Because of that, the great majority of our understanding of mild NCD and major NCD due to AD based on studies of MCI and AD.…”

Effects of Combined Physical Movement Activity and Multifaceted Cognitive Training in Older People with Mild Neurocognitive Disorder in a Rural Community: A Randomized Control Trial

“…Mild neurocognitive disorders (mNCD) is a new term that has been used to replace mild cognitive impairment (MCI) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association (APA), 2013 [1]. mNCD is related to a progressive neurocognitive condition which could convert to more severe neurocognitive disorders (major NCD) [2]. The transitional phase could affect ≥1 cognitive function such as complex attention, executive function, learning and memory, and language as well as perceptual-motor and social cognition.…”

Specific Cognitive–Psychopathological Phenotypes in Patients With Early Stages of Subcortical Vascular Neurocognitive Disorders: A Hospital-Based Case–Control Study

“…14 Investigations devoted to NPS in mild ScVNCD are even less numerous. In our recent study, 15 we found that patients with mild ScVNCD, unlike those with mild neurocognitive disorder due to Alzheimer disease and aged control persons, had a significantly higher incidence of depression. A comparison of NPS between mild ScVNCD and early stage of major ScVNCD could be interesting from the practical as well as theoretical points of view.…”

“…Earlier, we demonstrated the pathognomonic character of the dysexecutive-depressive phenotype in mild ScVNCD in a smaller sample of patients. 15 The transformation of the clinical phenotype mentioned above into dysexecutive-depressive-apathetic one at the early stage of major ScVNCD was proved for the first time.…”

“…The design and protocol of the study were as described previously. 15 All participants were outpatients of the neurological department of the Central Hospital of Kommunarsky District, Zaporizhzhia, Ukraine. The participants were evaluated and given their respective diagnoses by a team of a neurologist (NC) and psychiatrist (OL).…”