scholarly journals Hallucinations and Delusions Signal Alzheimer’s Associated Cognitive Dysfunction More Strongly Compared to Other Neuropsychiatric Symptoms

2019 ◽  
Vol 75 (9) ◽  
pp. 1894-1904 ◽  
Author(s):  
Joshua T Fuller ◽  
Tabina K Choudhury ◽  
Deborah A Lowe ◽  
Steve Balsis ◽  
Keyword(s):  
Item Response ◽  
Cognitive Dysfunction ◽  
Motor Behavior ◽  
Brain Volume ◽  
Neuropsychiatric Symptoms ◽  
Psychotic Symptoms ◽  
Depression And Anxiety ◽  
Cognitively Normal ◽  
The Relationship ◽  
The Continuum

AbstractObjectivesNeuropsychiatric symptoms (NPS) are common among individuals with dementia of the Alzheimer’s type (DAT). We sought to characterize which NPS more purely relate to cognitive dysfunction in DAT, relative to other NPS.MethodDemographic, neurocognitive, neuroimaging, and NPS data were mined from the Alzheimer’s Disease Neuroimaging Initiative database (n = 906). Using factor analysis, we analyzed the degree to which individual NPS were associated with DAT-associated cognitive dysfunction. We also employed item response theory to graphically depict the ability of individual NPS to index DAT-associated cognitive dysfunction across a continuum ranging from cognitively normal to mild DAT.ResultsPsychotic symptoms (hallucinations and delusions) were more strongly related to the continuum of DAT-associated cognitive dysfunction than other NPS, with the strength of the relationship peaking at high levels of disease severity. Psychotic symptoms also negatively correlated with brain volume and did not relate to the presence of vision problems. Aberrant motor behavior and apathy had relatively smaller associations with DAT-associated cognitive dysfunction, while other NPS showed minimal associations.DiscussionPsychotic symptoms most strongly indexed DAT-associated cognitive dysfunction, whereas other NPS, such as depression and anxiety, were not as precisely related to the DAT-associated cognitive dysfunction.

scholarly journals Subjective cognitive concern in multiple sclerosis is associated with reduced thalamic and cortical gray matter volumes

2019 ◽  
Vol 5 (1) ◽  
pp. 205521731982761 ◽  
Author(s):  
Isaiah Kletenik ◽  
Enrique Alvarez ◽  
Justin M Honce ◽  
Brooke Valdez ◽  
Timothy L Vollmer ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Dysfunction ◽  
Gray Matter ◽  
Brain Volume ◽  
Brain Magnetic Resonance Imaging ◽  
Regions Of Interest ◽  
Patient Reported ◽  
Cortical Gray Matter ◽  
Gray Matter Volumes ◽  
The Relationship

Objective Brain atrophy has been correlated with objective cognitive dysfunction in multiple sclerosis but few studies have explored self-reported subjective cognitive concerns and their relationship to brain volume changes. This study explores the relationship between subjective cognitive concerns in multiple sclerosis and reduced brain volume in regions of interest implicated in cognitive dysfunction. Methods A total of 158 patients with multiple sclerosis completed the Quality of Life in Neurologic Disorders Measures (Neuro-QoL) short forms to assess subjective cognitive concerns and underwent brain magnetic resonance imaging. Regional brain volumes from regions of interest implicated in cognitive dysfunction were measured using NeuroQuant automated volumetric quantitation. Linear regression was used to analyze the relationship between subjective cognitive concerns and brain volume. Results Controlling for age, disease duration, gender, depression and fatigue, increased subjective cognitive concerns were associated with reduced thalamic volume (standardized β = 0.223, t150 =2.406, P = 0.017) and reduced cortical gray matter volume (standardized β = 0.240, t150 = 2.777, P = 0.006). Increased subjective cognitive concerns were not associated with any other regions of interest that were analyzed. Conclusions Subjective cognitive concern in MS is associated with reduced thalamic and cortical gray matter volumes, areas of the brain that have been implicated in objective cognitive impairment. These findings may lend neuroanatomical significance to subjective cognitive concerns and patient-reported outcomes as measured by Neuro-QoL.

scholarly journals Mild behavioral impairment is related to frailty in cognitively normal older adults: a cross-sectional study

