scholarly journals Association Between Neuropsychiatric Symptoms and Functional Change in Older Non-Demented Adults: Mayo Clinic Study of Aging

2020 ◽  
Vol 78 (3) ◽  
pp. 911-917
Author(s):  
Janina Krell-Roesch ◽  
Jeremy A. Syrjanen ◽  
Michelle M. Mielke ◽  
Teresa J. Christianson ◽  
Walter K. Kremers ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Sex Education ◽  
Functional Performance ◽  
Neuropsychiatric Symptoms ◽  
Functional Decline ◽  
Beck Depression Inventory Score ◽  
Functional Change ◽  
Neuropsychiatric Inventory ◽  
Functional Activities ◽  
Clinic Study

We examined the associations between baseline neuropsychiatric symptoms (NPS) and longitudinal changes in functional performance among 5,394 non-demented individuals aged ≥50 years (2,729 males; median age 74.2 years; 4,716 cognitively unimpaired, 678 mild cognitive impairment). After adjusting for age, sex, education, and medical comorbidities, NPS assessed by the Neuropsychiatric Inventory Questionnaire, clinical depression (Beck Depression Inventory score ≥13) and anxiety (Beck Anxiety Inventory score ≥10) were significantly associated with an increase in the Functional Activities Questionnaire score, indicating functional decline over time. This association may vary depending on the degree of cognitive impairment at baseline.

scholarly journals Longitudinal Trajectories of Informant-Reported Daily Functioning in Empirically Defined Subtypes of Mild Cognitive Impairment

2017 ◽  
Vol 23 (6) ◽  
pp. 521-527 ◽  
Author(s):  
Kelsey R. Thomas ◽  
Emily C. Edmonds ◽  
Lisa Delano-Wood ◽  
Mark W. Bondi
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Functional Decline ◽  
Executive Dysfunction ◽  
Functional Change ◽  
Cognitively Impaired ◽  
Cognitive Domains ◽  
Functional Activities ◽  
Rate Of Decline

AbstractObjectives: Within the Alzheimer’s Disease Neuroimaging Initiative (ADNI)’s mild cognitive impairment (MCI) cohort, we previously identified MCI subtypes as well as participants initially diagnosed with MCI but found to have normal neuropsychological, biomarker, and neuroimaging profiles. We investigated the functional change over time in these empirically derived MCI subgroups. Methods: ADNI MCI participants (n=654) were classified using cluster analysis as Amnestic MCI (single-domain memory impairment), Dysnomic MCI (memory+language impairments), Dysexecutive/Mixed MCI (memory+language+attention/executive impairments), or Cluster-Derived Normal (CDN). Robust normal control participants (NCs; n=284) were also examined. The Functional Activities Questionnaire (FAQ) was administered at baseline through 48-month follow-up. Multilevel modeling examined FAQ trajectories by cognitive subgroup. Results: The Dysexecutive/Mixed group demonstrated the fastest rate of decline across all groups. Amnestic and Dysnomic groups showed steeper rates of decline than CDNs. While CDNs had more functional difficulty than NCs across visits, both groups’ mean FAQ scores remained below its suggested cutoff at all visits. Conclusions: Results (a) show the importance of executive dysfunction in the context of other impaired cognitive domains when predicting functional decline in at-risk elders, and (b) support our previous work demonstrating that ADNI’s MCI criteria may have resulted in false-positive MCI diagnoses, given the CDN’s better FAQ trajectory than those of the cognitively impaired MCI groups. (JINS, 2017, 23, 521–527)

Acute Psychogeriatric Inpatient Treatment Improves Neuropsychiatric Symptoms but Impairs the Level of Functioning in Patients with Dementia

