The DOI matches its Crossref record; 47 of the 47 references it cites were found in a registry or an index.
Neuropsychiatric Symptoms and the Risk of Institutionalization and Death: The Aging, Demographics, and Memory Study
Open accessAbstract
OBJECTIVES: To examine the association between neuropsychiatric symptoms and risk of institutionalization and death. DESIGN: Analysis of longitudinal data. SETTING: The Aging, Demographics, and Memory Study (ADAMS). PARTICIPANTS: Five hundred thirty-seven adults aged 71 and older with cognitive impairment drawn from the Health and Retirement Study (HRS). MEASUREMENTS: Neuropsychiatric symptoms (delusions, hallucinations, agitation, depression, apathy, elation, anxiety, disinhibition, irritation, and aberrant motor behaviors) and caregiver distress were identified using the Neuropsychiatric Inventory. A consensus panel in the ADAMS assigned cognitive category. Date of nursing home placement and information on death, functional limitations, medical comorbidity, and sociodemographic characteristics were obtained from the HRS and ADAMS. RESULTS: Overall, the presence of one or more neuropsychiatric symptoms was not associated with a significantly higher risk for institutionalization or death during the 5-year study period, although when assessing each symptom individually, depression, delusions, and agitation were each associated with a significantly higher risk of institutionalization (hazard rate (HR)=3.06, 95% confidence interval (CI)=1.09-8.59 for depression; HR=5.74, 95% CI=1.94-16.96 for clinically significant delusions; HR=4.70, 95% CI=1.07-20.70 for clinically significant agitation). Caregiver distress mediated the association between delusions and agitation and institutionalization. Depression and hallucinations were associated with significantly higher mortality (HR=1.56, 95% CI=1.08-2.26 for depression; HR=2.59, 95% CI=1.09-6.16 for clinically significant hallucinations). CONCLUSION: Some, but not all, neuropsychiatric symptoms are associated with a higher risk of institutionalization and death in people with cognitive impairment, and caregiver distress also influences institutionalization. Interventions that better target and treat depression, delusions, agitation, and hallucinations, as well as caregiver distress, may help delay or prevent these negative clinical outcomes.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“During the course of their illness, as many as 85% to 90% of patients will experience neuropsychiatric symptoms or problem behaviors, such as noncognitive behavioral symptoms and behavioral and psychological symptoms of dementia (BPSD)”
From The Alzheimer’s Disease Clinical Spectrum (2019) · cites this paper as [53]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders, 5th ed.
Carter, M. J. (2014) · Therapeutic Recreation Journal · Cited by 15,154
The Clinical Dementia Rating (CDR): Current version and scoring rules
Morris, J. C. (1993) · Neurology · doi:10.1212/wnl.43.11.2412-a · Cited by 9,882
The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A., & Gornbein, J. (1994) · Neurology · doi:10.1212/wnl.44.12.2308 · Cited by 7,568
A New Clinical Scale for the Staging of Dementia
Hughes, C. P., Berg, L., Danziger, W., Coben, L. A., & Martin, R. L. (1982) · British Journal of Psychiatry · doi:10.1192/bjp.140.6.566 · Cited by 7,056
Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J., & DeKosky, S. (2002) · JAMA · doi:10.1001/jama.288.12.1475 · Cited by 2,049
Survival Analysis: A Self-Learning Text
Carpenter, M., & Kleinbaum, D. G. (1997) · Technometrics · doi:10.1080/00401706.1997.10485091 · Cited by 1,822
An Overview of the Health and Retirement Study
Juster, F., & Suzman, R. (1995) · The Journal of Human Resources · doi:10.2307/146277 · Cited by 1,476
Lyketsos, C. G., Steinberg, M., Tschanz, J. T., Norton, M. C., Steffens, D. C., & Breitner, J. C. S. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.5.708 · Cited by 1,144
