Neuropsychiatric Symptoms as Risk Factors for Progression From CIND to Dementia: The Cache County Study.
OBJECTIVES:: To examine the association of neuropsychiatric symptom (NPS) severity with risk of transition to all-cause dementia, Alzheimer disease (AD), and vascular dementia (VaD). DESIGN:: Survival analysis of time to dementia, AD, or VaD onset. SETTING:: Population-based study. PARTICIPANTS:: 230 participants diagnosed with cognitive impairment, no dementia (CIND) from the Cache County Study of Memory Health and Aging were followed for a mean of 3.3 years. MEASUREMENTS:: The Neuropsychiatric Inventory (NPI) was used to quantify the presence, frequency, and severity of NPS. Chi-squared statistics, t-tests, and Cox proportional hazard ratios were used to assess associations. RESULTS:: The conversion rate from CIND to all-cause dementia was 12% per year, with risk factors including an APOE [Latin Small Letter Open E]4 allele, lower Mini-Mental State Examination, lower 3MS, and higher CDR sum-of-boxes. The presence of at least one NPS was a risk factor for all-cause dementia, as was the presence of NPS with mild severity. Nighttime behaviors were a risk factor for all-cause dementia and of AD, whereas hallucinations were a risk factor for VaD. CONCLUSIONS:: These data confirm that NPS are risk factors for conversion from CIND to dementia. Of special interest is that even NPS of mild severity are a risk for all-cause dementia or AD.
Peters, ME; Rosenberg, PB; Steinberg, M; Norton, MC; Welsh-Bohmer, KA; Hayden, KM; Breitner, J; Tschanz, JT; Lyketsos, CG; the Cache County Investigators,
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