scholarly journals Associations of neuropsychiatric symptoms with cognitive impairment: The utility of the mild behavioral impairment checklist and the neuropsychiatric interview questionnaire in a cognitive neurology clinic population

2021 ◽  
Vol 17 (S6) ◽  
Author(s):  
Sophie Hu ◽  
Scott B Patten ◽  
Anna Charlton ◽  
Karyn Fischer ◽  
Gordon Fick ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Neuropsychiatric Symptoms ◽  
Behavioral Impairment ◽  
Neurology Clinic ◽  
Clinic Population ◽  
Interview Questionnaire ◽  
Cognitive Neurology

scholarly journals Prevalence and Predictors of Caregiver Burden in a Memory Clinic Population

2021 ◽  
pp. 1-9
Author(s):  
Rónán O’Caoimh ◽  
Mareeta Calnan ◽  
Arup Dhar ◽  
D. William Molloy
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Caregiver Burden ◽  
Neuropsychiatric Symptoms ◽  
University Hospital ◽  
Patient Specific ◽  
Subjective Cognitive Decline ◽  
Memory Clinic ◽  
People With Dementia ◽  
Clinic Population

Background: Although caregiver burden is common among carers of people with dementia, little is known about its prevalence and predictors among caregivers of patients attending memory clinics. Objective: To examine carer and patient-specific characteristics associated with caregiver burden across the cognitive spectrum in a memory clinic population. Methods: Consecutive patients referred to a university hospital geriatric memory clinic were included. Caregiver burden was scored using the Caregiver Burden Score (CBS), (modified Zarit), with scores≥15/30 suggesting burden. BPSD were measured with the dysfunctional behaviour rating instrument (DBRI). Cognition was screened using the Montreal Cognitive Assessment (MoCA) and Quick Mild Cognitive Impairment (Qmci) screen. Results: In all, 351 patients were included, median age 77 (±11) years; 65.5% were female. The prevalence of caregiver burden was 33.6% overall, increasing from 10.8% in subjective cognitive decline (SCD), to 15% in mild cognitive impairment (MCI) and 43% in dementia; CBS scores were significantly higher in dementia (p < 0.001). Caregivers with burden were significantly younger (p = 0.045) and were more likely to be adult children (p = 0.007). The CBS weakly correlated with the stage of cognitive impairment (r = 0.16) but had moderate correlation with MoCA (r = –0.54) and Qmci scores (r = –0.60). After adjustment for co-variates, DBRI scores alone independently predicted burden (odds ratio 1.23;1.11–1.35, p < 0.001). Conclusion: Caregiver burden is associated with the stage of cognitive impairment, with higher prevalence proportions in those with dementia compared with MCI and SCD. Only the severity of neuropsychiatric symptoms independently predicted caregiver burden in this population and its presence should prompt assessment for burden.

scholarly journals Alzheimer’s Genetic Risk Score linked to Incident Mild Behavioral Impairment

2017 ◽  
Author(s):  
Shea J. Andrews ◽  
Zahinoor Ismail ◽  
Kaarin J. Anstey ◽  
Moyra Mortby
Keyword(s):  
Cognitive Impairment ◽  
Risk Score ◽  
Genetic Risk ◽  
Genetic Risk Score ◽  
Neuropsychiatric Symptoms ◽  
Later Life ◽  
Behavioral Impairment ◽  
Affective Dysregulation ◽  
Weighted Genetic Risk Score ◽  
Shared Risk

