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Neuropsychiatric Symptoms Could Predict Dementia Risk
Neuropsychiatric symptoms (NPS) could be a significant predictor in whether a patient with mild cognitive impairment (MCI) will develop Alzheimer disease (AD), according to recent study results published in The Journal of Alzheimer’s Disease.
“NPS may inform dementia risk assessment in conjunction with cognitive testing and imaging and laboratory AD biomarkers. NPS is independently associated with the risk of MCI-dementia progression, over and beyond the contributions of CSF biomarkers,” noted lead author Maria Vittoria Spampinato, MD, division director of Neuroradiology at the Medical University of South Carolina, and co-authors.
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Among the 300 elderly subjects over a 5-year follow-up period, 219 maintained stable MCI, while 81 experienced progression from MCI to AD (MCI-AD). The study used the Neuropsychiatric Inventory (NPI) to measure NPS, such as anxiety, depression, delusions, hallucinations, or sleep disorders. A multivariate Cox Proportional Hazards Regression Analysis was conducted to evaluate the impact of various factors including APOE4 status, baseline NPI scores, baseline levels of CSF amyloid-β, phosphorylated and total tau, baseline AD-signature MRI biomarkers, and baseline memory and executive function on the progression from MCI to AD.
Over a median follow-up period of 43 months, 27% of individuals progressed to dementia. Neuropsychiatric symptoms were present in 62.6% of those with stable MCI and 70.3% of individuals with MCI-AD. The Cox model showed significant associations, with neuropsychiatric symptoms (HR = 1.033, p = 0.027), phosphorylated tau (HR = 1.011, p = 0.025), total tau (HR = 1.005, p = 0.024), AD-signature MRI biomarkers (HR = 0.111, p = 0.002), executive function (HR = 0.727, p = 0.045), and memory performance (HR = 0.387, p < 0.001) significantly associated with the risk of dementia.
“If you feel down or anxious and you experience memory issues as you age, it is important to seek help early and get a thorough evaluation for both cognitive and mental health concerns,” said Spampinato.
