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. 2013 Nov;21(11):1116-24.
doi: 10.1016/j.jagp.2013.01.049. Epub 2013 Feb 6.

Neuropsychiatric symptoms as risk factors for progression from CIND to dementia: the Cache County Study

M E Peters  1 , P B Rosenberg, M Steinberg, M C Norton, K A Welsh-Bohmer, K M Hayden, J Breitner, J T Tschanz, C G Lyketsos; Cache County Investigators
Affiliations

Neuropsychiatric symptoms as risk factors for progression from CIND to dementia: the Cache County Study

M E Peters et al. Am J Geriatr Psychiatry. 2013 Nov.

Abstract

Objectives: To examine the association of neuropsychiatric symptom (NPS) severity with risk of transition to all-cause dementia, Alzheimer 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-squared 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 Mini-Mental State Examination, 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, whereas 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.

Keywords: Agitation; CIND; Cache County; MCI; NPI; NPS; anxiety; dementia; depression.

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Conflict of interest statement

Authors have no conflicts of interest unless listed: Dr. Rosenberg receives research support from Pfizer, Merck, Elan, Lilly, NIA, and the American Foundation for Aging research. Dr. Welsh-Bohmer is a consultant to Medivation and Zynfandel Pharmaceuticals and a paid speaker for Wyeth & Elan Pharmaceuticals. Dr. Lyketsos has received grant support (research or CME) from NIMH, NIA, Associated Jewish Federation of Baltimore, Weinberg Foundation, Forest, Glaxo-Smith-Kline, Eisai, Pfizer, Astra-Zeneca, Lilly, Ortho-McNeil, Bristol-Myers, Novartis, National Football League, Elan; has been consultant or advisor to Astra-Zeneca, Glaxo-Smith Kline, Eisai, Novartis, Forest, Supernus, Adlyfe, Takeda, Wyeth, Lundbeck, Merz, Lilly, Pfizer, Genentech, Elan, NFL Players Association, NFL Benefits Office; and has received honorarium or travel support from Pfizer, Forest, Glaxo-Smith Kline, Health Monitor.

Figures

Figure 1
Figure 1. Cache County and Current Study Design
1. CIND: cognitive impairment, no dementia; 2. aMCI: amnestic cognitive impairment.
See this image and copyright information in PMC

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