Self-citationPrevalence of Cognitive Impairment without Dementia in the United States
Plassman, B. L., Langa, K. M., Fisher, G. G., Heeringa, S. G., Weir, D. R., Ofstedal, M. B., Burke, J. R., Hurd, M. D., Potter, G. G., Rodgers, W. L., et al. (2008) · Annals of Internal Medicine · doi:10.7326/0003-4819-148-6-200803180-00005 · Cited by 946
Self-citationPatient and Caregiver Characteristics and Nursing Home Placement in Patients With Dementia
Yaffe, K. (2002) · JAMA · doi:10.1001/jama.287.16.2090 · Cited by 903
Survival Analysis: A Self-Learning Text
Carpenter, M., & Kleinbaum, D. G. (1997) · Technometrics · doi:10.2307/1270914 · Cited by 812
Psychiatric symptoms and nursing home placement of patients with Alzheimer's disease
(1990) · American Journal of Psychiatry · doi:10.1176/ajp.147.8.1049 · Cited by 744
Clinical Dementia Rating (CDR)
Gauthier, S. G. (2001) · CRC Press eBooks · doi:10.3109/9780203213896-34 · Cited by 696
Kaufer, D., Cummings, J. L., Christine, D., Bray, T., Castellon, S., Masterman, D. L., MacMillan, A., Ketchel, P., & DeKosky, S. T. (1998) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1998.tb02542.x · Cited by 607
Survival after Initial Diagnosis of Alzheimer Disease
Larson, E. B., Shadlen, M., Wang, L., McCormick, W. C., Bowen, J. D., Teri, L. L., & Kukull, W. A. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-140-7-200404060-00008 · Cited by 562
Prevalence of Neuropsychiatric Symptoms in Mild Cognitive Impairment and Normal Cognitive Aging
Geda, Y. E., Roberts, R. O., Knopman, D. S., Petersen, R. C., Christianson, T. J. H., Pankratz, V. S., Smith, G. E., Boeve, B. F., Ivnik, R. J., Tangalos, E. G., et al. (2008) · Archives of General Psychiatry · doi:10.1001/archpsyc.65.10.1193 · Cited by 460
The Aging, Demographics, and Memory Study: Study Design and Methods
Langa, K. M., Plassman, B. L., Wallace, R. B., Herzog, A. R., Heeringa, S. G., Ofstedal, M. B., Burke, J. R., Fisher, G. G., Fultz, N. H., Hurd, M. D., et al. (2005) · Neuroepidemiology · doi:10.1159/000087448 · Cited by 415
Self-citationPredicting Time to Nursing Home Care and Death in Individuals With Alzheimer Disease
Stern, Y. (1997) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1997.03540340040030 · Cited by 359
Kleinbaum, D. G. (1996) · Springer eBooks · doi:10.1007/978-1-4757-2555-1 · Cited by 351
Delusions and Hallucinations Are Associated With Worse Outcome in Alzheimer Disease
Scarmeas, N., Brandt, J., Albert, M., Hadjigeorgiou, G. M., Papadimitriou, A., Dubois, B., Sarazin, M., Devanand, D. P., Honig, L. S., Marder, K. S., et al. (2005) · Archives of Neurology · doi:10.1001/archneur.62.10.1601 · Cited by 350
Major and minor depression in Alzheimer's disease: prevalence and impact
Lyketsos, C. G., Steele, C., Baker, L., Galik, E. M., Kopunek, S., Steinberg, M., & Warren, A. (1997) · Journal of Neuropsychiatry · doi:10.1176/jnp.9.4.556 · Cited by 321
Schnaider Beeri, M., Werner, P., Davidson, M., & Noy, S. (2002) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.490 · Cited by 284
Premature Death Associated With Delirium at 1-Year Follow-up
LESLIE, D. L., Zhang, Y., Holford, T. R., Bogardus, S. T., Leo-Summers, L. S., & Inouye, S. K. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.14.1657 · Cited by 247
Survival and mortality differences between dementia with Lewy bodies vs Alzheimer disease
Williams, M. M., Xiong, C., Morris, J. C., & Galvin, J. E. (2006) · Neurology · doi:10.1212/01.wnl.0000247041.63081.98 · Cited by 239
Informal Costs of Dementia Care: Estimates From the National Longitudinal Caregiver Study
Moore, M. J., Zhu, C., & Clipp, E. C. (2001) · The Journals of Gerontology Series B · doi:10.1093/geronb/56.4.s219 · Cited by 237
The contribution of neuropsychiatric symptoms to the cost of dementia care
Herrmann, N., Lanctôt, K. L., Sambrook, R., Lesnikova, N., Hébert, R., McCracken, P., Robillard, A., & Nguyen, E. H. L. (2006) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.1594 · Cited by 232
