Departments of Psychiatry, Medicine, Family and Community Medicine, and the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Disease, The University of Texas Health Science Center, San Antonio, Texas, USA.
Department of Family and Community Medicine, The University of Texas Health Science Center, San Antonio, Texas, USA.
Int J Geriatr Psychiatry. 2020 Nov;35(11):1341-1348. doi: 10.1002/gps.5371. Epub 2020 Aug 16.
Dementia severity is strongly related to Spearman's general intelligence factor "g", via the latent dementia phenotype "δ" and is distinct from domain-specific cognitive impairments arising from disease-specific regional pathologies. It is an empiric question whether behavioral and psychological symptoms of dementia (BPSD) are associated with δ or with domain-specific constructs.
A recently developed δ homolog ("dDx") was tested as a predictor of 1 year prospective BPSD in n = 723 Mexican-American and non-Hispanic White participants in the Texas Alzheimer's Research and Care Consortium (TARCC). The informant-rated frequencies of 12 BPSD were rated by the neuropsychiatric inventory (NPI-Q). Baseline BPSD, demographic features, selected biomarkers, and treatment exposure to acetylcholinesterase inhibitors were used as covariates. Composite scores derived from orthogonal latent measures of domain-specific memory (MEM) and executive function (EF) were also tested as predictors.
"Functionally salient cognitive impairment (FSCI)" that is, categorical "dementia" as diagnosed by dDx was associated with increased prospective frequency of 11/12 BPSD, independently of baseline behavior and covariates. Age, depressive symptoms, and EF were associated with individual BPSD. MEM was not associated with any. Dementia severity, as measured by dDx, was also associated with a prospective increase in total NPI-Q scores.
δ is associated non-specifically with multiple BPSD. This suggests the existence of a dementia-specific behavioral profile, arising from insults to general intelligence, and unrelated to disease-specific regional pathology(ies).
痴呆症的严重程度与斯皮尔曼的一般智力因素“g”密切相关，通过潜在的痴呆表型“δ”，并与特定疾病的区域病理学引起的特定领域认知障碍不同。经验性问题是痴呆的行为和心理症状（BPSD）是否与δ或特定领域的结构相关。
最近开发的δ同系物（“dDx”）被测试为 n = 723 名墨西哥裔美国人和非西班牙裔白人参与者在德克萨斯州阿尔茨海默病研究和护理联盟（TARCC）中 1 年前瞻性 BPSD 的预测因子。12 种 BPSD 的频率由神经精神病学库存（NPI-Q）评定。将基线 BPSD、人口统计学特征、选定的生物标志物和乙酰胆碱酯酶抑制剂的治疗暴露作为协变量。还测试了源自特定领域记忆（MEM）和执行功能（EF）的正交潜在测量的综合评分作为预测因子。
“功能明显认知障碍（FSCI）”，即由 dDx 诊断的分类“痴呆”与 11/12 种 BPSD 的前瞻性频率增加独立相关，与基线行为和协变量无关。年龄、抑郁症状和 EF 与个别 BPSD 相关。MEM 与任何一个都不相关。由 dDx 测量的痴呆严重程度也与前瞻性 NPI-Q 总分增加相关。
δ与多种 BPSD 非特异性相关。这表明存在一种特定于痴呆的行为特征，源于对一般智力的损害，与特定疾病的区域病理学无关。