AbstractMild Behavioral Impairment (MBI) describes the emergence of later-life Neuropsychiatric Symptoms (NPS) as an at-risk state for cognitive decline and dementia and as a potential manifestation of prodromal dementia. How NPS mechanistically link to the development of Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD) is not fully understood. Potential mechanisms include either shared risk factors that are related to both NPS and cognitive impairment, or AD pathology promoting NPS. This is the first study to examine whether AD genetic loci, individually and as a genetic risk score, are a shared risk factor with MBI. 1377 older adults (aged 72-79; 738 males; 763 normal cognition) from the PATH Through Life project. MBI was assessed in accordance with Criterion 1 of the ISTAART-AA diagnostic criteria using the Neuropsychiatric Inventory. 25 LOAD risk loci were genotyped and a weighted genetic risk score (GRS) was constructed. Binomial logistic regression adjusting for age, gender, and education examined the association between LOAD GRS and MBI domains. An increase in the LOAD GRS and APOE*ε4 were associated with higher likelihood of Affective Dysregulation;MS4A4A-rs4938933*C andMS4A6A-rs610932*G were associated with a reduced likelihood of Affective Dysregulation;ZCWPW1-rs1476679*C was associated with a reduced likelihood of Social Inappropriateness and Abnormal Perception;BIN1-rs744373*G andEPHA1-rs11767557*C were associated with higher likelihood of Abnormal Perception;NME8-rs2718058*G was associated with a reduced likelihood Decreased Motivation. These findings suggest a common genetic etiology between MBI and traditionally recognized memory problems observed in AD and improve our understanding of the pathophysiological features underlying MBI.

Prevalence of mild behavioral impairment in mild cognitive impairment and subjective cognitive decline, and its association with caregiver burden

2017 ◽  
Vol 30 (2) ◽  
pp. 233-244 ◽  
Author(s):  
Faisal Sheikh ◽  
Zahinoor Ismail ◽  
Moyra E. Mortby ◽  
Philip Barber ◽  
Alicja Cieslak ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Caregiver Burden ◽  
Neuropsychiatric Symptoms ◽  
Subjective Cognitive Decline ◽  
Memory Clinic ◽  
Behavioral Impairment ◽  
Affective Dysregulation ◽  
Definition Of

ABSTRACTBackground:Mild behavioral impairment (MBI) describes later life acquired, sustained neuropsychiatric symptoms (NPS) in cognitively normal individuals or those with mild cognitive impairment (MCI), as an at-risk state for incident cognitive decline and dementia. We developed an operational definition of MBI and tested whether the presence of MBI was related to caregiver burden in patients with subjective cognitive decline (SCD) or MCI assessed at a memory clinic.Methods:MBI was assessed in 282 consecutive memory clinic patients with SCD (n = 119) or MCI (n = 163) in accordance with the International Society to Advance Alzheimer's Research and Treatment – Alzheimer's Association (ISTAART–AA) research diagnostic criteria. We operationalized a definition of MBI using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Caregiver burden was assessed using the Zarit caregiver burden scale. Generalized linear regression was used to model the effect of MBI domains on caregiver burden.Results:While MBI was more prevalent in MCI (85.3%) than in SCD (76.5%), this difference was not statistically significant (p = 0.06). Prevalence estimates across MBI domains were affective dysregulation (77.8%); impulse control (64.4%); decreased motivation (51.7%); social inappropriateness (27.8%); and abnormal perception or thought content (8.7%). Affective dysregulation (p = 0.03) and decreased motivation (p=0.01) were more prevalent in MCI than SCD patients. Caregiver burden was 3.35 times higher when MBI was present after controlling for age, education, sex, and MCI (p < 0.0001).Conclusions:MBI was common in memory clinic patients without dementia and was associated with greater caregiver burden. These data show that MBI is a common and clinically relevant syndrome.

scholarly journals Network analysis of impulse dyscontrol in mild cognitive impairment and subjective cognitive decline

2020 ◽  
Author(s):  
Toni Saari ◽  
Eric E. Smith ◽  
Zahinoor Ismail
Keyword(s):  
At Risk ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Neuropsychiatric Symptoms ◽  
Network Models ◽  
Subjective Cognitive Decline ◽  
Behavioral Impairment ◽  
Disease States ◽  
With Memory

