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 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.

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 Neuropsychiatric symptoms in at-risk groups for AD dementia and their association with worry and AD biomarkers—results from the DELCODE study

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Lena Sannemann ◽  
◽  
Ann-Katrin Schild ◽  
Slawek Altenstein ◽  
Claudia Bartels ◽  
...  
Keyword(s):  
At Risk ◽  
Clinical Trials ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Neuropsychiatric Symptoms ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Risk Groups ◽  
Subjective Cognitive Decline ◽  
Healthy Controls

Abstract Background Early identification of individuals at risk of dementia is mandatory to implement prevention strategies and design clinical trials that target early disease stages. Subjective cognitive decline (SCD) and neuropsychiatric symptoms (NPS) have been proposed as potential markers for early manifestation of Alzheimer’s disease (AD). We aimed to investigate the frequency of NPS in SCD, in other at-risk groups, in healthy controls (CO), and in AD patients, and to test the association of NPS with AD biomarkers, with a particular focus on cognitively unimpaired participants with or without SCD-related worries. Methods We analyzed data of n = 687 participants from the German DZNE Longitudinal Cognitive Impairment and Dementia (DELCODE) study, including the diagnostic groups SCD (n = 242), mild cognitive impairment (MCI, n = 115), AD (n = 77), CO (n = 209), and first-degree relatives of AD patients (REL, n = 44). The Neuropsychiatric Inventory Questionnaire (NPI-Q), Geriatric Depression Scale (GDS-15), and Geriatric Anxiety Inventory (GAI-SF) were used to assess NPS. We examined differences of NPS frequency between diagnostic groups. Logistic regression analyses were carried out to further investigate the relationship between NPS and cerebrospinal fluid (CSF) AD biomarkers, focusing on a subsample of cognitively unimpaired participants (SCD, REL, and CO), who were further differentiated based on reported worries. Results The numbers of reported NPS, depression scores, and anxiety scores were significantly higher in subjects with SCD compared to CO. The quantity of reported NPS in subjects with SCD was lower compared to the MCI and AD group. In cognitively unimpaired subjects with worries, low Aß42 was associated with higher rates of reporting two or more NPS (OR 0.998, 95% CI 0.996–1.000, p < .05). Conclusion These findings give insight into the prevalence of NPS in different diagnostic groups, including SCD and healthy controls. NPS based on informant report seem to be associated with underlying AD pathology in cognitively unimpaired participants who worry about cognitive decline. Trial registration German Clinical Trials Register DRKS00007966. Registered 4 May 2015.

Subjective Spatial Navigation Complaints - A Frequent Symptom Reported by Patients with Subjective Cognitive Decline, Mild Cognitive Impairment and Alzheimer's Disease

2018 ◽  
Vol 15 (3) ◽  
pp. 219-228 ◽  
Author(s):  
Jiri Cerman ◽  
Ross Andel ◽  
Jan Laczo ◽  
Martin Vyhnalek ◽  
Zuzana Nedelska ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Spatial Navigation ◽  
Subjective Cognitive Decline ◽  
Great Effort ◽  
Frequent Symptom ◽  
Normal Controls

Background: Great effort has been put into developing simple and feasible tools capable to detect Alzheimer's disease (AD) in its early clinical stage. Spatial navigation impairment occurs very early in AD and is detectable even in the stage of mild cognitive impairment (MCI). Objective: The aim was to describe the frequency of self-reported spatial navigation complaints in patients with subjective cognitive decline (SCD), amnestic and non-amnestic MCI (aMCI, naMCI) and AD dementia and to assess whether a simple questionnaire based on these complaints may be used to detect early AD. Method: In total 184 subjects: patients with aMCI (n=61), naMCI (n=27), SCD (n=63), dementia due to AD (n=20) and normal controls (n=13) were recruited. The subjects underwent neuropsychological examination and were administered a questionnaire addressing spatial navigation complaints. Responses to the 15 items questionnaire were scaled into four categories (no, minor, moderate and major complaints). Results: 55% of patients with aMCI, 64% with naMCI, 68% with SCD and 72% with AD complained about their spatial navigation. 38-61% of these complaints were moderate or major. Only 33% normal controls expressed complaints and none was ranked as moderate or major. The SCD, aMCI and AD dementia patients were more likely to express complaints than normal controls (p's<0.050) after adjusting for age, education, sex, depressive symptoms (OR for SCD=4.00, aMCI=3.90, AD dementia=7.02) or anxiety (OR for SCD=3.59, aMCI=3.64, AD dementia=6.41). Conclusion: Spatial navigation complaints are a frequent symptom not only in AD, but also in SCD and aMCI and can potentially be detected by a simple and inexpensive questionnaire.

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