Neuropsychiatric Inventory in Community-Dwelling Older Adults with Mild Cognitive Impairment and Dementia

Nenhuma Miniatura disponível
Citações na Scopus
25
Tipo de produção
article
Data de publicação
2019
Título da Revista
ISSN da Revista
Título do Volume
Editora
IOS PRESS
Citação
JOURNAL OF ALZHEIMERS DISEASE, v.68, n.2, p.669-678, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: Behavioral and psychological symptoms (BPSD) can be a prodrome of dementia, and the Neuropsychiatric Inventory (NPI) is widely used for BPSD evaluation. Objective: To compare the prevalence of BPSD according to cognitive status, and to determine NPI cutoffs that best discern individuals with mild cognitive impairment (MCI) and dementia from those without dementia. Methods: We included 1,565 participants (mean age = 72.7 +/- 12.2 years, 48% male). BPSD and cognitive status were assessed with the NPI and the Clinical Dementia Rating (CDR). We used multivariable logistic regression models to investigate the association of BPSD with cognitive status. The area under the curve (AUC) was used to assess model discrimination, and to determine the best NPI cutoff for MCI and dementia. Results: Participants were cognitively normal (CDR = 0; n = 1,062), MCI (CDR = 0.5; n = 145), or dementia (CDR >= 1.0, n = 358). NPI symptoms were more frequent in dementia and MCI when compared to cognitively normal. Higher odds for delusions, hallucinations, disinhibition, and psychomotor alterations were found among participants with dementia and MCI than in those who were cognitively normal. The best NPI cutoff to discern participants with dementia from those cognitively normal was 11 (AUC = 0.755). Poor discrimination (AUC = 0.563) was found for the comparison of MCI and those cognitively normal. Conclusions: We found an increase in BPSD frequencies across the continuum of cognitive impairment. BPSD severity and frequency in MCI was more similar to individuals cognitively normal than with dementia. NPI scores >= to 11 in individuals with no diagnosis of dementia can support the decision for further investigation of dementia.
Palavras-chave
Behavioral and psychological symptoms, dementia, mild cognitive impairment, Neuropsychiatric Inventory
Referências
  1. Aalten P, 2005, INT J GERIATR PSYCH, V20, P523, DOI 10.1002/gps.1316
  2. Cummings JL, 1997, NEUROLOGY, V48, pS10, DOI 10.1212/WNL.48.5_Suppl_6.10S
  3. CUZICK J, 1985, STAT MED, V4, P87, DOI 10.1002/sim.4780040112
  4. DELONG ER, 1988, BIOMETRICS, V44, P837, DOI 10.2307/2531595
  5. Dillon C, 2013, NEUROPSYCH DIS TREAT, V9, P1443, DOI 10.2147/NDT.S47133
  6. Farfel JM, 2013, NEUROLOGY, V81, P650, DOI 10.1212/WNL.0b013e3182a08f1b
  7. Feast A, 2016, BRIT J PSYCHIAT, V208, P429, DOI 10.1192/bjp.bp.114.153684
  8. Ferretti Renata Eloah de Lucena, 2010, Dement. neuropsychol., V4, P138, DOI 10.1590/S1980-57642010DN40200011
  9. Ferretti-Rebustini Renata Eloah de Lucena, 2015, Dement. neuropsychol., V9, P103, DOI 10.1590/1980-57642015DN92000004
  10. Fuh JL, 2005, J NEUROL NEUROSUR PS, V76, P1337, DOI 10.1136/jnnp.2004.056408
  11. Geda YE, 2008, ARCH GEN PSYCHIAT, V65, P1193, DOI 10.1001/archpsyc.65.10.1193
  12. Grinberg LT, 2013, CLINICS, V68, P1140, DOI 10.6061/clinics/2013(08)13
  13. Hsieh CJ, 2009, INT J GERIATR PSYCH, V24, P570, DOI 10.1002/gps.2156
  14. JORM AF, 1994, PSYCHOL MED, V24, P145, DOI 10.1017/S003329170002691X
  15. KATZ S, 1963, JAMA-J AM MED ASSOC, V185, P914, DOI 10.1001/jama.1963.03060120024016
  16. Kazui H, 2016, PLOS ONE, V11, DOI 10.1371/journal.pone.0161092
  17. Knopman DS, 2008, BRAIN, V131, P2957, DOI 10.1093/brain/awn234
  18. Lai CKY, 2014, CLIN INTERV AGING, V9, P1051, DOI 10.2147/CIA.S63504
  19. LAWTON MP, 1969, GERONTOLOGIST, V9, P9, DOI 10.1093/geront/9.1.9
  20. Leoutsakos JMS, 2015, J ALZHEIMERS DIS, V48, P483, DOI 10.3233/JAD-150421
  21. Lima-Silva TB, 2018, ALZ DIS ASSOC DIS, V32, P220, DOI 10.1097/WAD.0000000000000246
  22. Lyketsos CG, 2000, AM J PSYCHIAT, V157, P708, DOI 10.1176/appi.ajp.157.5.708
  23. Lyketsos CG, 2002, JAMA-J AM MED ASSOC, V288, P1475, DOI 10.1001/jama.288.12.1475
  24. Masters MC, 2015, NEUROLOGY, V84, P617, DOI 10.1212/WNL.0000000000001238
  25. Mioshi E, 2010, NEUROLOGY, V74, P1591, DOI 10.1212/WNL.0b013e3181e04070
  26. Mjorud M, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0115248
  27. MORRIS JC, 1993, NEUROLOGY, V43, P2412, DOI 10.1212/WNL.43.11.2412-a
  28. Muangpaisan W, 2008, INT J GERIATR PSYCH, V23, P699, DOI 10.1002/gps.1963
  29. Nunes PV, 2018, INT J GERIATR PSYCH, V33, P14, DOI 10.1002/gps.4649
  30. Peters ME, 2013, AM J GERIAT PSYCHIAT, V21, P1116, DOI 10.1016/j.jagp.2013.01.049
  31. Petersen RC, 2001, NEUROLOGY, V56, P1133, DOI 10.1212/WNL.56.9.1133
  32. Roe CM, 2013, NEUROLOGY, V81, P2028, DOI 10.1212/01.wnl.0000436940.78152.05
  33. Rog LA, 2014, CLIN NEUROPSYCHOL, V28, P215, DOI 10.1080/13854046.2013.876101
  34. Salazar R, 2015, INT J GERIATR PSYCH, V30, P300, DOI 10.1002/gps.4141
  35. Somme J, 2013, CURR ALZHEIMER RES, V10, P86
  36. Steinberg M, 2008, INT J GERIATR PSYCH, V23, P170, DOI 10.1002/gps.1858
  37. Suemoto CK, 2017, PLOS MED, V14, DOI 10.1371/journal.pmed.1002267
  38. Terum TM, 2017, INT J GERIATR PSYCH, V32, P703, DOI 10.1002/gps.4704
  39. Vieira Renata Teles, 2013, Clin Pract Epidemiol Ment Health, V9, P88, DOI 10.2174/1745017901309010088
  40. Xu X, 2015, INT PSYCHOGERIATR, V27, P1839, DOI 10.1017/S1041610215000976
  41. YOUDEN WJ, 1950, CANCER, V3, P32, DOI 10.1002/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3