2020 ◽  
Author(s):  
Shaoyi Fan ◽  
Ximin Liang ◽  
Tianchan Yun ◽  
Zhong Pei ◽  
Bin Hu ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Neuropsychiatric Symptoms ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Multivariate Logistic Regression ◽  
Behavioral Impairment ◽  
Cross Sectional ◽  
Cognitively Normal ◽  
The Relationship

Abstract Background: Frailty and cognitive decline are highly prevalent among older adults. However, the relationship between frailty and mild behavioral impairment (MBI), a neurobehavioral syndrome characterized by later-life emergence of sustained neuropsychiatric symptoms, has yet to be elucidated.We aimed to evaluate the associations between mild behavioral impairment and frailty in cognitively normal older adults.Methods: This is a cross-sectional study. A consecutive series of 137 cognitively normal older adults in the Anti-Aging study, recruited from primary care clinics, were enrolled. Frailty was estimated using the original Fried phenotype. MBI was evaluated by the Mild Behavioral Impairment Checklist at a cut-off point of >8 (optimizing sensitivity and specificity), which was developed to assess emergent neuropsychiatric symptoms in accordance with the MBI criteria. Cognition was assessed with the Chinese versions of the Montreal Cognitive Assessment (MoCA-BC) and Mini-mental State Examination (MMSE). Multivariate logistic regression was performed to estimate the relationship between MBI and objective cognition with frailty status.Results: At baseline, 30.6% of the older adults had frailty, 35.0% had prefrailty and 18.2% had MBI (MBI+ status). Multivariate logistic regression analysis demonstrated that compared to MBI- status (without MBI), MBI+ was more likely to have frailty (odds ratio [OR] = 7.44, p = 0.02). The frailty and MBI categories were both significantly associated with both MMSE and MoCA-BC score (p<0.05).Conclusions: Both frailty and MBI status are related to higher risk of cognitive impairment. MBI is significantly associated with an increased risk of having frailty before overt cognitive impairment. This association merits further study to identify strategies to the early detection, prevention and therapeutic intervention of frailty.

scholarly journals C-10 Interaction of ApoE4 and Gender in Neuropsychiatric Presentation in Probable Alzheimer’s Disease

2019 ◽  
Vol 34 (6) ◽  
pp. 1037-1037
Author(s):  
C Alexander ◽  
J Suhr
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Mini Mental State Examination ◽  
Neuropsychiatric Symptoms ◽  
Depression And Anxiety ◽  
Apoe4 Allele ◽  
And Gender ◽  
Relationship Of ◽  
The Relationship ◽  
State Examination

Abstract Objective Individuals with probable Alzheimer’s disease (pAD) often have neuropsychiatric symptoms; however, the relationship of these symptoms and ApoE4 status is unclear. Recent research suggests gender moderates the relationship of ApoE4 to AD. We examined how ApoE4 genetic status and gender predict neuropsychiatric symptoms in older adults with pAD. Method Data from the National Alzheimer’s Coordinating Centers (NACC) was utilized in the present study. We included only individuals diagnosed with pAD with collaterals who were judged reliable by clinical NACC staff and who saw the participant at least three times per week. The selected sample (N = 6943) was 52% male; 85.6% White, 10.2% African American; and 7.5% Hispanic. Average age was 73 years. The Neuropsychiatric Inventory-Questionnaire, completed by the participant’s collateral, was used to assess symptoms. Analyses controlled for age and cognitive impairment as measured by the Mini-Mental State Examination. Results The presence of at least one ApoE4 allele predicted higher severity of delusions, p = .04. Males had higher severity of agitation, apathy, and irritability; females had higher delusions, depression, and anxiety, all p’s < .05. Gender moderated the relationship of ApoE4 with disinhibition, night disturbances, and appetite, all p’s < .05. In all three cases, for males, scores were higher for non-carriers than for ApoE4 carriers; however, for females, differences did not exist between carriers and non-carriers. Conclusions Differences between ApoE4 carriers and non-carriers as well as between genders are demonstrated, and evidence supports the hypothesis that gender and ApoE4 status interact to predict some pAD neuropsychiatric symptomatology.

