Salazar Ricardo, Dwivedi Alok K, Alvarado Luis A, Escamilla Michael
Department of Psychiatry, Division of Geriatric Psychiatry and Behavioral Neurosciences (Salazar), and Department of Molecular and Translational Medicine, Division of Biostatistics and Epidemiology (Dwivedi, Alvarado), Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso; Department of Psychiatry, School of Medicine, University of Texas Rio Grande Valley, Edinburg, Texas (Escamilla).
J Neuropsychiatry Clin Neurosci. 2025 Winter;37(1):29-37. doi: 10.1176/appi.neuropsych.20230180. Epub 2024 Aug 22.
Neuropsychiatric symptoms (NPSs) have been linked to cognitive decline. This study explored ethnic differences and the effects of baseline NPSs on incident mild cognitive impairment (MCI) among 386 Hispanic and non-Hispanic participants from the Texas Harris Alzheimer's Research Study.
Data on NPSs from the Neuropsychiatric Inventory Questionnaire were available for all participants. Cox proportional hazards regression models were used to estimate the effect of ≥1 NPS at baseline and Hispanic ethnicity on incident MCI over a 7-year follow-up period.
NPSs at baseline were associated with incident MCI for Hispanic participants but not non-Hispanic participants. Being Hispanic with at least one NPS at baseline had an 11-times higher risk of incident MCI.
The Hispanic participants converted to MCI to a greater extent than the non-Hispanic participants. Only depressive symptoms increased the risk of MCI among non-Hispanics. Being of Hispanic ethnicity and having NPSs appeared to jointly increase the risk of progressing to MCI. To better understand the Alzheimer's disease continuum, further studies should explore other cultural, genetic, and medical risk factors influencing disease progression. Our findings strongly suggest the need to incorporate NPSs as outcomes of disease progression in future clinical trials involving Hispanic participants.
神经精神症状(NPSs)与认知功能下降有关。本研究在德克萨斯州哈里斯阿尔茨海默病研究中的386名西班牙裔和非西班牙裔参与者中,探讨了种族差异以及基线NPSs对轻度认知障碍(MCI)发病的影响。
所有参与者均有来自神经精神问卷的NPSs数据。采用Cox比例风险回归模型,估计在7年随访期内,基线时≥1种NPSs以及西班牙裔种族对MCI发病的影响。
基线时的NPSs与西班牙裔参与者的MCI发病相关,但与非西班牙裔参与者无关。基线时至少有一种NPSs的西班牙裔人群发生MCI的风险高出11倍。
西班牙裔参与者比非西班牙裔参与者更多地转化为MCI。只有抑郁症状会增加非西班牙裔人群患MCI的风险。西班牙裔种族和患有NPSs似乎共同增加了发展为MCI的风险。为了更好地理解阿尔茨海默病的连续过程,进一步的研究应探索影响疾病进展的其他文化、遗传和医学风险因素。我们的研究结果强烈表明,在未来涉及西班牙裔参与者的临床试验中,有必要将NPSs纳入疾病进展的结果指标。