2015 ◽  
Vol 40 (5-6) ◽  
pp. 290-296 ◽  
Author(s):  
Hanna-Mari Alanen ◽  
Anneli Pitkänen ◽  
Kirsti Suontaka-Jamalainen ◽  
Olli Kampman ◽  
Esa Leinonen
Keyword(s):  
Mental State ◽  
Daily Living ◽  
Mini Mental State Examination ◽  
Neuropsychiatric Symptoms ◽  
Functional Decline ◽  
Neuropsychiatric Inventory ◽  
Behavioral Disturbances ◽  
Level Of Functioning ◽  
The Impact ◽  
State Examination

Aims: To explore the impact of hospitalization on neuropsychiatric symptoms (NPS) and the level of functioning in patients with dementia. Our aim was also to study the influence of psychotropic medications. Methods: Behavioral disturbances, cognition and functional status of 89 patients were assessed using the Neuropsychiatric Inventory (NPI), Mini-Mental State Examination, Barthel Index, and Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCSADL). Results: The total NPI score decreased from 34.6 to 19.5 (p < 0.001), and ADL decreased from 32.2 to 21.7 (p < 0.001) during the hospital stay (mean of 44 days). For a change in ADL, only the effect of anxiolytics was significant (p = 0.045). For a change in NPI with antipsychotic and anxiolytic doses and Mini-Mental State Examination as covariates, no significant relationship was found. Conclusion: NPS improved significantly during hospitalization, but neither antipsychotic nor anxiolytic medication use explained this improvement. In patients using anxiolytics, the functional decline was substantial. These results do not support anxiolytic use in demented patients with NPS.

scholarly journals Functional Status in Behavioral Variant Frontotemporal Dementia: A Systematic Review

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Thais Bento Lima-Silva ◽  
Valéria Santoro Bahia ◽  
Ricardo Nitrini ◽  
Mônica Sanches Yassuda
Keyword(s):  
Systematic Review ◽  
Functional Status ◽  
Frontotemporal Dementia ◽  
Frontotemporal Lobar Degeneration ◽  
Functional Performance ◽  
Functional Decline ◽  
Behavioral Variant Frontotemporal Dementia ◽  
Functional Activities ◽  
Bibliographic Search

The aim was to conduct a systematic review of studies that described the functional profile of patients with behavioral variant frontotemporal dementia (bvFTD), published between 2000 and 2013. The bibliographic search was conducted using the terms “frontotemporal dementia” and “frontotemporal lobar degeneration” in combination with “independence,” “functionality,” “basic activities of daily living,” “disability,” and scales that measure functional performance: “Disability Assessment for Dementia-DAD,” “Functional Activities Questionnaire (FAQ),” “Direct Assessment of Functional Status (DAFS).” To be included in the review, the study had to mention the characterization of the functional status of patients with bvFTD in the objectives of the study, using a previously validated instrument of functional assessment. Fourteen studies met this criterion. The reviewed studies suggested that individuals with bvFTD have greater functional impairment when compared to those with other subtypes of frontotemporal lobar degeneration or Alzheimer’s disease. The studies documented a significant association between cognitive impairment and measures of functionality in these patients. The cognitive profile of patients may predict faster functional decline.

scholarly journals Correlation of Frontal Atrophy and CSF Tau Levels With Neuropsychiatric Symptoms in Patients With Cognitive Impairment: A Memory Clinic Experience

2021 ◽  
Vol 13 ◽  
Author(s):  
Matteo Cotta Ramusino ◽  
Giulia Perini ◽  
Gloria Vaghi ◽  
Beatrice Dal Fabbro ◽  
Marco Capelli ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Lewy Body Disease ◽  
Cortical Atrophy ◽  
Psychotic Symptoms ◽  
Memory Clinic ◽  
Neuropsychiatric Inventory ◽  
Clinic Experience ◽  
Behavioral And Psychological Symptoms

