TY - JOUR
T1 - The association of neuropsychiatric symptoms in MCI with incident dementia and alzheimer disease
AU - Rosenberg, Paul B.
AU - Mielke, Michelle M.
AU - Appleby, Brian S.
AU - Oh, Esther S.
AU - Geda, Yonas E.
AU - Lyketsos, Constantine G.
N1 - Funding Information:
Disclosures: PBR has received research support from NIA, American Foundation for Aging Research, Merck, Pfizer, Lilly, Elan, and Jannsen. MMM has received research support from NIA, NINDS, and the George and Cynthia Mitchell Foundation. BSA has received research support from Forrest Research Institute, Richmond Family Foundation for Alzheimer's and Related Diseases, and the Stempler Fund for Dementia Research; loan repayment support from LRP/NIA. ESO has received research support from The Rosalinde and Arthur Gilbert Foundation/ American Foundation for Aging Research, NIA, Johns Hopkins Institute for Clinical and Translational Research, Fidelity Foundation, and Hartford Center of Excellence. YEG has received research support from NIMH, NIH, Mayo CTSA, the Robert Wood Johnson Foundation, and Clarice Smith and Abigail Van Buren Alzheimer's Disease Research Program.
Funding Information:
Sponsors: National Institute of Aging 1 K08 AG029157-01A1 (to PBR), U01 AG016976 (to the National Alzheimer's Coordinating Center), National Institute of Mental Health 1U01MH066136 (to CGL), and Stempler Fund for Dementia Research and the Richmond Family Fund for Alzheimer's and Related Diseases (to BSA).
PY - 2013/7
Y1 - 2013/7
N2 - Objectives: Individuals with mild cognitive impairment (MCI) are at high risk of developing dementia and/or Alzheimer disease (AD). Among persons with MCI, depression and anxiety have been associated with an increased risk of incident dementia. We examined whether neuropsychiatric symptoms in MCI increased the risk of incident dementia (all-cause) and incident AD. Design: Longitudinal cohort study followed annually (median: 1.58 years). Setting: National Alzheimer's Coordinating Center database combining clinical data from 29 Alzheimer's Disease Centers. Participants: A total of 1,821 participants with MCI. Measurements: 1) Progression to dementia (all-cause) or AD, 2) Neuropsychiatric Inventory Questionnaire (NPI-Q), 3) Geriatric Depression Scale (GDS), 4) Clinical Dementia Rating Global Score and Sum of Boxes, and 5) Mini-Mental State Examination (MMSE). The association of covariates with risk of incident dementia or AD was evaluated with hazard ratios (HR) determined by Cox proportional-hazards models adjusted for age, ethnicity, Clinical Dementia Rating Global Score and Sum of Boxes, and MMSE. Results: A total of 527 participants (28.9%) progressed to dementia and 454 (24.9%) to AD. Baseline GDS > 0 was associated with an increased risk of incident dementia (HR: 1.47, 95% CI: 1.17-1.84) and AD (HR: 1.45, 95% CI: 1.14-1.83). Baseline NPI > 0 was associated with an increased risk of incident dementia (HR: 1.37, 95% CI: 1.12-1.66) and AD (HR: 1.35, 95% CI: 1.09-1.66). Conclusions: Neuropsychiatric symptoms in MCI are associated with significantly an increased risk of incident dementia and AD. Neuropsychiatric symptoms may be among the earliest symptoms of preclinical stages of AD and targeting them therapeutically might delay transition to dementia.
AB - Objectives: Individuals with mild cognitive impairment (MCI) are at high risk of developing dementia and/or Alzheimer disease (AD). Among persons with MCI, depression and anxiety have been associated with an increased risk of incident dementia. We examined whether neuropsychiatric symptoms in MCI increased the risk of incident dementia (all-cause) and incident AD. Design: Longitudinal cohort study followed annually (median: 1.58 years). Setting: National Alzheimer's Coordinating Center database combining clinical data from 29 Alzheimer's Disease Centers. Participants: A total of 1,821 participants with MCI. Measurements: 1) Progression to dementia (all-cause) or AD, 2) Neuropsychiatric Inventory Questionnaire (NPI-Q), 3) Geriatric Depression Scale (GDS), 4) Clinical Dementia Rating Global Score and Sum of Boxes, and 5) Mini-Mental State Examination (MMSE). The association of covariates with risk of incident dementia or AD was evaluated with hazard ratios (HR) determined by Cox proportional-hazards models adjusted for age, ethnicity, Clinical Dementia Rating Global Score and Sum of Boxes, and MMSE. Results: A total of 527 participants (28.9%) progressed to dementia and 454 (24.9%) to AD. Baseline GDS > 0 was associated with an increased risk of incident dementia (HR: 1.47, 95% CI: 1.17-1.84) and AD (HR: 1.45, 95% CI: 1.14-1.83). Baseline NPI > 0 was associated with an increased risk of incident dementia (HR: 1.37, 95% CI: 1.12-1.66) and AD (HR: 1.35, 95% CI: 1.09-1.66). Conclusions: Neuropsychiatric symptoms in MCI are associated with significantly an increased risk of incident dementia and AD. Neuropsychiatric symptoms may be among the earliest symptoms of preclinical stages of AD and targeting them therapeutically might delay transition to dementia.
KW - Alzheimer disease
KW - Dementia
KW - Depression
KW - Longitudinal study
KW - Mild cognitive impairment
KW - Neuropsychiatric symptoms
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U2 - 10.1016/j.jagp.2013.01.006
DO - 10.1016/j.jagp.2013.01.006
M3 - Article
AN - SCOPUS:85027941701
SN - 1064-7481
VL - 21
SP - 685
EP - 695
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
IS - 7
ER -