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

Steinberg, Martin; Shao, Huibo; Zandi, Peter P.; Lyketsos, Constantine G.; Welsh‐Bohmer, Kathleen A.; Norton, Maria C.; Breitner, John C.S.; Steffens, David C.; Tschanz, JoAnn T.

doi:10.1002/gps.1858

Cited by 615 publications

(480 citation statements)

References 30 publications

Supporting

Mentioning

437

Contrasting

Unclassified

Order By: Relevance

“…As expected, those with MCI and dementia reported the highest prevalence of NPS (53.4% and 80%, respectively). This is consistent with previous reports of NPS in community-based samples of clinical groups, where NPS have been reported in 61%-97% of individuals with dementia [7,8] and 31%-50% of individuals with MCI [4][5][6]8]. These finding are or particular clinical relevance as it is well accepted that the comorbid presentation of NPS in MCI is linked to higher progression to dementia and that for patients with AD, NPS are associated with an increased likelihood of progression from mild to severe dementia [35].…”

Section: Prevalence Of Npssupporting

confidence: 93%

“…Prevalence estimates of NPS are reported among 31%-50% of individuals with MCI [4][5][6] and 61%-97% of individuals with dementia [7,8]. It is well accepted that the comorbid presentation of NPS in MCI is linked to higher progression to dementia [9][10][11][12][13][14][15] and that for patients with Alzheimer's disease (AD), NPS are associated with an increased likelihood of progression from mild to severe dementia [16].…”

Section: Introductionmentioning

confidence: 99%

“…Most of the studies on NPS to date have focused on highly selective clinical samples recruited from tertiary care centers [12,[23][24][25] or as subsamples of population-based cohorts [4,7,8,14,19,26]. This means that there is a gap in our knowledge about the spectrum of NPS occurring in the population across different cognitive phenotypes, disorders, outcomes, and status.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Mortby

Burns

Eramudugolla

et al. 2017

JAD

View full text Add to dashboard Cite

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.

show abstract

Section: Prevalence Of Npssupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Mortby

Burns

Eramudugolla

et al. 2017

JAD

View full text Add to dashboard Cite

show abstract

“…Neuropsychiatric symptoms (NPS) are nearly universal in dementia through the course of illness 8 . As a result, and because NPS are associated with a worse prognosis in dementia 9 , the occurrence of NPS in MCI/CIND has become of interest to clinicians and researchers.…”

Section: Objectivementioning

confidence: 99%

Neuropsychiatric Symptoms as Risk Factors for Progression From CIND to Dementia: The Cache County Study

Peters¹,

Rosenberg²,

Steinberg³

et al. 2013

The American Journal of Geriatric Psychiatry

127

104

View full text Add to dashboard Cite

Objectives To examine the association of neuropsychiatric symptom (NPS) severity with risk of transition to all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD). Design Survival analysis of time to dementia, AD, or VaD onset. Setting Population-based study. Participants 230 participants diagnosed with cognitive impairment, no dementia (CIND) from the Cache County Study of Memory Health and Aging were followed for a mean of 3.3 years. Measurements The Neuropsychiatric Inventory (NPI) was used to quantify the presence, frequency, and severity of NPS. Chi-square statistics, t-tests, and Cox proportional hazard ratios were used to assess associations. Results The conversion rate from CIND to all-cause dementia was 12% per year, with risk factors including an APOE ε4 allele, lower MMSE, lower 3MS, and higher CDR sum-of-boxes. The presence of at least one NPS was a risk factor for all-cause dementia, as was the presence of NPS with mild severity. Nighttime behaviors were a risk factor for all-cause dementia and of AD, while hallucinations were a risk factor for VaD. Conclusions These data confirm that NPS are risk factors for conversion from CIND to dementia. Of special interest is that even NPS of mild severity are a risk for all-cause dementia or AD.

show abstract

“…Neuropsychiatric symptoms affect most people with AD at some point during the illness (2–5). Apathy is one of the most common neuropsychiatric symptoms with prevalence estimates ranging from 36% to 70% of people with AD (2,6) and is associated with increased care needs and caregiver burden and distress (7,8), increased risk of institutionalization (9), and higher costs of care (10). Given the prevalence and consequences of apathy in AD dementia, identifying methods of managing apathetic symptoms is an important public health priority.…”

Section: Introductionmentioning

confidence: 99%

Designing a Trial to Evaluate Potential Treatments for Apathy in Dementia: The Apathy in Dementia Methylphenidate Trial (ADMET)

Drye

Scherer

Lanctôt

et al. 2013

The American Journal of Geriatric Psychiatry

View full text Add to dashboard Cite

Background Research on efficacious treatments for apathy in Alzheimer’s disease has been hindered by a lack of consensus diagnosis, difficulties in measurement, and studies with small sample sizes. Methods In designing the Apathy in Dementia Methylphenidate Trial (ADMET), a trial to evaluate the efficacy and safety of methylphenidate for the treatment of apathy in Alzheimer’s disease, we encountered the following issues: defining and measuring apathy, distinguishing apathy and depression, determining an appropriate test treatment, selecting relevant secondary outcomes, recruiting participants, and deciding on a suitable method for treatment unmasking. ADMET is a 6-week randomized, double-masked, placebo-controlled multicenter clinical trial with two parallel treatment groups assigned in a 1:1 ratio with randomization stratified by clinical center. The recruitment goal is 60 randomized participants over 2 years. The primary outcomes are change in apathy severity as measured by the Apathy Evaluation Scale and the Alzheimer Disease Cooperative Study-Clinical Global Impression of Change. Conclusion The design decisions made for ADMET are important elements to be considered in trials assessing the safety and efficacy of medications for clinically significant apathy in Alzheimer’s disease.

show abstract

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

Abstract: SUMMARYBackground-Neuropsychiatric symptoms are nearly universal in dementia, yet little is known about their longitudinal course in the community.

Cited by 615 publications

References 30 publications

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

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

Neuropsychiatric Symptoms as Risk Factors for Progression From CIND to Dementia: The Cache County Study

Designing a Trial to Evaluate Potential Treatments for Apathy in Dementia: The Apathy in Dementia Methylphenidate Trial (ADMET)

Contact Info

Product

Resources

About