Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-22T19:42:32.906Z Has data issue: false hasContentIssue false
  • English
  • Français

Persistence of neuropsychiatric symptoms over six months in mild cognitive impairment in community-dwelling Korean elderly

Published online by Cambridge University Press:  24 September 2010

Seung-Ho Ryu ,
Jee Hyun Ha ,
Doo-Heum Park ,
Jaehak Yu  and
Gill Livingston
Seung-Ho Ryu*
Affiliation:
Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea
Jee Hyun Ha
Affiliation:
Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea
Doo-Heum Park
Affiliation:
Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea
Jaehak Yu
Affiliation:
Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea
Gill Livingston
Affiliation:
Centre for Aging and Mental Health Sciences, University College London, London, U.K.
*
Correspondence should be addressed to: Seung-Ho Ryu, MD, PhD, Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, 4-12 Hwayang-dong, Gwangjin-gu, Seoul 143-729Korea. Phone: +82-2-2030-7567; Fax: +82-2-2030-7748; Email: [email protected].
Get access

Abstract

Background: Several studies of patients with mild cognitive impairment (MCI) have revealed that this population, like people with dementia, have neuropsychiatric symptoms (NPS) as well as memory impairment. No study has reported on the natural history and course of NPS in MCI although this is important in terms of management. We aimed to determine the persistence of NPS over six months in participants with MCI.

Method: The Neuropsychiatric Inventory (NPI) was used to rate the severity of NPS in 241 consecutive referrals with MCI from a Korean clinic at baseline and in 220 patients at 6-month follow-up. We also collected information about the cognition and quality of life of patients and their caregivers.

Results: Ninety-seven (44.1%) MCI participants who completed the 6-month follow-up exhibited at least one NPS at baseline; 60 (27.3%) were clinically significant NPS. Seventy (72.1%) of those with any symptom had at least one persistent NPS at 6-month follow-up, and 44 (73.3%) of those with clinically significant symptoms had at least one significant and persistent NPS at 6-month follow-up. Those with persistent symptoms had more severe baseline symptoms. Both patients and caregivers had a poorer quality of life when the patient had at least one clinically significant symptom.

Conclusions: NPS were highly persistent overall in older people with MCI. Persistence was predicted by having more severe symptoms at baseline. Clinically significant levels of NPS were associated with decreased quality of life. We conclude that clinicians should be aware that NPS symptoms in MCI usually persist.

