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

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N Siafarikas, G Selbaek, T Fladby, J Šaltytė Benth, E Auning, D. Aarsland

Original languageEnglish
Pages (from-to)103-113
JournalInternational Psychogeriatrics
Volume30
Issue number1
Early online date20 Sep 2017
DOIs
Accepted/In press21 Aug 2017
E-pub ahead of print20 Sep 2017
PublishedJan 2018

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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. Method: This was a cross-sectional study using data from a Norwegian national registry of memory clinics. From a total sample of 4571 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.

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