Persistent Delirium Predicts Greater Mortality
Kiely, D. K., Marcantonio, E. R., Inouye, S. K., Shaffer, M. L., Bergmann, M. A., Yang, F. M., Fearing, M. A., & Jones, R. N. (2008) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2008.02092.x · Cited by 231
Determinants of costs of care for patients with Alzheimer's disease
Jönsson, L., Eriksdotter, M., Kilander, L., Soininen, H. S., Hallikainen, M., Waldemar, G., Nygaard, H. A., Andreasen, N., Winblad, B. G., & Wimo, A. B. (2006) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.1489 · Cited by 225
Okura, T., Plassman, B. L., Steffens, D. C., Llewellyn, D. J., Potter, G. G., & Langa, K. M. (2010) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2009.02680.x · Cited by 222
Self-citationClinical and neuropathological correlates of depression in Alzheimer's disease
Förstl, H., Burns, A. S., Luthert, P. J., Cairns, N. J., Lantos, P. L., & Levy, R. (1992) · Psychological Medicine · doi:10.1017/s0033291700038459 · Cited by 208
Schneider, L. S. S., Tariot, P. N., Lyketsos, C. G., Dagerman, K., Davis, K. L., Thomas, S., Hsiao, J., Jeste, D. V., Katz, I. R., Olin, J. T., et al. (2001) · American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200111000-00004 · Cited by 208
Disruptive Behavior as a Predictor in Alzheimer Disease
Scarmeas, N., Brandt, J., Blacker, D., Albert, M., Hadjigeorgiou, G. M., Dubois, B., Devanand, D. P., Honig, L. S., & Stern, Y. (2007) · Archives of Neurology · doi:10.1001/archneur.64.12.1755 · Cited by 171
A SPECT study of delusions in Alzheimer's disease
STARKSTEIN, S. E., Vázquez, S., Petracca, G., Sabe, L., Migliorelli, R., Tesón, A., & Leiguarda, R. C. (1994) · Neurology · doi:10.1212/wnl.44.11.2055 · Cited by 123
Predicting Nursing Home Admission
Banaszak‐Holl, J., Fendrick, A. M., Foster, N. L., Herzog, A. R., Kabeto, M. U., Kent, D. M., Straus, W. L., & Langa, K. M. (2004) · Alzheimer Disease & Associated Disorders · doi:10.1097/01.wad.0000126619.80941.91 · Cited by 122
Self-citationMehta, K. M., Yaffe, K. S., Langa, K. M., Sands, L. P., Whooley, M. A., & Covinsky, K. E. (2003) · The Journals of Gerontology Series A · doi:10.1093/gerona/58.5.m461 · Cited by 120
Self-citationWandering: A Significant Problem among Community Residing Individuals with Alzheimer's Disease
Logsdon, R. G., Teri, L. L., McCurry, S. M., Gibbons, L. E., Kukull, W. A., & Larson, E. B. (1998) · The Journals of Gerontology Series B · doi:10.1093/geronb/53b.5.p294 · Cited by 109
Health Care Proxy Grief Symptoms Before the Death of Nursing Home Residents With Advanced Dementia
Kiely, D. K., Prigerson, H. G., & Mitchell, S. L. (2008) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181784143 · Cited by 95
Cognitive Impairment and Depression Predict Mortality in Medically Ill Older Adults
Arfken, C. L., Lichtenberg, P. A., & Tancer, M. E. (1999) · The Journals of Gerontology Series A · doi:10.1093/gerona/54.3.m152 · Cited by 86
Failure To Thrive in Older Adults
Still, C. D., Apovian, C. M., & Jensen, G. L. (1997) · Annals of Internal Medicine · doi:10.7326/0003-4819-126-8-199704150-00035 · Cited by 72
“Failure To Thrive” in Older Adults
Sarkisian, C. A., & Lachs, M. S. (1996) · Annals of Internal Medicine · doi:10.7326/0003-4819-124-12-199606150-00008 · Cited by 71
Prevalence and clinical correlates of neuropsychiatric symptoms in dementia
Steffens, D. C., Maytan, M., Helms, M. J., & Plassman, B. L. (2005) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/153331750502000611 · Cited by 65
Self-citationPredicting time to nursing home care and death in individuals with Alzheimer disease
Stern, Y. (1997) · JAMA · doi:10.1001/jama.277.10.806 · Cited by 46
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A., & Gornbein, J. (1994) · PsycTESTS Dataset · doi:10.1037/t28621-000 · Cited by 35
Cognitive Predictors of Mortality in Elderly Retirees: Results From the Freedom House Study
