Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jul;21(7):685-95.
doi: 10.1016/j.jagp.2013.01.006. Epub 2013 Feb 6.

The association of neuropsychiatric symptoms in MCI with incident dementia and Alzheimer disease

Paul B Rosenberg  1 , Michelle M Mielke, Brian S Appleby, Esther S Oh, Yonas E Geda, Constantine G Lyketsos
Affiliations

The association of neuropsychiatric symptoms in MCI with incident dementia and Alzheimer disease

Paul B Rosenberg et al. Am J Geriatr Psychiatry. 2013 Jul.

Abstract

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.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1. RISK OF INCIDENT DEMENTIA STRATIFIED BY PRESENCE/ABSENCE OF NPI SYMPTOMS AT BASELINE
Kaplan-Meier survival curves for risk of incident dementia in the 1821 MCI participants with at least one follow-up are displayed, stratified by baseline NPI=0 vs. NPI>=1. Statistics are reported in Table 3.
See this image and copyright information in PMC

References

    1. Alzheimer's Association: 2009. Alzheimer's disease facts and figures. Alzheimers Dement. 2009;5:234–270. - PubMed
    1. Riley KP, Snowdon DA, Desrosiers MF, et al. Early life linguistic ability, late life cognitive function, and neuropathology: findings from the Nun Study. Neurobiol Aging. 2005;26:341–347. - PubMed
    1. Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med. 2004;256:183–194. - PubMed
    1. Dickerson BC, Sperling RA, Hyman BT, et al. Clinical prediction of Alzheimer disease dementia across the spectrum of mild cognitive impairment. Arch Gen Psychiatry. 2007;64:1443–1450. - PMC - PubMed
    1. Okello A, Koivunen J, Edison P, et al. Conversion of amyloid positive and negative MCI to AD over 3 years: an 11C-PIB PET study. Neurology. 2009;73:754–760. - PMC - PubMed

Publication types