Sleep disturbances in older adults with mild cognitive impairment

ABSTRACTBackground:Normal aging and dementia are characterized by increased prevalence of sleep disorders and alterations of both sleep continuity and architecture. However, little is still known about the nature of sleep in mild cognitive impairment (MCI), which is presumably situated on the continuum from healthy aging to dementia. This unsystematic review summarizes the current literature on the prevalence and severity of sleep disturbances in MCI.Methods:Eighteen studies addressing sleep/night-time disturbances among other neuropsychiatric symptoms in individuals with MCI were identified through a search of databases and an examination of reference lists of selected papers. Fifteen of those studies reported data on prevalence or severity of sleep/night-time disturbances.Results:Results indicated that 14–59% of patients with MCI had sleep disturbances. These disturbances were often identified as one of the four most prevalent neuropsychiatric symptoms of MCI and were considered as clinically significant in some studies. In addition, there was some evidence that the prevalence of sleep disturbances in MCI is intermediate between that of normal aging and dementia. Longitudinal data suggest that sleep problems are associated with both incident MCI and dementia.Conclusions:These findings support the hypothesis that sleep disturbances are one of the core non-cognitive symptoms of MCI. It remains to be known whether sleep problems could help to identify those individuals with MCI who will eventually develop dementia. Studies characterizing sleep more systematically are needed to verify this proposition and to clarify the associations between sleep disturbances and other neuropsychiatric symptoms of MCI.

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Occurrence of neuropsychiatric symptoms and psychiatric disorders in mild Alzheimer's disease and mild cognitive impairment subtypes

International Psychogeriatrics ◽

10.1017/s1041610210000281 ◽

2010 ◽

Vol 22 (4) ◽

pp. 629-640 ◽

Cited By ~ 66

Author(s):

Fulvia Di Iulio ◽

Katie Palmer ◽

Carlo Blundo ◽

Anna Rosa Casini ◽

Walter Gianni ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Psychiatric Disorders ◽

Neuropsychiatric Symptoms ◽

Neuropsychiatric Disorders ◽

Structured Interviews ◽

Night Time ◽

Amnestic Mci

ABSTRACTBackground: Neuropsychiatric disorders are common in cognitively impaired older persons, and associated with institutionalization and caregiver stress in Alzheimer's disease (AD). Few studies have compared the occurrence of both psychiatric disorders and neuropsychiatric symptoms in patients with AD and mild cognitive impairment (MCI) subtypes. We aimed to investigate the frequency of psychiatric disorders and neuropsychiatric symptoms in AD and MCI patients, compared to controls.Methods: We included 245 outpatients of a memory clinic in Rome, Italy (119 AD; 68 multidomain-MCI; 58 amnestic-MCI) and 107 controls. Categorical disorders of depression and apathy were diagnosed with structured interviews. Symptoms were evaluated with the Neuropsychiatric Inventory (NPI). The odds ratios (OR) of patients having neuropsychiatric symptoms compared to controls were calculated with logistic regression, adjusted for sociodemographic and clinical variables.Results: A large proportion of AD (49.6%) and multidomain-MCI (44.1%) patients had depression disorder. Apathy disorder was common in AD (51.3%) but less frequent in amnestic-MCI (6.9%) and multidomain-MCI (14.7%). AD patients were three times more likely to have depression disorders (OR = 3.0, CI = 1.1–7.6) or apathy (OR = 16.9, CI = 4.6–61.8) compared to amnestic-MCI, and seven times more likely to have apathy disorder than multidomain-MCI (OR = 7.5, CI = 3.0–19.2). After apathy and depression, the most prevalent neuropsychiatric symptoms in AD and MCI were anxiety, agitation, irritability, night-time behaviors, and appetite disturbances. There was an increasing prevalence of many neuropsychiatric symptoms with increasing severity of cognitive syndromes.Conclusions: Clinicians should consider the relevance of neuropsychiatric disorders and symptoms in patients with cognitive disturbances, and incorporate a thorough psychiatric examination in the evaluation of patients.