Background: Behavioral and psychological symptoms of dementia (BPSD) are a distressful condition. We aimed to investigate the BPSD distribution in subjects with cognitive impairment, and the potential correlations between BPSD and neurodegeneration in terms of cerebrospinal fluid (CSF) tau and brain atrophy.Methods: One-hundred patients with mild cognitive impairment (MCI) or dementia (Alzheimer’s disease, AD; Lewy-body disease, LBD; frontotemporal dementia, FTD; vascular dementia, VD) underwent a complete diagnostic workup, including 3T-MRI and/or CT and CSF. Cortical atrophy was assessed with medial temporal atrophy (MTA), posterior atrophy (PA), and global cortical atrophy-frontal lobe (GCA-F) scales. BPSD were rated using the Neuropsychiatric Inventory (NPI), and BPSD clusters were defined according to the European Alzheimer Disease Consortium.Results: Delusions, hallucinations, and psychosis cluster were differently distributed among the diagnostic groups (p &lt; 0.05, p &lt; 0.001, and p &lt; 0.05), with LBD patients showing higher scores for hallucinations (vs. MCI, p &lt; 0.001, and AD, p &lt; 0.05) and psychosis cluster (vs. MCI, p &lt; 0.05). In primary dementias, we found a negative correlation between NPI total score and tau levels (p = 0.08), confirmed by beta regression (p &lt; 0.01), while a positive non-significant relationship was observed in MCI. Higher GCA-F scores were associated with delusions and apathy (p &lt; 0.05, on both hemispheres) and hallucinations (left: p &lt; 0.01, right: p &lt; 0.05). GCA-F scores were positively correlated with psychosis cluster (right: p &lt; 0.05), and agitation/aggression (left: p &lt; 0.05). Conversely, nighttime disturbances were positively correlated with both GCA-F and MTA scores (left: p &lt; 0.01; right: p &lt; 0.05).Conclusion: Our results suggest that psychotic symptoms are significantly more represented in LBD patients and that CSF tau and frontal atrophy are associated with the occurrence and severity of BPSD in clinical practice. Longitudinal studies are however required to ascertain their actual predictive value.

Can the Clinical Dementia Rating Scale Identify Mild Cognitive Impairment and Predict Cognitive and Functional Decline?

2016 ◽  
Vol 41 (5-6) ◽  
pp. 292-302 ◽  
Author(s):  
Claudia Woolf ◽  
Melissa J. Slavin ◽  
Brian Draper ◽  
Floortje Thomassen ◽  
Nicole A. Kochan ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Rating Scale ◽  
Functional Decline ◽  
High Specificity ◽  
Cognitive Change ◽  
Functional Change ◽  
Clinical Dementia Rating ◽  
Dementia Rating Scale ◽  
Low Sensitivity

Background: The Clinical Dementia Rating Scale (CDR) is used to rate dementia severity. Its utility in diagnosing mild cognitive impairment (MCI) and its predictive value remain unknown. Aims: The aim of this study was to examine the association between CDR scores and expert MCI diagnosis, and to determine whether baseline CDR scores were predictive of cognitive or functional decline and progression to dementia over 6 years. Methods: At baseline, the sample comprised 733 non-demented participants aged 70-90 years from the longitudinal Sydney Memory and Ageing Study. Global and sum of boxes CDR scores were obtained at baseline. Participants also received comprehensive neuropsychological and functional assessment as well as expert consensus diagnoses at baseline and follow-up. Results: At baseline, CDR scores had high specificity but low sensitivity for broadly defined MCI. The balance of sensitivity and specificity improved for narrowly defined MCI. Longitudinally, all baseline CDR scores predicted functional change and dementia, but CDR scores were not predictive of cognitive change. Conclusion: CDR scores do not correspond well with MCI, except when MCI is narrowly defined, suggesting that the CDR taps into the more severe end of MCI. All CDR scores usefully predict functional decline and incident dementia.

scholarly journals Neuropsychiatric Symptoms in Patients with Dementia Associated with Increased Psychological Distress in Caregivers During the COVID-19 Pandemic

