P490: Neuropsychiatric symptoms in patients with mild cognitive impairment and mild Alzheimer disease: a cross sectional comparison

ABSTRACTBackground:Neuropsychiatric symptoms (NPS), such as depression, apathy, agitation, and psychotic symptoms are common in mild cognitive impairment (MCI) and dementia in Alzheimer's disease (AD). Subgroups of NPS have been reported. Yet the relationship of NPS and their subgroups to different stages of cognitive impairment is unclear. Most previous studies are based on small sample sizes and show conflicting results. We sought to examine the frequency of NPS and their subgroups in MCI and different stages of dementia in AD.Methods:This was a cross-sectional study using data from a Norwegian national registry of memory clinics. From a total sample of 4,571 patients, we included those with MCI or AD (MCI 817, mild AD 883, moderate–severe AD 441). To compare variables across groups ANOVA or χ2-test was applied. We used factor analysis of Neuropsychiatric Inventory Questionnaire (NPI-Q) items to identify subgroups of NPS.Results:The frequency of any NPS was 87.2% (AD 91.2%, MCI 79.5%; p < 0.001) and increased with increasing severity of cognitive decline. The most frequent NPS in MCI was depression. Apathy was the most frequent NPS in AD across different stages of severity. The factor analysis identified three subgroups in MCI and mild AD, and a fourth one in moderate–severe AD. We labelled the subgroups “depression,” “agitation,” “psychosis,” and “elation.”Conclusions:The frequency of NPS is high in MCI and AD and increases with the severity of cognitive decline. The subgroups of NPS were relatively consistent from MCI to moderate-severe AD. The subgroup elation appeared only in moderate-severe AD.

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De novo genesis of neuropsychiatric symptoms in Mild Cognitive Impairment (MCI)

International Psychogeriatrics ◽

10.1017/s1041610204000067 ◽

2004 ◽

Vol 16 (1) ◽

pp. 51-60 ◽

Cited By ~ 64

Author(s):

Yonas E. Geda ◽

Glenn E. Smith ◽

David S. Knopman ◽

Bradley F. Boeve ◽

Eric G. Tangalos ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Rating Scale ◽

De Novo ◽

Psychiatric Symptoms ◽

Neuropsychiatric Symptoms ◽

Cross Sectional ◽

Neuropsychological Profile ◽

Pair Wise Comparison ◽

Normal Controls

Background: There is inadequate information regarding the neuropsychiatric aspect of Mild Cognitive Impairment (MCI).Objective: To determine the neuropsychiatric profile of MCI, and compare this with normal controls and patients with mild Alzheimer's Disease (AD).Design: Cross-sectional assessment of psychiatric symptoms in subjects that are enrolled in Mayo Clinic's longitudinal study of normal aging, MCI and dementia.Methods and Participants: The Neuropsychiatric Inventory (NPI) was administered to normal control subjects, MCI subjects and patients with early AD. Individual NPI domain scores and total NPI scores were compared among the three groups after controlling for age, educational status, Dementia Rating Scale (DRS) and Mini-Mental State Examination (MMSE) scores. Statistical analysis was performed by utilizing ANOVA, χ2 and Fisher's exact test.Results: Data were analyzed on 514 normal controls, 54 MCI subjects, and 87 subjects with mild AD (CDR of 0.5 or 1); females consisted of 60.3%, 53.7% and 57.5%; and, the average ages (SD) were 77.8 (1.95), 79 (4.6), 80.5 (14.6) respectively. ANOVA pair-wise comparison revealed that both MMSE and DRS differences among the three groups were significantly different at (p=0.05). The total NPI scores were significantly different (p=0.0001, F=107.93) among the three groups using ANOVA. Pair-wise comparison of individual behavioral domain of NPI showed statistically significant differences between MCI and normals; and MCI and AD (p=0.001). Group differences on NPI remained after controlling for age and education at p=0.0375 and p=0.0050 respectively.Conclusion: The neuropsychiatric pattern is reminiscent of the clinical, neuroimaging and neuropsychological profile of MCI. It gives further credence to the view that MCI is indeed the gray zone, with overlap on both ends of the pole.