Background: Impulse dyscontrol is a common feature in neurodegenerative diseases but challenging to conceptualize. It has also been shown that impulsivity could be one of the earliest neuropsychiatric symptoms emerging in advance of dementia. Both frequent and rare symptoms of impulse dyscontrol are recognized, as are interpersonal and generalized symptoms, but the relationships between these different symptoms remain poorly understood. To address this gap, we examine the network structure of impulse dyscontrol in at-risk states for dementia.Methods: We estimated network models of the Mild Behavioral Impairment-Checklist impulse dyscontrol subscale in 235 patients with mild cognitive impairment (n=159) or subjective cognitive decline (n=76) from the Prospective Study for Persons with Memory Symptoms dataset. Frequency of the symptoms was also examined.Results: Stubbornness/rigidity, agitation/aggressiveness, and argumentativeness were frequent and the most central symptoms in the network. Impulsivity, the fourth most central symptom in the network, served as the bridge between these common symptoms and less central and rare symptoms.Conclusions: Impulse dyscontrol in at-risk states for dementia is characterized by closely connected symptoms of irritability, agitation and rigidity. Compulsions and difficulties in regulating rewarding behaviors are relatively isolated symptoms. Future studies could augment network models of impulse dyscontrol with cognitive and neuroimaging variables in addition to examining the replicability and generalizability of networks across populations and disease states.

scholarly journals Brain mechanisms underlying neuropsychiatric symptoms in Alzheimer’s disease: a systematic review of symptom-general and –specific lesion patterns

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yaojing Chen ◽  
Mingxi Dang ◽  
Zhanjun Zhang
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Neuropsychiatric Symptoms ◽  
Onset Time ◽  
Anterior Cingulate ◽  
Neural Basis ◽  
Preclinical Ad ◽  
Disease Stages ◽  
Mild Cognitive Impairment Stage

AbstractNeuropsychiatric symptoms (NPSs) are common in patients with Alzheimer’s disease (AD) and are associated with accelerated cognitive impairment and earlier deaths. This review aims to explore the neural pathogenesis of NPSs in AD and its association with the progression of AD. We first provide a literature overview on the onset times of NPSs. Different NPSs occur in different disease stages of AD, but most symptoms appear in the preclinical AD or mild cognitive impairment stage and develop progressively. Next, we describe symptom-general and -specific patterns of brain lesions. Generally, the anterior cingulate cortex is a commonly damaged region across all symptoms, and the prefrontal cortex, especially the orbitofrontal cortex, is also a critical region associated with most NPSs. In contrast, the anterior cingulate-subcortical circuit is specifically related to apathy in AD, the frontal-limbic circuit is related to depression, and the amygdala circuit is related to anxiety. Finally, we elucidate the associations between the NPSs and AD by combining the onset time with the neural basis of NPSs.

scholarly journals Network analysis of impulse dyscontrol in mild cognitive impairment and subjective cognitive decline

2021 ◽  
pp. 1-10
Author(s):  
T. Saari ◽  
E. E. Smith ◽  
Z. Ismail
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Observational Study ◽  
Cognitive Decline ◽  
Prospective Observational Study ◽  
Subjective Cognitive Decline ◽  
Behavioral Impairment ◽  
Conditional Dependence ◽  
With Memory ◽  
Central Symptom

ABSTRACT Objectives: To investigate conditional dependence relationships of impulse dyscontrol symptoms in mild cognitive impairment (MCI) and subjective cognitive decline (SCD). Design: A prospective, observational study. Participants: Two hundred and thirty-five patients with MCI (n = 159) or SCD (n = 76) from the Prospective Study for Persons with Memory Symptoms dataset. Measurements: Items of the Mild Behavioral Impairment Checklist impulse dyscontrol subscale. Results: Stubbornness/rigidity, agitation/aggressiveness, and argumentativeness were frequent and the most central symptoms in the network. Impulsivity, the fourth most central symptom in the network, served as the bridge between these common symptoms and less central and rare symptoms. Conclusions: Impulse dyscontrol in at-risk states for dementia is characterized by closely connected symptoms of irritability, agitation, and rigidity. Compulsions and difficulties in regulating rewarding behaviors are relatively isolated symptoms.

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