2021 ◽  
pp. 1-8
Author(s):  
Wyllians Vendramini Borelli ◽  
Marina Coutinho Augustin ◽  
Paola Bell Felix de Oliveira ◽  
Lorenzo Casagrande Reggiani ◽  
Renato Gorga Bandeira-de-Mello ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Neuropsychiatric Symptoms ◽  
Functional Decline ◽  
Cross Sectional Study ◽  
Caregiver Distress ◽  
Neuropsychiatric Inventory ◽  
Cross Sectional ◽  
Functional Changes ◽  
Dementia Patients ◽  
The Social

Background: The social isolation imposed by COVID-19 pandemic can have a major impact on the mental health of dementia patients and their caregivers. Objective: We aim to evaluate the neurological decline of patients with dementia and the caregivers’ burden during the pandemic. Methods: We performed a cross-sectional study. Caregivers of dementia patients following in the outpatient clinic were included. A structured telephone interview composed of the Neuropsychiatric Inventory Questionnaire (NPI-Q), Zarit Burden Interview (ZBI), Beck Depression (BDI) and Anxiety (BAI) Inventories to address cognitive, behavioral, and functional changes associated with social distancing during the Sars-Cov-2 outbreak. Patients were divided in two groups according to caregivers’ report: with perceived Altered Cognition (AC) and Stable Cognition (SC). Results: A total of 58 patients (median age: 57 years [21–87], 58.6%females) and caregivers (median age: 76.5 years [55–89], 79.3%females) were included. Cognitive decline was shown by most patients (53.4%), as well as behavioral symptoms (48.3%), especially apathy/depression (24.1%), and functional decline (34.5%). The AC group (n = 31) presented increased behavioral (67.7%versus 25.9%, p = 0.002) and functional (61.3%versus 3.7%, p <  0.001) changes when compared to the SC group. In the AC group, ZBI, BDI, NPI-Q caregiver distress, and NPI-Q patient’s severity of symptoms scores were worse than the SC group (p <  0.005 for all). Conclusion: Patients’ neuropsychiatric worsening and caregiver burden were frequent during the pandemic. Worsening of cognition was associated with increased caregivers’ psychological distress.

scholarly journals Lack of physical activity, neuropsychiatric symptoms and the risk of incident mild cognitive impairment in older community-dwelling individuals

2021 ◽  
Author(s):  
Janina Krell-Roesch ◽  
Jeremy A. Syrjanen ◽  
Jelena Bezold ◽  
Sandra Trautwein ◽  
Bettina Barisch-Fritz ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Sex Education ◽  
Reference Group ◽  
Neuropsychiatric Symptoms ◽  
Community Dwelling ◽  
Clinical Depression ◽  
Increased Risk ◽  
Vigorous Intensity

AbstractThe present study examined the longitudinal association and interaction between lack of engaging in physical activity (PA) and presence of neuropsychiatric symptoms (NPS) with the risk of incident mild cognitive impairment (MCI). The authors conducted a prospective cohort study in the setting of the population-based Mayo Clinic Study of Aging in Minnesota, USA, involving 3083 cognitively unimpaired persons aged ≥ 50 years (1570 males; median age, 74 years). Predictors included: lack of engaging in light, moderate, and vigorous intensity PA within 1 year of baseline assessment as measured by a self-reported questionnaire; and presence of NPS (agitation, anxiety, apathy, appetite change, sleep/nighttime disturbance, depression, irritability, clinical depression, clinical anxiety) as measured by standardized tools. When the authors detected a statistically significant interaction, they compared the risk of incident MCI between four groups of participants (no NPS/engaging in PA = reference group; NPS/engaging in PA; no NPS/not engaging in PA; NPS/not engaging in PA) by calculating hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazard models adjusted for age (as time scale), sex, education, global cognition, medical comorbidities, and apolipoprotein E ɛ4 status. After a median follow-up of 6.3 years, 599 participants developed incident MCI. Not engaging in vigorous intensity PA and having sleep/nighttime disturbance (HR [95% CI], 1.61 [1.07, 2.43]; p = 0.021), clinical depression (1.98 [1.34, 2.92]; p < 0.001) or clinical anxiety (1.63 [1.11, 2.41]; p = 0.013) was associated with an increased risk of incident MCI as compared to the reference group. Thus, the combined presence of lack of vigorous intensity physical activity with sleep/nighttime disturbance behavior, clinical depression, or clinical anxiety was greater than the expected arithmetic sum of their independent effects. Neuropsychiatric symptoms appear to be a stronger driving force of incident MCI than lack of physical activity.

