Title | Neuropsychiatric Symptoms and the Diagnostic Stability of Mild Cognitive Impairment. |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Sugarman, MA, Alosco, ML, Tripodis, Y, Steinberg, EG, Stern, RA |
Journal | J Alzheimers Dis |
Volume | 62 |
Issue | 4 |
Pagination | 1841-1855 |
Date Published | 2018 |
ISSN | 1875-8908 |
Abstract | BACKGROUND: Mild cognitive impairment (MCI) is an intermediate diagnosis between normal cognition (NC) and dementia, including Alzheimer's disease (AD) dementia. However, MCI is heterogeneous; many individuals subsequently revert to NC while others remain stable at MCI for several years. Identifying factors associated with this diagnostic instability could assist in defining clinical populations and determining cognitive prognoses. OBJECTIVE: The current study examined whether neuropsychiatric symptoms could partially account for the temporal instability in cognitive diagnoses. METHOD: The sample included 6,763 participants from the National Alzheimer's Coordinating Center Uniform Data Set. All participants had NC at baseline, completed at least two follow-up visits (mean duration: 5.5 years), and had no recent neurological conditions. Generalized linear models estimated by generalized estimating equations examined associations between changes in cognitive diagnoses and symptoms on the Neuropsychiatric Inventory Questionnaire (NPI-Q) and Geriatric Depression Scale (GDS-15). RESULTS: 1,121 participants converted from NC to MCI; 324 reverted back to NC and 242 progressed to AD dementia. Higher symptoms on the GDS-15 and circumscribed symptom domains on the NPI-Q were associated with conversion from NC to MCI and a decreased likelihood of reversion from MCI to NC. Individuals with higher symptoms on NPI-Q Hyperactivity and Mood items were more likely to progress to AD dementia. DISCUSSION: The temporal instability of MCI can be partially explained by neuropsychiatric symptoms. Individuals with higher levels of specific symptoms are more likely to progress to AD dementia and less likely to revert to NC. Identification and treatment of these symptoms might support cognitive functioning in older adults. |
DOI | 10.3233/JAD-170527 |
Alternate Journal | J. Alzheimers Dis. |
PubMed ID | 29614641 |
Grant List | U01 AG016976 / AG / NIA NIH HHS / United States P30 AG019610 / AG / NIA NIH HHS / United States P30 AG013846 / AG / NIA NIH HHS / United States P50 AG008702 / AG / NIA NIH HHS / United States P50 AG025688 / AG / NIA NIH HHS / United States P30 AG010133 / AG / NIA NIH HHS / United States P50 AG005146 / AG / NIA NIH HHS / United States P50 AG005134 / AG / NIA NIH HHS / United States P50 AG016574 / AG / NIA NIH HHS / United States P50 AG005138 / AG / NIA NIH HHS / United States P30 AG008051 / AG / NIA NIH HHS / United States P30 AG013854 / AG / NIA NIH HHS / United States P30 AG008017 / AG / NIA NIH HHS / United States P30 AG010161 / AG / NIA NIH HHS / United States P30 AG010129 / AG / NIA NIH HHS / United States P50 AG016573 / AG / NIA NIH HHS / United States P50 AG016570 / AG / NIA NIH HHS / United States P50 AG005131 / AG / NIA NIH HHS / United States P50 AG023501 / AG / NIA NIH HHS / United States P30 AG035982 / AG / NIA NIH HHS / United States P30 AG028383 / AG / NIA NIH HHS / United States P30 AG010124 / AG / NIA NIH HHS / United States P50 AG005133 / AG / NIA NIH HHS / United States P50 AG005142 / AG / NIA NIH HHS / United States P30 AG012300 / AG / NIA NIH HHS / United States P50 AG005136 / AG / NIA NIH HHS / United States P50 AG033514 / AG / NIA NIH HHS / United States P50 AG005681 / AG / NIA NIH HHS / United States |