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Mild Cognitive Impairment and Anti-Alzheimer Disease Medications: A Cross Sectional Study of the French National Alzheimer Databank (BNA)

Journal of Alzheimer s Disease ◽

10.3233/jad-131103 ◽

2013 ◽

Vol 38 (3) ◽

pp. 541-549 ◽

Cited By ~ 2

Author(s):

Karim Tifratene ◽

Charlotte Sakarovitch ◽

Amel Rouis ◽

Christian Pradier ◽

Philippe Robert ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Alzheimer Disease ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Anosognosia and Neuropsychiatric Symptoms and Disorders in Mild Alzheimer Disease and Mild Cognitive Impairment

Journal of Alzheimer s Disease ◽

10.3233/jad-2012-111886 ◽

2012 ◽

Vol 29 (4) ◽

pp. 761-772 ◽

Cited By ~ 37

Author(s):

Gianfranco Spalletta ◽

Paolo Girardi ◽

Carlo Caltagirone ◽

Maria Donata Orfei

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Alzheimer Disease ◽

Neuropsychiatric Symptoms

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Relationships Between Balance and Cognition in Patients With Subjective Cognitive Impairment, Mild Cognitive Impairment, and Alzheimer Disease

Physical Therapy ◽

10.2522/ptj.20130298 ◽

2014 ◽

Vol 94 (8) ◽

pp. 1123-1134 ◽

Cited By ~ 52

Author(s):

Gro Gujord Tangen ◽

Knut Engedal ◽

Astrid Bergland ◽

Tron Anders Moger ◽

Anne Marit Mengshoel

Keyword(s):

Cognitive Impairment ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Alzheimer Disease ◽

Balance Control ◽

Linear Regression Analysis ◽

Cross Sectional ◽

Cognitive Domains ◽

Subjective Cognitive Impairment ◽

Postural Responses

Background Balance impairments are common in patients with Alzheimer disease (AD), but which aspects of balance are affected, at which stage of cognitive impairment, and their associations with cognitive domains remain unexplored. Objectives The aims of this study were: (1) to explore differences in balance abilities among patients with subjective cognitive impairment (SCI) or mild cognitive impairment (MCI), mild AD, and moderate AD and (2) to examine the relationship between the various aspects of balance and cognitive domains. Design This was a cross-sectional study. Methods Home-dwelling patients with SCI or MCI (n=33), mild AD (n=99), and moderate AD (n=38) participated in this study. The Balance Evaluation Systems Test (BESTest), comprising 6 subscales—“Biomechanical Constraints,” “Stability Limits/Verticality,” “Anticipatory Postural Adjustments,” “Postural Responses,” “Sensory Orientation,” and “Stability in Gait”—was used to assess balance. Cognitive domains were assessed using the following measures: Mini-Mental Status Examination, Word-List Learning Test from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Verbal Fluency Test, Clock Drawing Test, and Trail Making Test, parts A and B (TMT-A and TMT-B, respectively). Two-way between-group analyses of variance, adjusted for age, were used to analyze differences among the groups. Multiple linear regression analysis was used to explore the associations between balance and cognition. Results Differences were found between the groups on all BESTest subscales; the moderate AD group had the worst scores. The TMT-B (measuring executive function) was associated with all of the BESTest subscales after controlling for demographic factors. Limitations The cross-sectional design hampered interpretation of the development of balance impairments. Conclusions The study findings indicate that all aspects of balance control deteriorate with increasing severity of cognitive impairment and that executive function plays an important role in balance control. Physical therapists should pay attention to these findings both in clinical practice and in future research.

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Neuropsychiatric Features of Neurosyphilis: Frequency, Relationship with the Severity of Cognitive Impairment and Comparison with Alzheimer Disease

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000476060 ◽

2017 ◽

Vol 43 (5-6) ◽

pp. 308-319 ◽

Cited By ~ 4

Author(s):

Xiaomei Zhong ◽

Haishan Shi ◽

Le Hou ◽

Ben Chen ◽

Qi Peng ◽

...

Keyword(s):

Factor Analysis ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Alzheimer Disease ◽

Rating Scale ◽

Neuropsychiatric Symptoms ◽

Clinical Dementia Rating ◽

Frequency Relationship ◽

The Impact ◽

Mild Cognitive Impairment Stage

Background: The pattern of neuropsychiatric features of patients with neurosyphilis and the impact of the severity of cognitive impairment on neuropsychiatric syndromes are unknown. Objective: We aim to assess the neuropsychiatric features of patients with neurosyphilis, and compare the impact of the severity of cognitive impairment on the neuropsychiatric syndromes between neurosyphilis and Alzheimer disease (AD). Methods: Neuropsychiatric symptoms and the degree of cognitive impairment were assessed in a case-control study of 91 neurosyphilis, 162 AD, 157 mild cognitive impairment, and 139 normal controls by the Neuropsychiatric Inventory (NPI) scale and Clinical Dementia Rating scale, respectively. Factor analysis was performed on the 12 NPI items. Results: Factor analysis showed that patients with neurosyphilis showed more severe neuropsychiatric syndromes at the dementia stage than those neurosyphilis patients at the mild cognitive impairment stage, while neuropsychiatric manifestations were equally common among the different stages of dementia (all p < 0.05). Frontal lobe syndrome was more severe in patients with neurosyphilis than in patients with AD from the early mild cognitive impairment stage to the moderate dementia stage (all p < 0.01). Conclusions: Patients with neurosyphilis show different patterns of neuropsychiatric syndromes at the mild cognitive impairment and dementia stages, and differ from patients with AD.

