Department of Psychological Science, University of Texas Rio Grande Valley, Brownsville, TX, USA.
Department of Neuroscience, School of Medicine, University of Texas Rio Grande Valley, Harlingen, TX, USA.
J Alzheimers Dis. 2021;82(s1):S251-S261. doi: 10.3233/JAD-201144.
Neuropsychiatric symptoms play an important role in diagnosing and clinical follow-up of cognitive impairment and dementia.
We investigated the relationship between neuropsychiatric symptoms, cognitive impairment, and dementia in Hispanics.
We included 529 participants (age ≥40 years) from the Maracaibo Aging Study with standardized neuropsychiatric assessments, including the Neuropsychiatric Inventory (NPI). Based on the Clinical Dementia Rating and the Mini-Mental State Examination scores, participants' cognitive status was categorized into normal cognition, mild/moderate, and severe cognitive impairment. Diagnosis of dementia was established in a consensus conference. Statistical analyses included multivariable logistic regression models and area under the curve (AUC).
The mean age of participants was 59.3 years, and 71.8%were women. The proportion of dementia was 6.8%. Disturbed sleep, anxiety, and depression were the most common neuropsychiatric symptoms in the study sample. In crude analyses, the proportions of hallucinations, aberrant motor behavior, agitation/aggression, apathy, delusions, irritability, eating disturbance, depression, and euphoria were differently distributed among cognitive status groups (p < 0.05). After accounting for confounders, aberrant motor behavior and agitation/aggression remained significantly associated with cognitive impairment and dementia (p < 0.05). The inclusion of the NPI domains significantly improved the AUC to discriminate severe cognitive impairment and dementia compared to a basic model that included sex, age, education, alcohol, obesity, serum glucose, total cholesterol, hypertension, and stroke.
Neuropsychiatric symptoms are associated with severe cognitive impairment and dementia. The addition of NPI items to the global cognitive assessment might help early detection of dementia in primary care settings.
神经精神症状在认知障碍和痴呆的诊断和临床随访中起着重要作用。
我们研究了西班牙裔人群中神经精神症状、认知障碍和痴呆之间的关系。
我们纳入了来自马拉凯博老龄化研究的 529 名参与者(年龄≥40 岁),这些参与者接受了标准化的神经精神评估,包括神经精神问卷(NPI)。根据临床痴呆评定量表和简易精神状态检查评分,将参与者的认知状况分为正常认知、轻度/中度和重度认知障碍。在共识会议上确定痴呆的诊断。统计分析包括多变量逻辑回归模型和曲线下面积(AUC)。
参与者的平均年龄为 59.3 岁,71.8%为女性。痴呆的比例为 6.8%。睡眠障碍、焦虑和抑郁是研究样本中最常见的神经精神症状。在粗分析中,幻觉、异常运动行为、激越/攻击、淡漠、妄想、易怒、饮食障碍、抑郁和欣快的比例在认知状态组之间存在差异(p<0.05)。在考虑混杂因素后,异常运动行为和激越/攻击与认知障碍和痴呆仍显著相关(p<0.05)。与仅包含性别、年龄、教育程度、酒精、肥胖、血糖、总胆固醇、高血压和中风的基本模型相比,包含 NPI 各域的模型能够显著提高区分严重认知障碍和痴呆的 AUC。
神经精神症状与严重认知障碍和痴呆有关。在常规认知评估中增加 NPI 项目可能有助于在基层医疗环境中早期发现痴呆。