Keywords

neuropsychiatric symptomsmild cognitive impairmentpersistence
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 2 , March 2011 , pp. 214 - 220
Copyright
Copyright © International Psychogeriatric Association 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aalten, P., de Vugt, M. E., Jaspers, N., Jolles, J. and Verhey, R. J. (2005). The course of neuropsychiatric symptoms in dementia. Part I: findings from the two-year longitudinal Maasbed study. International Journal of Geriatric Psychiatry, 20, 523–530.CrossRefGoogle ScholarPubMed
Ballard, C. G. et al. (2001). A 1-year follow-up study of behavioral and psychological symptoms in dementia among people in care environments. Journal of Clinical Psychiatry, 62, 631–636.CrossRefGoogle ScholarPubMed
Chan, D. C., Kasper, J. D., Black, B. S. and Rabins, P. V. (2003). Prevalence and correlates of behavioral and psychiatric symptoms in community-dwelling elders with dementia or mild cognitive impairment: the Memory and Medical Care Study. International Journal of Geriatric Psychiatry, 18, 174–182.CrossRefGoogle ScholarPubMed
Cho, M. J. et al. (1999). Validation of Geriatric Depression Scale, Korean Version (GDS) in the assessment of DSM-III-R major depression. Journal of Korean Neuropsychiatric Association, 38, 48–63.Google Scholar
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D.A. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.CrossRefGoogle ScholarPubMed
Devanand, D. P. et al. (1997). The course of psychopathologic features in mild to moderate Alzheimer disease. Archives of General Psychiatry, 54, 257–263.CrossRefGoogle ScholarPubMed
Edwards, E. R., Spira, A. P., Barnes, D. E. and Yaffe, K. (2009). Neuropsychiatric symptoms in mild cognitive impairment: differences by subtype and progression to dementia. International Journal of Geriatric Psychiatry, 24, 716–722.CrossRefGoogle ScholarPubMed
Feldman, H. et al. (2004). Behavioral symptoms in mild cognitive impairment. Neurology, 62, 1199–1201.CrossRefGoogle ScholarPubMed
Geda, Y. E. et al. (2008). Prevalence of Neuropsychiatric Symptoms in Mild Cognitive Impairment and Normal Cognitive Aging Population-Based Study. Archives of General Psychiatry, 65, 1193–1198.CrossRefGoogle ScholarPubMed
Geslani, D. M., Tierney, M. C., Herrmann, N. and Szalai, J. P. (2005). Mild cognitive impairment: an operational definition and its conversion rate to Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 19, 383–389.CrossRefGoogle ScholarPubMed
Grundman, M. et al. (2004). Mild cognitive impairment can be distinguished from Alzheimer disease and normal aging for clinical trials. Archives of Neurology, 61, 59–66.CrossRefGoogle ScholarPubMed
Haupt, M., Kurz, A. and Jänner, M. (2000). A 2-year follow-up of behavioural and psychological symptoms in Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 11, 147–152.CrossRefGoogle ScholarPubMed
Lee, J. H. et al. (2002). Development of the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K): clinical and neuropsychological assessment batteries. Journal of Gerontology, Series B: Psychological Sciences and Social Sciences, 57, 47–53.CrossRefGoogle Scholar
Lee, K. S., Cho, H. S., Hong, C. H., Kim, D. G. and Oh, B. H. (2008). Differences in Neuropsychiatric Symptoms according to mild cognitive impairment subtypes in the community. Dementia and Geriatric Cognitive Disorders, 26, 212–217.CrossRefGoogle ScholarPubMed
Levy, M. L., Cummings, J. L., Fairbanks, L. A., Bravi, D., Calvani, M. and Carta, A. (1996). Longitudinal assessment of symptoms of depression, agitation, and psychosis in 181 patients with Alzheimer's disease. American Journal of Psychiatry, 153, 1438–1443.Google ScholarPubMed
Logsdon, R. G., Gibbons, L. E., McCurry, S. M. and Teri, L. (1999). Quality of life in Alzheimer's disease: patient and caregiver reports. Journal of Mental Health and Aging, 5, 21–32.Google Scholar
Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J. and DeKosky, S. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the Cardiovascular Health Study. JAMA, 288, 1475–1483.CrossRefGoogle ScholarPubMed
Monastero, R., Mangialasche, F., Camarda, C., Ercolani, S. and Camarda, R. (2009). A systematic review of neuropsychiatric symptoms in mild cognitive impairment. Journal of Alzheimer's Disease, 18, 11–30.CrossRefGoogle ScholarPubMed
Muangpaisan, W., Intalapaporn, S. and Assantachai, P. (2008). Neuropsychiatric symptoms in the community-based patients with mild cognitive impairment and the influence of demographic factors. International Journal of Geriatric Psychiatry, 23, 699–703.CrossRefGoogle ScholarPubMed
Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 183–194.CrossRefGoogle ScholarPubMed
Petersen, R. C., Smith, G.E., Waring, S.C., Ivnik, R. J., Tangalos, E. G. and Kokmen, E. (1999). Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology, 56, 303–308.CrossRefGoogle ScholarPubMed
Petersen, R. C., Stevens, J. C., Ganguli, M., Tangalos, E. G., Cummings, J. L. and DeKosky, S. T. (2001). Practice parameter: early detection of dementia. Mild cognitive impairment: an evidence-based review: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 56, 1133–1142.CrossRefGoogle Scholar
Robert, P. H. et al. (2006). Apathy in patients with mild cognitive impairment and the risk of developing dementia of Alzheimer's disease: a one-year follow-up study. Clinical Neurology and Neurosurgery, 108, 733–736.CrossRefGoogle ScholarPubMed
Rozzini, L. et al. (2008). Neuropsychiatric symptoms in amnestic and nonamnestic mild cognitive impairment. Dementia and Geriatric Cognitive Disorders, 25, 32–36.CrossRefGoogle ScholarPubMed
Ryu, S. H., Katona, C., Rive, B. and Livingston, G. (2005). Persistence of and changes in neuropsychiatric symptoms in Alzheimer's disease over six months – the LASER-AD Study. American Journal of Geriatric Psychiatry, 13, 976–983.Google Scholar
Schneider, L. S. et al. (2001). National Institute of Mental Health Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE): Alzheimer disease trial methodology. American Journal of Geriatric Psychiatry, 9, 346–360.CrossRefGoogle ScholarPubMed
Selbaek, G., Kirkevold, O. and Engedal, K. (2008). The course of psychiatric and behavioral symptoms and the use of psychotropic medication in patients with dementia in Norwegian nursing homes: a 12-month follow-up study. American Journal of Geriatric Psychiatry, 16, 528–536.CrossRefGoogle ScholarPubMed
Steinberg, M. et al. (2004). The persistence of neuropsychiatric symptoms in dementia: the Cache County Study. International Journal of Geriatric Psychiatry, 19, 19–26.CrossRefGoogle ScholarPubMed
Teng, E., Lu, P. H. and Cummings, J. L. (2007). Neuropsychiatric symptoms are associated with progression from mild cognitive impairment to Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 24, 253–259.CrossRefGoogle ScholarPubMed