Royall, D. R., Chiodo, L. K., Mouton, C. P., & Polk, M. J. (2007) · American Journal of Geriatric Psychiatry · doi:10.1097/01.jgp.0000240824.84867.02 · Cited by 23
Informal Costs of Dementia Care
Moore, M. J., Zhu, C. W., & Clipp, E. C. (2001) · Cited by 14
Royall, D. R., Palmer, R. F., Chiodo, L. K., Polk, M. J., Markides, K. S., & Hazuda, H. P. (2008) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.1990 · Cited by 11
Gonzalez-Salvador (1999) · doi:10.1002/(sici)1099-1166(199909)14:9
Research works printed but not linked: 4
- OfstedalMB FisherG HerzogAR. Documentation of cognitive functioning measures in the Health and Retirement Study. Ann Arbor MI: University of Michigan; 2005. [on‐line]. Available athttp://www.hrsonline.isr.umich.edu/docs/userg/dr‐006.pdfAccessed December 12 2008. · DOI
- HeeringaSG FisherGG HurdMDet al. Aging Demographics And Memory Study (ADAMS). Sample design weighting and analysis for ADAMS. 2009. [on‐line]. Available athttp://www.hrsonline.isr.umich.edu/sitedocs/userg/ADAMSSampleWeights_Jun2009.pdfAccessed August 29 2009. · DOI
- American Psychiatric Association, 1987, Diagnostic and Statistical Manual of Mental Disorders, 3rd Ed. Revised
- Schneider LS, 2001, NIMH‐CATIE, Alzheimer's disease clinical trial methodology, 9, 346
Cited by
Sorted by citations
2012 Alzheimer's disease facts and figures Alzheimer's Association ∗
Thies, W. H., & Bleiler, L. (2012) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2012.02.001 · Cited by 1,014
The Alzheimer’s Disease Clinical Spectrum
Atri, A. (2019) · Medical Clinics of North America · doi:10.1016/j.mcna.2018.10.009 · Cited by 623
“such as noncognitive behavioral symptoms and behavioral and psychological symptoms of dementia (BPSD), which are associated with more rapid decline, earlier institutionalization, higher distress, worse quality of life, and greater health care utilization and costs.(53,54) Treatment of BPSD using pharmacology alone has…”
Maust, D. T., Kim, H. M., Seyfried, L. S., Chiang, C., Kavanagh, J., Schneider, L. S., & Kales, H. C. (2015) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2014.3018 · Cited by 617
Nonpharmacologic Management of Behavioral Symptoms in Dementia
Gitlin, L. N., Kales, H. C., & Lyketsos, C. G. (2012) · JAMA · doi:10.1001/jama.2012.36918 · Cited by 495
Cummings, J. L., Mintzer, J. E., Brodaty, H., Sano, M. C., Banerjee, S., Devanand, D. P., Gauthier, S. G., Howard, R. J., Lanctôt, K. L., Lyketsos, C. G., et al. (2014) · International Psychogeriatrics · doi:10.1017/s1041610214001963 · Cited by 364
Self-citation
Metadata
- Authors
- Okura, T., Plassman, B. L., Steffens, D. C., Llewellyn, D. J., Potter, G. G., & Langa, K. M.
- Affiliations
- Duke Medical Center (US)
- University of Exeter (GB)
- United States Department of Veterans Affairs (US)
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2011-03
- Volume
- 59
- Issue
- 3
- Pages
- 473-481
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC3088883
- OpenAlex
- W1584246255
- Cited by
- 174
- References
- 47
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 13 · 2023: 7 · 2022: 17 · 2021: 12 · 2020: 16 · 2019: 17 · 2018: 10 · 2017: 14 · 2016: 10 · 2015: 11 · 2014: 12 · 2013: 9 · 2012: 6
- FWCI
- 6.35
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- National Institute on Aging (U01 AG 09740, R01AG030155, U01AG009740, R01AG027010)
- National Institute of Mental Health (K23MH087741)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- neuropsychiatric symptoms, institutionalization, nursing home admission, mortality, cognitive impairment, delusions, hallucinations, agitation, depression, caregiver distress, older adults, functional limitations, comorbidities
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Behavioral Symptoms, Cognition Disorders, Female, Humans, Institutionalization, Male, Neuropsychological Tests, Proportional Hazards Models, Caregivers
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
