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Frequency and subgroups of neuropsychiatric symptoms in mild cognitive impairment and different stages of dementia in Alzheimer's disease

Published online by Cambridge University Press:  20 September 2017

N. Siafarikas Open the ORCID record for N. Siafarikas [Opens in a new window] ,
G. Selbaek ,
T. Fladby ,
J. Šaltytė Benth ,
E. Auning  and
D. Aarsland
N. Siafarikas*
Affiliation:
Department of Geriatric Psychiatry, Akershus University Hospital, Lørenskog, Norway
G. Selbaek
Affiliation:
Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway Faculty of Medicine, University of Oslo, Oslo, Norway
T. Fladby
Affiliation:
Department of Neurology, Akershus University Hospital, Lørenskog, Norway Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
J. Šaltytė Benth
Affiliation:
Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
E. Auning
Affiliation:
Department of Geriatric Psychiatry, Akershus University Hospital, Lørenskog, Norway
D. Aarsland
Affiliation:
Department of Neurology, Akershus University Hospital, Lørenskog, Norway Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK
*
Correspondence should be addressed to: Nikias Siafarikas, AHUS, Alderspsykiatrisk avdeling, Sykehusveien 25, 1478 Lørenskog, Norway. Phone: +0047 91502900. Email: nikias.siafarikas@googlemail.com.
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Abstract

Background:

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.

Keywords

neuropsychiatrycognitive impairmentdementiaAlzheimer's disease
Type
Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 1 , January 2018 , pp. 103 - 113
Copyright
Copyright © International Psychogeriatric Association 2017 

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