The relationship of subcortical MRI hyperintensities and brain volume to cognitive function in vascular dementia

2002 ◽  
Vol 8 (6) ◽  
pp. 743-752 ◽  
Author(s):  
RONALD A. COHEN ◽  
ROBERT H. PAUL ◽  
BRIAN R. OTT ◽  
DAVID J. MOSER ◽  
TRICIA M. ZAWACKI ◽  
...  
Keyword(s):  
Vascular Dementia ◽  
Cognitive Dysfunction ◽  
Brain Volume ◽  
Subcortical White Matter ◽  
Mri Findings ◽  
Cognitive Domains ◽  
And Performance ◽  
Relationship Of ◽  
The Relationship ◽  
Subcortical Hyperintensities

The relationship between MRI findings (i.e., subcortical hyperintensities; SH, whole brain volume) and the cognitive dysfunction of vascular dementia (VaD) was examined. Participants included 24 persons that met NINDS-AIREN criteria for VaD (MMSE = 19.9 ± 4.2) and underwent comprehensive neuropsychological assessment and MRI brain imaging. The volume of subcortical hyperintensities (SH) was strongly associated with executive–psychomotor performance, but not with performance across other cognitive domains or global cognitive functional level. Conversely, WBV was strongly associated with global cognitive functioning and performance across most cognitive domains (memory, language, visual integration), but not with executive–psychomotor functioning. The failure of SH to account for either the global dementia evident in these VaD patients or impairments across most cognitive domains suggests that deep subcortical white matter disease may only indirectly contribute to the global cognitive dysfunction of VaD. That WBV emerged as a stronger correlate of dementia raises further questions regarding the cerebral mechanisms that contribute to the development of VaD. (JINS, 2002, 8, 743–752.)

scholarly journals The prevalence and the course of neuropsychiatric symptoms in patients with dementia

2012 ◽  
Vol 22 (2) ◽  
Author(s):  
Sverre Bergh ◽  
Geir Selbæk
Keyword(s):  
Cognitive Abilities ◽  
Prevalence Rate ◽  
Motor Behavior ◽  
Neuropsychiatric Symptoms ◽  
Population Based ◽  
Depression And Anxiety ◽  
Term Care ◽  
High Prevalence ◽  
Clinically Significant

Dementia is prevalent in Norway and other countries and is hallmarked by a decline in memory and other cognitive abilities. In addition to cognitive decline, the vast majority of patients with dementia experience neuropsychiatric symptoms (NPS) such as depression, agitation, psychosis, apathy, or irritability. In this review, we describe the prevalence and the course of NPS in patients with dementia, referring to results of population-based studies, studies of outpatients, and studies of patients in long-term care. For a better comparison of the included studies and for clarification, we have included studies that have assessed NPS with the Neuropsychiatric Inventory (NPI). Overall, we found a high prevalence rate of NPS. At least one NPS (NPI &gt; 0) was present in 56% to 98% of the patients and 62% to 84% of the patients had at least one clinically significant NPS (NPI &gt; 3). The NPS with the highest prevalence rate were apathy, irritability, agitation, depression and anxiety; while delusion, hallucination, disinhibition, aberrant motor behavior and euphoria were the least frequent NPS.

A Meta-Analytic Investigation of the Relationship Between Scale-Item Length, Label Format, and Reliability

Methodology ◽  
2016 ◽  
Vol 12 (3) ◽  
pp. 89-96 ◽  
Author(s):  
Tyler Hamby ◽  
Robert A. Peterson
Keyword(s):  
Item Response ◽  
Big Five ◽  
Rating Scales ◽  
Category Label ◽  
Response Category ◽  
Analytic Investigation ◽  
Scale Item ◽  
Item Characteristics ◽  
The Relationship ◽  
Reliability Coefficients

Abstract. Using two meta-analytic datasets, we investigated the effect that two scale-item characteristics – number of item response categories and item response-category label format – have on the reliability of multi-item rating scales. The first dataset contained 289 reliability coefficients harvested from 100 samples that measured Big Five traits. The second dataset contained 2,524 reliability coefficients harvested from 381 samples that measured a wide variety of constructs in psychology, marketing, management, and education. We performed moderator analyses on the two datasets with the two item characteristics and their interaction. As expected, as the number of item response categories increased, so did reliability, but more importantly, there was a significant interaction between the number of item response categories and item response-category label format. Increasing the number of response categories increased reliabilities for scale-items with all response categories labeled more so than for other item response-category label formats. We explain that the interaction may be due to both statistical and psychological factors. The present results help to explain why findings on the relationships between the two scale-item characteristics and reliability have been mixed.

