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Cited by 167Dementia and Cognitive Impairment ResearchCancer-related cognitive impairment studiesAlzheimer's disease research and treatments

Neuropsychiatric symptoms as risk factors for progression from CIND to dementia: the Cache County Study

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Peters, M.E., Rosenberg, P.B., Steinberg, M., Norton, M.C., Welsh-Bohmer, K.A., Hayden, K.M., Breitner, J., Tschanz, J.T. +1 more·2013·The American Journal of Geriatric Psychiatry
DOI 10.1016/j.jagp.2013.01.049PMC PMC3525756
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Abstract

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 ε4 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.

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  • These behavioral changes are associated with increased risk of dementia and AD, suggesting that they contribute to AD pathogenesis.

    “These behavioral changes are associated with increased risk of dementia and AD,13,14 suggesting that they contribute to AD pathogenesis.13,14”

    From Machine learning reveals prominent spontaneous behavioral changes and treatment efficacy in humanized and transgenic Alzheimer's disease models (2024) · cites this paper as [14]

    The Results (page unavailable) associate neuropsychiatric symptoms with progression from CIND to all-cause dementia and identify nighttime behaviors as a risk factor for AD. The Discussion (page unavailable) describes these symptoms as predictors, but does not establish that they contribute to AD pathogenesis; the aMCI subgroup also showed no significant neuropsychiatric-symptom risk factors for dementia or AD. (LLM, conf=0.88)

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  • During the extended preclinical period prior to dementia diagnosis, many patients develop behavioral or neuropsychiatric changes, including agitation, irritability, decreased motivation, loss of empathy, and depression, which increase the risk of transition to mild cognitive impairment and AD.

    “During this extended preclinical period prior to the dementia diagnosis, many patients develop behavioral or neuropsychiatric changes, including agitation, irritability, decreased motivation, loss of empathy, and depression, which increase the risk of transition to mild cognitive impairment and AD.12-14”

    From Machine learning reveals prominent spontaneous behavioral changes and treatment efficacy in humanized and transgenic Alzheimer's disease models (2024) · cites this paper as [14]

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  • These behavioral changes may be the earliest symptoms of preclinical stages of AD.

    “Thus, these behavioral changes may be the earliest symptoms of preclinical stages of AD.13,14”

    From Machine learning reveals prominent spontaneous behavioral changes and treatment efficacy in humanized and transgenic Alzheimer's disease models (2024) · cites this paper as [14]

    The Discussion (page unavailable) reports that neuropsychiatric symptoms, even at low severity, increased the risk of progression from cognitive impairment without dementia (CIND) to dementia. The Results (page unavailable) specifically identify nighttime behaviors as a risk factor for progression to AD. The paper does not establish that behavioral changes are the earliest symptoms of preclinical AD; its participants already had cognitive impairment. (LLM, conf=0.82)

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Research works printed but not linked: 29

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Authors
Peters, M. E., Rosenberg, P. B., Steinberg, M., Norton, M. C., Welsh-Bohmer, K. A., Hayden, K. M., Breitner, J., Tschanz, J. T., & Lyketsos, C. G.
Affiliations
  • Johns Hopkins University (US)
  • Utah State University (US)
  • Duke University (US)
  • University of Washington (US)
ORCID
Venue
The American Journal of Geriatric Psychiatry
Publisher
Elsevier BV
Published
2013-11
Volume
21
Issue
11
Pages
1116-1124
ISSN
1064-7481 (ISSN-L)
DOI
10.1016/j.jagp.2013.01.049
PMC
PMC3525756
OpenAlex
W2080575732
Cited by
167
References
2
Citations by year
2026: 5 · 2025: 14 · 2024: 17 · 2023: 13 · 2022: 11 · 2021: 16 · 2020: 20 · 2019: 13 · 2018: 12 · 2017: 11 · 2016: 5 · 2015: 14 · 2014: 5 · 2013: 11
FWCI
8.30
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Geriatric Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Aging (R01 AG 11380, P30AG028377, R01AG011380, AG028377, R01AG021136, P50AG005146, R01 AG 21136)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
Keywords
neuropsychiatric symptoms, conversion to dementia, cognitive impairment without dementia, Alzheimer's disease, vascular dementia, all-cause dementia, risk factors, nocturnal activity, hallucinations, APOE ε4, Mini-Mental State Examination, Clinical Dementia Rating, Neuropsychiatric Inventory
MeSH terms
Aged, 80 and over, Alzheimer Disease, Mental Disorders, Cognition Disorders, Dementia, Female, Humans, Male, Neuropsychological Tests, Psychiatric Status Rating Scales, Risk Factors, Models, Statistical, Disease Progression

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