Corinne E Fischer1,2, Ines Kortebi3, Wael K Karameh1,4,5, Sanjeev Kumar4, Damien Gallagher3,6, Angela Golas1,4,5, David Munoz2,3, Joseph Barfett2,5, Meryl A Butters7, Christopher R Bowie4,8, Alastair Flint1,9, Tarek Rajji1,4, Nathan Herrmann1,6, Bruce G Pollock10, Benoit Mulsant1,4, Tom A Schweizer2,3, Linda Mah1,11. 1. Department of Psychiatry, University of Toronto, Toronto, Canada. 2. Keenan Research Centre for Biomedical Research, St. Michael's Hospital, Toronto, Canada. 3. University of Toronto, Toronto, Canada. 4. Centre for Addiction and Mental Health, Toronto, Canada. 5. St. Michael's Hospital, Toronto, Canada. 6. Sunnybrook Health Sciences Centre, Toronto, Canada. 7. Department of Psychiatry, University of Pittsburgh School of Medicine, USA. 8. Queen's University, Kingston, Canada. 9. Centre for Mental Health, University Health Network, Toronto, Canada. 10. Campbell Family Mental Health Research Institute, Division of Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Canada. 11. Rotman Research Institute, Baycrest Health Sciences Centre, Toronto, Canada.
Abstract
BACKGROUND: Cardiovascular risk factors (CVRFs) have been linked to both depression and cognitive decline but their role in neuropsychiatric symptoms (NPS) has yet to be clarified. OBJECTIVE: Understanding the role of CVRFs in the etiology of NPS for prospective treatments and preventive strategies to minimize these symptoms. METHODS: We examined the distribution of NPS using the Neuropsychiatric Inventory (NPI) scores in three cohorts from the Prevention of Alzheimer's Dementia with Cognitive Remediation Plus Transcranial Direct Current Stimulation in Mild Cognitive Impairment and Depression (PACt-MD) study: older patients with a lifetime history of major depressive disorder (MDD) in remission, patients with mild cognitive impairment (MCI), and patients with combined MCI and MDD. We also examined the link between individual NPS and CVRFs, Framingham risk score, and Hachinski ischemic score in a combined sample. RESULTS: Analyses were based on a sample of 140 subjects, 70 with MCI, 38 with MCI plus MDD, and 32 with MDD. There was no effect of age, gender, education, cognition, or CVRFs on the presence (NPI >1) or absence (NPI = 0) of NPS. Depression was the most prevalent affective NPS domain followed by night-time behaviors and appetite changes across all three diagnostic groups. Agitation and aggression correlated negatively while anxiety, disinhibition, night-time behaviors, and irritability correlated positively with CVRFs (all p-values <0.05). Other NPS domains showed no significant association with CVRFs. CONCLUSION: CVRFs are significantly associated with individual NPI sub-scores but not with total NPI scores, suggesting that different pathologies may contribute to different NPS domains.
BACKGROUND: Cardiovascular risk factors (CVRFs) have been linked to both depression and cognitive decline but their role in neuropsychiatric symptoms (NPS) has yet to be clarified. OBJECTIVE: Understanding the role of CVRFs in the etiology of NPS for prospective treatments and preventive strategies to minimize these symptoms. METHODS: We examined the distribution of NPS using the Neuropsychiatric Inventory (NPI) scores in three cohorts from the Prevention of Alzheimer's Dementia with Cognitive Remediation Plus Transcranial Direct Current Stimulation in Mild Cognitive Impairment and Depression (PACt-MD) study: older patients with a lifetime history of major depressive disorder (MDD) in remission, patients with mild cognitive impairment (MCI), and patients with combined MCI and MDD. We also examined the link between individual NPS and CVRFs, Framingham risk score, and Hachinski ischemic score in a combined sample. RESULTS: Analyses were based on a sample of 140 subjects, 70 with MCI, 38 with MCI plus MDD, and 32 with MDD. There was no effect of age, gender, education, cognition, or CVRFs on the presence (NPI >1) or absence (NPI = 0) of NPS. Depression was the most prevalent affective NPS domain followed by night-time behaviors and appetite changes across all three diagnostic groups. Agitation and aggression correlated negatively while anxiety, disinhibition, night-time behaviors, and irritability correlated positively with CVRFs (all p-values <0.05). Other NPS domains showed no significant association with CVRFs. CONCLUSION: CVRFs are significantly associated with individual NPI sub-scores but not with total NPI scores, suggesting that different pathologies may contribute to different NPS domains.
Entities:
Keywords:
Affective symptoms; sep alzheimer’s disease; sep cardiovascular diseases; sep cognitive dysfunction; sep dementia; sep major depressive disorder; sep mental status and dementia tests; sep neurobehavioral manifestations