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Review
. 2017 Mar;62(3):161-169.
doi: 10.1177/0706743716648296.

Neuropsychiatric Symptoms in Mild Cognitive Impairment

Damien Gallagher  1   2 , Corinne E Fischer  2   3   4 , Andrea Iaboni  2   5
Affiliations
Review

Neuropsychiatric Symptoms in Mild Cognitive Impairment

Damien Gallagher et al. Can J Psychiatry. 2017 Mar.

Abstract
in English, French

Objective: Neuropsychiatric symptoms (NPS) may be the first manifestation of an underlying neurocognitive disorder. We undertook a review to provide an update on the epidemiology and etiological mechanisms of NPS that occur in mild cognitive impairment (MCI) and just before the onset of MCI. We discuss common clinical presentations and the implications for diagnosis and care.

Method: The authors conducted a selective review of the literature regarding the emergence of NPS in late life, before and after the onset of MCI. We discuss recent publications that explore the epidemiology and etiological mechanisms of NPS in the earliest clinical stages of these disorders.

Results: NPS have been reported in 35% to 85% of adults with MCI and also occur in advance of cognitive decline. The occurrence of NPS for the first time in later life should increase suspicion for an underlying neurocognitive disorder. The presenting symptom may provide a clue regarding the etiology of the underlying disorder, and the co-occurrence of NPS may herald a more accelerated cognitive decline.

Conclusions: NPS are prevalent in the early clinical stages of neurocognitive disorders and can serve as both useful diagnostic and prognostic indicators. Recognition of NPS as early manifestations of neurocognitive disorders will become increasingly important as we move towards preventative strategies and disease-modifying treatments that may be most effective when deployed in the earliest stages of disease.

Objectif:: Les symptômes neuropsychiatriques (SNP) peuvent être la première manifestation d’un trouble neurocognitif sous-jacent. Nous avons entrepris une revue pour offrir une mise à jour de l’épidémiologie et des mécanismes étiologiques des SNP qui surviennent dans la déficience cognitive bénigne (DCB) et immédiatement avant le début de la DCB. Nous discutons des présentations cliniques communes et des implications pour le diagnostic et les soins.

Méthode:: Les auteurs ont mené une revue sélective de la littérature au sujet de l’apparition des SNP en fin de vie, avant et après le début de la DCB. Nous discutons des publications récentes qui explorent l’épidémiologie et les mécanismes étiologiques des SNP dans les premiers stades cliniques de ces troubles.

Résultats:: Les SNP ont été signalés chez 35 à 85% des adultes souffrant de DCB et surviennent également préalablement au déclin cognitif. L’occurrence des SNP pour la première fois en fin de vie devrait faire soupçonner davantage la présence d’un trouble neurocognitif sous-jacent. Le symptôme présent peut fournir un indice de l’étiologie du trouble sous-jacent et la cooccurrence des SNP peut annoncer un déclin cognitif plus accéléré.

Conclusions:: Les SNP sont prévalents dans les premiers stades cliniques des troubles neurocognitifs et peuvent servir d’indicateurs utiles du diagnostic et du pronostic. Reconnaître les SNP comme étant des manifestations précoces des troubles neurocognitifs deviendra de plus en plus important puisque nous nous dirigeons vers des stratégies préventives et des traitements modifiant l’évolution de la maladie qui seront le plus efficaces lorsqu’ils seront appliqués aux premiers stades de la maladie.

Keywords: behavioural and psychological symptoms of dementia; mild cognitive impairment; mild neurocognitive disorder; neuropsychiatric symptoms.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Suggested initial management approach for older adults with new changes in behaviour or personality. NPS, neuropsychiatric symptoms.
See this image and copyright information in PMC

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