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Neuropsychiatric symptoms common in predementia, cognitive decline

Neuropsychiatric symptoms occur frequently in predementia clinical states, as well as subjective cognitive decline and mild cognitive impairment, according to data presented at the Alzheimer’s Association International Conference 2016, in Toronto.

Zahinoor Ismail, MD, of the University of Calgary Cumming School of Medicine, and colleagues also found that neuropsychiatric symptoms were linked to greater caregiver burden, and suggest that mild behavioral impairment could prove to be a clinically relevant condition.

To determine the prevalence of neuropsychiatric symptoms, grouped by mild behavioral impairment domains in a memory clinic population, Ismail and colleagues analyzed neuropsychiatric inventory questionnaires (NPI-Q) from 282 patients with subjective cognitive decline or mild cognitive impairment, recruited from Jan. 1, 2010, to Sept. 30, 2015.

The 15-item Zarit Caregiver Burden Scale was used to determine caregiver burden. In addition, the researchers used descriptive statistics to identify frequency of neuropsychiatric symptoms by domain, with Chi square tests performed when appropriate.

According to the researchers, the prevalence of any neuropsychiatric symptom was 81.6%, and for mild behavioral impairment domains, the frequency of neuropsychiatric symptoms was 77.8% for mood, 64.4% for impulse control, 51.7% for apathy, 27.8% for social appropriateness, and 8.7% for psychosis. Neuropsychiatric symptoms of any kind were reported in 76.5% of patients with subjective cognitive decline and 83.5% of patients with mild cognitive decline.

There were no gender or age differences in neuropsychiatric symptom prevalence. In addition, mean Montreal Cognitive Assessment (23.5) and Mini Mental State Examination (27.8) scores in patients with neuropsychiatric symptoms were not significantly different than participants without. However, mean caregiver burden scores were significantly higher in patients with mild behavioral impairment, at 19.1 compared with 5.4 (P < .001).

“Our study suggests that mild behavioral impairment may be a common and clinically relevant syndrome, particularly given that neuropsychiatric symptoms are associated with greater caregiver burden,” Ismail said in a press release. “However, because the NPI-Q was designed for use in a dementia population, further research is needed to develop mild behavioral impairment–specific questionnaires that may be more appropriate for use in younger and non-demented persons.” – by Jason Laday

Disclosure: Healio Family Medicine could not confirm researchers’ relevant financial disclosures.

Reference:

Ismail Z, et al. Poster 11588. Presented at AAIC 2016; July 22-28, 2016; Toronto, Canada.