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Eye movements in mild cognitive impairment diagnosis due to Alzheimer disease

10.26226/morressier.5b31ec642afeeb001345ac06 ◽

2018 ◽

Author(s):

Osvaldo Enrique Agamennoni

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Eye Movements ◽

Alzheimer Disease

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Association of Circulating Cholesterol Level with Cognitive Function and Mild Cognitive Impairment in the Elderly: A Community-based Population Study

Current Alzheimer Research ◽

10.2174/1567205017666200810165758 ◽

2020 ◽

Vol 17 (6) ◽

pp. 556-565

Author(s):

Yujie Guo ◽

Pengfei Li ◽

Xiaojun Ma ◽

Xiaochen Huang ◽

Zhuoheng Liu ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Function ◽

Cholesterol Level ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Cross Sectional ◽

Increased Risk ◽

Aging Adults ◽

Female Subjects

Background: The present study was designed to examine the association of circulating cholesterol with cognitive function in non-demented community aging adults. Methods: This was a cross-sectional study including 1754 Chinese adults aged 55-80 years. The association between serum cholesterol levels and cognitive function was examined. Participants were categorized into four groups according to the quartile of circulating TC (total cholesterol), High Density Lipoprotein Cholesterol (HDL-c), Low Density Lipoprotein Cholesterol (LDL-c) levels and HDLc/ LDL-c ratio. The difference in cognitive performance among the groups was compared. Logistic regression model was used to determine the association of circulating cholesterol level with the risk of Mild Cognitive Impairment (MCI). Results: Mild increase of serum LDL-c level correlated with better visual and executive, language, memory and delayed recall abilities. Higher circulating TC and HDL-c levels were found to be associated with poorer cognitive function, especially in aging female subjects. Higher circulating TC, HDL-c and HDL/LDL ratio indicated an increased risk of MCI, especially in female subjects. Conclusion: Slight increase in circulating LDL-c level might benefit cognitive function in aging adults. However, higher circulating TC and HDL-c levels might indicate a decline of cognitive function, especially in aging female subjects.

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Psychometric Properties of the Persian Montreal Cognitive Assessment in Mild Cognitive Impairment and Alzheimer Disease

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000514673 ◽

2021 ◽

pp. 51-57

Author(s):

Vahid Rashedi ◽

Mahshid Foroughan ◽

Negin Chehrehnegar

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Alzheimer Disease ◽

Psychometric Properties ◽

Cognitive Assessment ◽

Screening Test ◽

Cognitive Status ◽

Montreal Cognitive Assessment ◽

Cutoff Score ◽

Persian Version

Introduction: The Montreal Cognitive Assessment (MoCA) is a cognitive screening test widely used in clinical practice and suited for the detection of Mild Cognitive Impairment (MCI). The aims were to evaluate the psychometric properties of the Persian MoCA as a screening test for mild cognitive dysfunction in Iranian older adults and to assess its accuracy as a screening test for MCI and mild Alzheimer disease (AD). Method: One hundred twenty elderly with a mean age of 73.52 ± 7.46 years participated in this study. Twenty-one subjects had mild AD (MMSE score ≤21), 40 had MCI, and 59 were cognitively healthy controls. All the participants were administered the Mini-Mental State Examination (MMSE) to evaluate their general cognitive status. Also, a battery of comprehensive neuropsychological assessments was administered. Results: The mean score on the Persian version of the MoCA and the MMSE were 19.32 and 25.62 for MCI and 13.71 and 22.14 for AD patients, respectively. Using an optimal cutoff score of 22 the MoCA test detected 86% of MCI subjects, whereas the MMSE with a cutoff score of 26 detected 72% of MCI subjects. In AD patients with a cutoff score of 20, the MoCA had a sensitivity of 94% whereas the MMSE detected 61%. The specificity of the MoCA was 70% and 90% for MCI and AD, respectively. Discussion: The results of this study show that the Persian version of the MoCA is a reliable screening tool for detection of MCI and early stage AD. The MoCA is more sensitive than the MMSE in screening for cognitive impairment, proving it to be superior to MMSE in detecting MCI and mild AD.

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