Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study.
Constantine G. Lyketsos,Oscar L. Lopez,Beverly N. Jones,Annette L. Fitzpatrick,John C.S. Breitner,Steven T. DeKosky +5 more
TLDR
These are the first population-based estimates for neuropsychiatric symptoms in MCI, indicating a high prevalence associated with this condition as well.Abstract:
ContextMild cognitive impairment (MCI) may be a precursor to dementia, at least
in some cases. Dementia and MCI are associated with neuropsychiatric symptoms
in clinical samples. Only 2 population-based studies exist of the prevalence
of these symptoms in dementia, and none exist for MCI.ObjectiveTo estimate the prevalence of neuropsychiatric symptoms in dementia
and MCI in a population-based study.DesignCross-sectional study derived from the Cardiovascular Health Study,
a longitudinal cohort study.Setting and ParticipantsA total of 3608 participants were cognitively evaluated using data collected
longitudinally over 10 years and additional data collected in 1999-2000 in
4 US counties. Dementia and MCI were classified using clinical criteria and
adjudicated by committee review by expert neurologists and psychiatrists.
A total of 824 individuals completed the Neuropsychiatric Inventory (NPI);
362 were classified as having dementia, 320 as having MCI; and 142 did not
meet criteria for MCI or dementia.Main Outcome MeasurePrevalence of neuropsychiatric symptoms, based on ratings on the NPI
in the previous month and from the onset of cognitive symptoms.ResultsOf the 682 individuals with dementia or MCI, 43% of MCI participants
(n = 138) exhibited neuropsychiatric symptoms in the previous month (29% rated
as clinically significant) with depression (20%), apathy (15%), and irritability
(15%) being most common. Among the dementia participants, 75% (n = 270) had
exhibited a neuropsychiatric symptom in the past month (62% were clinically
significant); 55% (n = 199) reported 2 or more and 44% (n = 159) 3 or more
disturbances in the past month. In participants with dementia, the most frequent
disturbances were apathy (36%), depression (32%), and agitation/aggression
(30%). Eighty percent of dementia participants (n = 233) and 50% of MCI participants
(n = 139) exhibited at least 1 NPI symptom from the onset of cognitive symptoms.
There were no differences in prevalence of neuropsychiatric symptoms between
participants with Alzheimer-type dementia and those with other dementias,
with the exception of aberrant motor behavior, which was more frequent in
Alzheimer-type dementia (5.4% vs 1%; P = .02).ConclusionsNeuropsychiatric symptoms occur in the majority of persons with dementia
over the course of the disease. These are the first population-based estimates
for neuropsychiatric symptoms in MCI, indicating a high prevalence associated
with this condition as well. These symptoms have serious adverse consequences
and should be inquired about and treated as necessary. Study of neuropsychiatric
symptoms in the context of dementia may improve our understanding of brain-behavior
relationships.read more
Citations
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Journal ArticleDOI
Mild cognitive impairment
Serge Gauthier,Barry Reisberg,Michael Zaudig,Ronald C. Petersen,Karen Ritchie,Karl Broich,Sylvie Belleville,Henry Brodaty,David A. Bennett,Howard Chertkow,Jeffrey L. Cummings,Mony J. de Leon,Howard Feldman,Mary Ganguli,Harald Hampel,Philip Scheltens,Mary C. Tierney,Peter J. Whitehouse,Bengt Winblad +18 more
TL;DR: Mild cognitive impairment can be regarded as a risk state for dementia, and its identification could lead to secondary prevention by controlling risk factors such as systolic hypertension.
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Dementia prevention, intervention, and care
Gill Livingston,Gill Livingston,Andrew Sommerlad,Vasiliki Orgeta,Sergi G. Costafreda,Sergi G. Costafreda,Jonathan Huntley,Jonathan Huntley,David Ames,Clive Ballard,Sube Banerjee,Alistair Burns,Jiska Cohen-Mansfield,Claudia Cooper,Claudia Cooper,Nick C. Fox,Laura N. Gitlin,Robert Howard,Robert Howard,Helen C. Kales,Eric B. Larson,Eric B. Larson,Karen Ritchie,Karen Ritchie,Kenneth Rockwood,Elizabeth L Sampson,Quincy M. Samus,Lon S. Schneider,Geir Selbæk,Geir Selbæk,Linda Teri,Naaheed Mukadam +31 more
TL;DR: The Lancet Commission on Dementia Prevention, Intervention, and Care met to consolidate the huge strides that have been made and the emerging knowledge as to what the authors should do to prevent and manage dementia.
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Clinical Diagnosis of Alzheimer's Disease
TL;DR: There are a number of ways in which a clinical diagnosis of dementia of the Alzheimer type can be made – the application of clinical criteria is the commonest but ancillary techniques such as neuroima are also used.
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Enrichment Effects on Adult Cognitive Development: Can the Functional Capacity of Older Adults Be Preserved and Enhanced?
TL;DR: The available evidence suggests that activities can postpone decline, attenuate decline, or provide prosthetic benefit in the face of normative cognitive decline, while at the same time indicating that late-life cognitive changes can result in curtailment of activities.
Journal ArticleDOI
Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology
Ronald C. Petersen,Oscar L. Lopez,Melissa J. Armstrong,Thomas S.D. Getchius,Mary Ganguli,David Gloss,Gary S. Gronseth,Daniel C. Marson,Tamara Pringsheim,Gregory S. Day,Mark A. Sager,James C. Stevens,Alexander Rae-Grant +12 more
TL;DR: In patients with MCI, exercise training (6 months) is likely to improve cognitive measures and cognitive training may improve cognitive Measures, and no high-quality evidence exists to support pharmacologic treatments for MCI.
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