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Sensitivity to change of composite and frequency scores of the neuropsychiatric inventory in mild cognitive impairment

International Psychogeriatrics ◽

10.1017/s1041610214001185 ◽

2014 ◽

Vol 26 (11) ◽

pp. 1871-1874 ◽

Cited By ~ 3

Author(s):

Jeffrey L. Cummings ◽

Michael Tribanek ◽

Robert Hoerr

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Active Drug ◽

Neuropsychiatric Symptoms ◽

Composite Score ◽

Neuropsychiatric Inventory ◽

Treatment Groups ◽

Moderate Dementia ◽

Clinically Significant ◽

Composite Scores

ABSTRACTBackground:The most appropriate means of capturing data from the Neuropsychiatric Inventory (NPI) must be understood to optimize use of this instrument in clinical trials. The utility of the composite score (frequency times severity) was recently demonstrated in mild and moderate dementia. Determination of frequency compared to composite scores in mild cognitive impairment (MCI) warrants investigation.Methods:We used the NPI data from a randomized, placebo-controlled, multi-center, 24-week, clinical trial involving 160 patients who were diagnosed with amnestic MCI and had clinically significant neuropsychiatric symptoms (NPS). We calculated standardized changes for both frequency and composite scores.Results:There were improvements in NPI composite scores in both active drug- and placebo-treated patients, with significant superiority of active drug. Standardized changes in severity and composite scores tended to be larger than those in the frequency scores, whereas discrimination between treatment groups was similar for all three scores.Conclusions:Our findings support the hypothesis that in MCI, as in dementia, the NPI frequency score is not more sensitive to treatment-related change than the composite score. As the severity score adds information, the use of the composite score has better performance characteristics.

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P2-190: The prevalence of neuropsychiatric symptoms in normal aging and mild cognitive impairment: A population-based study

Alzheimer s & Dementia ◽

10.1016/j.jalz.2006.05.1028 ◽

2006 ◽

Vol 2 ◽

pp. S291-S291

Author(s):

Yonas E. Geda ◽

Walter A. Rocca ◽

Rosebud Roberts ◽

David S. Knopman ◽

Ronald C. Petersen

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Neuropsychiatric Symptoms ◽

Population Based ◽

Normal Aging ◽

Population Based Study

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Functional Activity and Neuropsychiatric Symptoms in Normal Aging and Mild Cognitive Impairment

Alzheimer Disease & Associated Disorders ◽

10.1097/wad.0000000000000266 ◽

2019 ◽

Vol 33 (1) ◽

pp. 68-71

Author(s):

Janina Krell-Roesch ◽

Leah P. Cerhan ◽

Mary M. Machulda ◽

Rosebud O. Roberts ◽

Michelle M. Mielke ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Functional Activity ◽

Neuropsychiatric Symptoms ◽

Normal Aging

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Persistence of neuropsychiatric symptoms over six months in mild cognitive impairment in community-dwelling Korean elderly

International Psychogeriatrics ◽

10.1017/s1041610210001766 ◽

2010 ◽

Vol 23 (2) ◽

pp. 214-220 ◽

Cited By ~ 20

Author(s):

Seung-Ho Ryu ◽

Jee Hyun Ha ◽

Doo-Heum Park ◽

Jaehak Yu ◽

Gill Livingston

Keyword(s):

Quality Of Life ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Neuropsychiatric Symptoms ◽

Community Dwelling ◽

Persistent Symptoms ◽

People With Dementia ◽

Clinically Significant

ABSTRACTBackground: Several studies of patients with mild cognitive impairment (MCI) have revealed that this population, like people with dementia, have neuropsychiatric symptoms (NPS) as well as memory impairment. No study has reported on the natural history and course of NPS in MCI although this is important in terms of management. We aimed to determine the persistence of NPS over six months in participants with MCI.Method: The Neuropsychiatric Inventory (NPI) was used to rate the severity of NPS in 241 consecutive referrals with MCI from a Korean clinic at baseline and in 220 patients at 6-month follow-up. We also collected information about the cognition and quality of life of patients and their caregivers.Results: Ninety-seven (44.1%) MCI participants who completed the 6-month follow-up exhibited at least one NPS at baseline; 60 (27.3%) were clinically significant NPS. Seventy (72.1%) of those with any symptom had at least one persistent NPS at 6-month follow-up, and 44 (73.3%) of those with clinically significant symptoms had at least one significant and persistent NPS at 6-month follow-up. Those with persistent symptoms had more severe baseline symptoms. Both patients and caregivers had a poorer quality of life when the patient had at least one clinically significant symptom.Conclusions: NPS were highly persistent overall in older people with MCI. Persistence was predicted by having more severe symptoms at baseline. Clinically significant levels of NPS were associated with decreased quality of life. We conclude that clinicians should be aware that NPS symptoms in MCI usually persist.