Sensitivity to change of composite and frequency scores of the neuropsychiatric inventory in mild cognitive impairment

2014 ◽  
Vol 26 (11) ◽  
pp. 1871-1874 ◽  
Author(s):  
Jeffrey L. Cummings ◽  
Michael Tribanek ◽  
Robert Hoerr
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Active Drug ◽  
Neuropsychiatric Symptoms ◽  
Composite Score ◽  
Neuropsychiatric Inventory ◽  
Treatment Groups ◽  
Moderate Dementia ◽  
Clinically Significant ◽  
Composite Scores

ABSTRACTBackground:The most appropriate means of capturing data from the Neuropsychiatric Inventory (NPI) must be understood to optimize use of this instrument in clinical trials. The utility of the composite score (frequency times severity) was recently demonstrated in mild and moderate dementia. Determination of frequency compared to composite scores in mild cognitive impairment (MCI) warrants investigation.Methods:We used the NPI data from a randomized, placebo-controlled, multi-center, 24-week, clinical trial involving 160 patients who were diagnosed with amnestic MCI and had clinically significant neuropsychiatric symptoms (NPS). We calculated standardized changes for both frequency and composite scores.Results:There were improvements in NPI composite scores in both active drug- and placebo-treated patients, with significant superiority of active drug. Standardized changes in severity and composite scores tended to be larger than those in the frequency scores, whereas discrimination between treatment groups was similar for all three scores.Conclusions:Our findings support the hypothesis that in MCI, as in dementia, the NPI frequency score is not more sensitive to treatment-related change than the composite score. As the severity score adds information, the use of the composite score has better performance characteristics.

scholarly journals Relationship between Persistent Dizziness and Markers of Alzheimer's disease – Mayo Clinic Study of Aging

2021 ◽  
Author(s):  
RAZAN AL FAKIR
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Sex Education ◽  
Mayo Clinic ◽  
Cognitive Impairments ◽  
Neuropsychiatric Symptoms ◽  
Amyloid Β ◽  
Density Lipoprotein ◽  
Contributing Factors ◽  
Clinic Study

Abstract Persistent dizziness or lightheadedness ranks among the most frequent complaints in primary care. Persistent dizziness is frequently described as a consequence or side effect of defined entities such as cardiovascular, infectious, neurological, and otological disease. Persistent dizziness is potentially disabling and has a distinct impact on participation, psychosocial interaction, and quality of life. We examined the relationship between persistent dizziness or lightheadedness and Alzheimer's disease (AD) markers among 924 individuals aged ≥50 years (52.3% male, mean age 74 years) selected from 5707 individuals who participated in the population-based Mayo Clinic Study of Aging in Olmsted County, Minnesota. Neuropsychiatric symptoms (depression and anxiety), cognitive evaluation (overall and across multiple domains), magnetic resonance imaging for AD-signature "regional thickness," and 11Carbon-Pittsburgh compound B positron emission tomography (11C-PiB PET) for Amyloid deposition are all investigated. Significant contributing factors to persistent dizziness in older adults were found and include [age, sex (male), lower education, high comorbidity index, high-density lipoprotein, balance problems, neuropsychiatric symptoms, cognitive impairments, and AD-signature” regional thickness]. After adjusting for age, sex, education, medical comorbidities, and other variables, a statistically significant association between persistent dizziness/lightheadedness and neuropsychiatric symptoms, and Amyloid-β deposition. This finding implies that the underlying AD biology may drive both the neuropsychiatric symptoms and persistent dizziness or lightheadedness, even before the onset of cognitive impairments and dementia. Further studies are needed to support the findings.

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