Nicholas D David1, Feng Lin2, Anton P Porsteinsson3. 1. University of Rochester School of Medicine and Dentistry, Rochester, NY. 2. University of Rochester School of Medicine and Dentistry, Rochester, NY; University of Rochester School of Nursing, Rochester, NY. 3. University of Rochester School of Medicine and Dentistry, Rochester, NY. Electronic address: anton_porsteinsson@urmc.rochester.edu.
Abstract
OBJECTIVE: To characterize the course of neuropsychiatric symptoms (NPS) in adults with mild cognitive impairment (MCI), and to examine baseline individual-level predictors and associated cognitive and functional outcomes. DESIGN: A 2-year prospective cohort study. SETTING: Multicenter clinical settings. PARTICIPANTS: Five hundred sixty individuals with MCI at baseline. MEASUREMENTS: NPS severity (measured using Neuropsychiatric Inventory Questionnaire) and cognitive and functional outcomes were assessed at baseline and every 6 months thereafter. Potential individual-level predictors were collected at baseline. RESULTS: Three latent classes of NPS courses were identified using growth mixture modeling: a stable class in which a low NPS burden remained relatively unchanged over time (N = 503, 89.8%); a worsened class in which an initially moderate NPS burden increased (N = 39, 7.0%); and an improved class in which an initially high NPS burden decreased (N = 18, 3.2%). There were no associations between class membership and baseline individual characteristics. Members of the worsened class were 1.74 times more likely to be diagnosed with incident Alzheimer disease (AD) than members of the stable class (95% confidence interval: 1.07-2.84). The worsened class also showed significantly more rapid declines in cognitive and functional outcomes than the stable class. Class membership did not predict rate of brain atrophy. CONCLUSIONS: Patients with MCI may experience different trajectories of NPS over time. Patients with worsening NPS may be at greater risk of developing AD and severe cognitive and functional impairment.
OBJECTIVE: To characterize the course of neuropsychiatric symptoms (NPS) in adults with mild cognitive impairment (MCI), and to examine baseline individual-level predictors and associated cognitive and functional outcomes. DESIGN: A 2-year prospective cohort study. SETTING: Multicenter clinical settings. PARTICIPANTS: Five hundred sixty individuals with MCI at baseline. MEASUREMENTS: NPS severity (measured using Neuropsychiatric Inventory Questionnaire) and cognitive and functional outcomes were assessed at baseline and every 6 months thereafter. Potential individual-level predictors were collected at baseline. RESULTS: Three latent classes of NPS courses were identified using growth mixture modeling: a stable class in which a low NPS burden remained relatively unchanged over time (N = 503, 89.8%); a worsened class in which an initially moderate NPS burden increased (N = 39, 7.0%); and an improved class in which an initially high NPS burden decreased (N = 18, 3.2%). There were no associations between class membership and baseline individual characteristics. Members of the worsened class were 1.74 times more likely to be diagnosed with incident Alzheimer disease (AD) than members of the stable class (95% confidence interval: 1.07-2.84). The worsened class also showed significantly more rapid declines in cognitive and functional outcomes than the stable class. Class membership did not predict rate of brain atrophy. CONCLUSIONS:Patients with MCI may experience different trajectories of NPS over time. Patients with worsening NPS may be at greater risk of developing AD and severe cognitive and functional impairment.
Authors: Laura E Gibbons; Adam C Carle; R Scott Mackin; Danielle Harvey; Shubhabrata Mukherjee; Philip Insel; S McKay Curtis; Dan Mungas; Paul K Crane Journal: Brain Imaging Behav Date: 2012-12 Impact factor: 3.978
Authors: Pauline Aalten; Marjolein E de Vugt; Niek Jaspers; Jaspers Jolles; Frans R J Verhey Journal: Int J Geriatr Psychiatry Date: 2005-06 Impact factor: 3.485
Authors: Paul B Rosenberg; Michelle M Mielke; Brian S Appleby; Esther S Oh; Yonas E Geda; Constantine G Lyketsos Journal: Am J Geriatr Psychiatry Date: 2013-02-06 Impact factor: 4.105
Authors: M E Peters; P B Rosenberg; M Steinberg; M C Norton; K A Welsh-Bohmer; K M Hayden; J Breitner; J T Tschanz; C G Lyketsos Journal: Am J Geriatr Psychiatry Date: 2013-02-06 Impact factor: 4.105
Authors: Kate de Medeiros; P Robert; S Gauthier; F Stella; A Politis; J Leoutsakos; F Taragano; J Kremer; A Brugnolo; A P Porsteinsson; Y E Geda; H Brodaty; G Gazdag; J Cummings; C Lyketsos Journal: Int Psychogeriatr Date: 2010-07-01 Impact factor: 3.878
Authors: Florindo Stella; Márcia Radanovic; Márcio L F Balthazar; Paulo R Canineu; Leonardo C de Souza; Orestes V Forlenza Journal: Curr Opin Psychiatry Date: 2014-05 Impact factor: 4.741
Authors: Roland B Wetzels; Sytse U Zuidema; Jos F M de Jonghe; Frans R J Verhey; Raymond T C M Koopmans Journal: Am J Geriatr Psychiatry Date: 2010-12 Impact factor: 4.105
Authors: Michael W Weiner; Dallas P Veitch; Paul S Aisen; Laurel A Beckett; Nigel J Cairns; Robert C Green; Danielle Harvey; Clifford R Jack; William Jagust; John C Morris; Ronald C Petersen; Andrew J Saykin; Leslie M Shaw; Arthur W Toga; John Q Trojanowski Journal: Alzheimers Dement Date: 2017-03-22 Impact factor: 21.566
Authors: Xixi Wang; Ping Ren; Mark Mapstone; Yeates Conwell; Anton P Porsteinsson; John J Foxe; Rajeev D S Raizada; Feng Lin Journal: Brain Imaging Behav Date: 2019-02 Impact factor: 3.978
Authors: Jeannie-Marie S Leoutsakos; Elizabeth A Wise; Constantine G Lyketsos; Gwenn S Smith Journal: Int J Geriatr Psychiatry Date: 2019-09-02 Impact factor: 3.485
Authors: Eric E Smith; Stephanie Crites; Meng Wang; Anna Charlton; Angela Zwiers; Ramnik Sekhon; Tolulope Sajobi; Richard Camicioli; Cheryl R McCreary; Richard Frayne; Zahinoor Ismail Journal: J Am Heart Assoc Date: 2021-11-10 Impact factor: 5.501
Authors: Willem S Eikelboom; Esther van den Berg; Ellen H Singleton; Sara J Baart; Michiel Coesmans; Annebet E Leeuwis; Charlotte E Teunissen; Bart N M van Berckel; Yolande A L Pijnenburg; Philip Scheltens; Wiesje M van der Flier; Rik Ossenkoppele; Janne M Papma Journal: Neurology Date: 2021-08-19 Impact factor: 9.910
Authors: Leonie C P Banning; Inez H G B Ramakers; Paul B Rosenberg; Constantine G Lyketsos; Jeannie-Marie S Leoutsakos Journal: Int J Geriatr Psychiatry Date: 2020-09-11 Impact factor: 3.485
Authors: Jin San Lee; Seong-Kyung Cho; Hee Jin Kim; Yeo Jin Kim; Key-Chung Park; Samuel N Lockhart; Duk L Na; Changsoo Kim; Sang Won Seo Journal: Sci Rep Date: 2018-07-11 Impact factor: 4.379