Peters K R, Rockwood K, Black S E, Bouchard R, Gauthier S, Hogan D, Kertesz A, Loy-English I, Beattie B L, Sadovnick A D, Feldman H H
Department of Psychology, Trent University, Peterborough, Ontario, Canada.
Neurology. 2006 Feb 28;66(4):523-8. doi: 10.1212/01.wnl.0000198255.84842.06.
To characterize the neuropsychiatric symptoms (NPS) of subjects classified as not cognitively impaired (NCI), cognitively impaired-not demented (CIND), and dementia.
A Canadian Cohort Study of Cognitive Impairment and Related Dementias (ACCORD) is a longitudinal investigation of individuals referred to eight Canadian dementia centers for evaluation of cognitive impairment and neurobehavioral symptoms. Of the inception cohort of 804 subjects for whom the informant-based Neuropsychiatric Inventory (NPI) was completed at study entry, 35 were classified as NCI, 193 as CIND, and 576 as dementia. The three diagnostic groups were compared on each of the 12 NPI items. Within each diagnostic group, comparisons were also made between symptomatic (NPS+; total score > 1) and asymptomatic (NPS-; total score = 0) subjects on measures of general cognitive status and functional disability. A subset of the NCI and CIND individuals were also compared on a comprehensive neuropsychological test battery.
There was at least one NPI item reported in 60% of subjects with NCI, 74% with CIND, and 89% with dementia. The item scores for delusions, hallucinations, agitation, apathy, disinhibition, aberrant motor behavior, and problems with appetite were greater in dementia subjects than in NCI or CIND. There were no significant differences between subjects with NCI and CIND on any NPI item. For each diagnostic group, NPS+ subjects were more impaired on functional but not neuropsychological measures.
Across all levels of cognition, neuropsychiatric symptoms (NPS) are an important feature in individuals referred to dementia clinics. The current data suggest that NPS may precede cognitive deficits in individuals classified as not cognitively impaired and cognitively impaired-not demented.
对被分类为未认知受损（NCI）、认知受损但未患痴呆（CIND）和痴呆的受试者的神经精神症状（NPS）进行特征描述。
加拿大认知障碍及相关痴呆队列研究（ACCORD）是一项对转至八个加拿大痴呆中心进行认知障碍和神经行为症状评估的个体进行的纵向调查。在初始队列的804名受试者中，有35名被分类为NCI，193名被分类为CIND，576名被分类为痴呆。这三个诊断组在12项神经精神症状问卷（NPI）的每一项上进行了比较。在每个诊断组内，还对有症状（NPS+；总分>1）和无症状（NPS-；总分=0）的受试者在一般认知状态和功能残疾测量方面进行了比较。还对NCI和CIND个体的一个子集进行了全面的神经心理测试组比较。
60%的NCI受试者、74%的CIND受试者和89%的痴呆受试者报告了至少一项NPI项目。痴呆受试者在妄想、幻觉、激越、冷漠、去抑制、异常运动行为和食欲问题方面的项目得分高于NCI或CIND受试者。NCI和CIND受试者在任何NPI项目上均无显著差异。对于每个诊断组，NPS+受试者在功能方面受损更严重，但在神经心理测量方面并非如此。
在所有认知水平上，神经精神症状（NPS）是转至痴呆诊所的个体的一个重要特征。目前的数据表明，NPS可能在被分类为未认知受损和认知受损但未患痴呆的个体中先于认知缺陷出现。