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Neuropsychiatric Symptoms in Parkinson's Disease with Mild Cognitive Impairment and Dementia

Parkinson s Disease ◽

10.1155/2012/308097 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 19

Author(s):

Iracema Leroi ◽

Hiranmayi Pantula ◽

Kathryn McDonald ◽

Vijay Harbishettar

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Rating Scales ◽

Neuropsychiatric Symptoms ◽

Neuropsychiatric Symptom ◽

Depression And Anxiety ◽

The Past ◽

Clinically Significant

Neuropsychiatric symptoms commonly complicate Parkinson’s disease (PD), however the presence of such symptoms in mild cognitive impairment (PD-MCI) specifically has not yet been well described. The objective of this study was to examine and compare the prevalence and profile of neuropsychiatric symptoms in patients with PD-MCI (n= 48) to those with PD and no cognitive impairment (PD-NC,n= 54) and to those with dementia in PD (PDD,n= 25). PD-MCI and PDD were defined using specific consensus criteria, and neuropsychiatric symptoms were assessed with the 12-item Neuropsychiatric Inventory (NPI). Self-rated apathy, depression, and anxiety rating scales were also administered. Over 79% of all participants reported at least one neuropsychiatric symptom in the past month. The proportion in each group who had total NPI scores of ≥4 (“clinically significant”) was as follows: PD-NC, 64.8%; PD-MCI, 62%; PDD 76%. Apathy was reported in almost 50% of those with PD-MCI and PDD, and it was an important neuropsychiatric symptom differentiating PD-MCI from PD-NC. Psychosis (hallucinations and delusions) increased from 12.9% in PD-NC group; 16.7% in PD-MCI group; and 48% in PDD group. Identifying neuropsychiatric symptoms in PD-MCI may have implications for ascertaining conversion to dementia in PD.

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Trajectories of irregular word reading ability as a proxy for premorbid intelligence in Alzheimer’s disease, mild cognitive impairment, and healthy aging: A longitudinal study.

Psychological Assessment ◽

10.1037/pas0000565 ◽

2018 ◽

Vol 30 (10) ◽

pp. 1308-1316 ◽

Cited By ~ 2

Author(s):

Michael Weinborn ◽

Romola S. Bucks ◽

Hamid R. Sohrabi ◽

Stephanie R. Rainey-Smith ◽

Belinda M. Brown ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Longitudinal Study ◽

Reading Ability ◽

Healthy Aging ◽

Word Reading ◽

Irregular Word ◽

Premorbid Intelligence

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Cerebrospinal Fluid Correlates of Neuropsychiatric Symptoms in Patients with Alzheimer’s Disease/Mild Cognitive Impairment: A Systematic Review

Journal of Alzheimer s Disease ◽

10.3233/jad-190365 ◽

2019 ◽

Vol 71 (2) ◽

pp. 477-501 ◽

Cited By ~ 1

Author(s):

Alireza Showraki ◽

Geetanjali Murari ◽

Zahinoor Ismail ◽

Joseph J. Barfett ◽

Luis Fornazzari ◽

...

Keyword(s):

Systematic Review ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cerebrospinal Fluid ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Neuropsychiatric Symptoms

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Using Regional Homogeneity to Reveal Altered Spontaneous Activity in Patients with Mild Cognitive Impairment

BioMed Research International ◽

10.1155/2015/807093 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Yumei Wang ◽

Xiaochuan Zhao ◽

Shunjiang Xu ◽

Lulu Yu ◽

Lan Wang ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Spontaneous Activity ◽

Healthy Aging ◽

Early Stage ◽

Brain Activity ◽

Regional Homogeneity ◽

Whole Brain ◽

Spontaneous Brain Activity ◽

Regional Brain Activity

Most patients with mild cognitive impairment (MCI) are thought to be in an early stage of Alzheimer’s disease (AD). Resting-state functional magnetic resonance imaging reflects spontaneous brain activity and/or the endogenous/background neurophysiological process of the human brain. Regional homogeneity (ReHo) rapidly maps regional brain activity across the whole brain. In the present study, we used the ReHo index to explore whole brain spontaneous activity pattern in MCI. Our results showed that MCI subjects displayed an increased ReHo index in the paracentral lobe, precuneus, and postcentral and a decreased ReHo index in the medial temporal gyrus and hippocampus. Impairments in the medial temporal gyrus and hippocampus may serve as important markers distinguishing MCI from healthy aging. Moreover, the increased ReHo index observed in the postcentral and paracentral lobes might indicate compensation for the cognitive function losses in individuals with MCI.

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