Neuropsychiatric Symptoms and Antipsychotic Therapy in the Elderly Patients with Dementia

Psychiatry ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 6-15
Author(s):  
I. V. Kolykhalov
Keyword(s):  
Neuropsychiatric Symptoms ◽  
The Elderly ◽  
Psychotic Symptoms ◽  
Mixed Dementia ◽  
Short Term ◽  
Antipsychotic Therapy ◽  
Dementia Patients ◽  
Frequency Of Use ◽  
Number Of Patients ◽  
High Incidence

The objective of the study was to investigate syndromal-nosological specificities of neuropsychiatric symptoms (NPS) and the frequency of use of antipsychotics in patients with various types of dementias, institutionalized to geriatric units of mental hospitals.Patients and methods: a total of 106 in-patients of three psychogeriatric units were examined. The median age of patients is 75 years [69; 80].The diagnostic distribution of patients at the time of the examination was as follows: in 33 subjects (31.1%) Alzheimer’s disease (AD) was diagnosed, in 25 (23.6%) - mixed dementia (MD), in 32 (30.2%) - vascular dementia (VD) and in 16 (15.1%) patients had dementia of complex origin (DCO).Results: a high incidence (54.7%) of NPS was found in patients with dementia of various origins. The greatest number of patients with behavioral and psychotic symptoms was found in AD and MD. The proportion of dementia patients with such disorders in each of these types of dementia is about 70%, while in CGD and VD, the proportion of patients with NPS is noticeably smaller (30% and 40%, respectively). For the treatment of NPS, antipsychotics were most often prescribed, but their use caused adverse events (AEs) in 1/3 of cases. Patients with VD are most susceptible to the development of AE, and AD patients are the least susceptible.Conclusion: the study showed that NPS are one of the important components of dementia, regardless of the nosology and stage of the disease. The treatment of NPS in dementia is particularly challenging because, although the symptoms cause significant distress, there are currently no effective alternative therapies. The risk of AE can be minimized by carefully considering the indications for prescribing antipsychotics and their short-term use, regular monitoring of the patient’s condition, and educating caregivers.

Investigation of the role of anxiety and depression on the formation of phantom vibration and ringing syndrome induced by working stress during medical internship (Preprint)

2019 ◽  
Author(s):  
Yu-Hsuan Lin ◽  
Kuan-I Lin ◽  
Yuan-Chien Pan ◽  
Sheng-Hsuan Lin
Keyword(s):  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Prospective Longitudinal Study ◽  
Work Related ◽  
Working Stress ◽  
Causal Mediation Analysis ◽  
Accompanying Symptoms ◽  
Prospective Longitudinal ◽  
The Relationship

BACKGROUND Phantom vibrations syndrome (PVS) and phantom ringing syndrome (PRS) are prevalent hallucinations during medical internship. Depression and anxiety are probably understudied risk factors of PVS and PRS. OBJECTIVE The aim of this study was to investigate the role of anxiety and depression on the relationship between working stress during medical internship and PVS and PRS. METHODS A prospective longitudinal study of 74 medical interns was carried out using repeated investigations of the severity of phantom vibrations and ringing, as well as accompanying symptoms of anxiety and depression as measured by Beck Anxiety Inventory and the Beck Depression Inventory before, at the 3rd, 6th, and 12th month during internship, and 2 weeks after internship. We conducted a causal mediation analysis to investigate the role of depression and anxiety in the mechanism of working stress during medical internship inducing PVS and PRS. RESULTS The results showed that depression explained 21.9% and 8.4% for stress-induced PRS and PVS, respectively. In addition, anxiety explained 15.0% and 7.8% for stress-induced PRS and PVS, respectively. CONCLUSIONS Our findings showed both depression and anxiety can explain a portion of stress-induced PVS and PRS during medical internship and might be more important in clinical practice and benefit to prevention of work-related burnout.

Sign in / Sign up

Export Citation Format

Share Document