Differentiating traits and states identifies the importance of chronic neuropsychiatric symptoms for cognitive prognosis in mild dementia
Abstract Introduction Neuropsychiatric symptoms (NPS) in dementia are associated with poor cognitive outcomes in longitudinal studies. Whether this is due to differences in symptom burden between persons (BP) or changes within persons (WP) is unknown. Methods Patients with mild Alzheimer's dise...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/dad2.12152 |
| _version_ | 1828085273436618752 |
|---|---|
| author | Lasse M. Giil Dag Aarsland Audun Osland Vik‐Mo |
| author_facet | Lasse M. Giil Dag Aarsland Audun Osland Vik‐Mo |
| author_sort | Lasse M. Giil |
| collection | DOAJ |
| description | Abstract Introduction Neuropsychiatric symptoms (NPS) in dementia are associated with poor cognitive outcomes in longitudinal studies. Whether this is due to differences in symptom burden between persons (BP) or changes within persons (WP) is unknown. Methods Patients with mild Alzheimer's disease (AD, n = 111) and Lewy‐body dementia (LBD, n = 85) were assessed annually for 8 years. We modelled the association between NPS assessed by the Neuropsychiatric Inventory (NPI) and Mini‐Mental State Examinations (MMSE) using Tobit mixed‐effects model with NPS as individual means over time (BP) and its deviance (WP). Results The association between higher NPS and poorer cognitive outcomes was mostly due to BP differences for the NPI‐total score, and in particular for delusions, hallucinations, agitation, aberrant motor behavior, and apathy scores. Discussion The NPS trait (BP) effect on cognitive decline is considerably stronger than the state effect (WP). Clinically, long‐term rather than episodic NPS better identifies patients with poor cognitive outcomes. |
| first_indexed | 2024-04-11T04:37:30Z |
| format | Article |
| id | doaj.art-f85fbbd25d07400b85118a79e89d7e92 |
| institution | Directory Open Access Journal |
| issn | 2352-8729 |
| language | English |
| last_indexed | 2024-04-11T04:37:30Z |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring |
| spelling | doaj.art-f85fbbd25d07400b85118a79e89d7e922022-12-28T09:12:14ZengWileyAlzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring2352-87292021-01-01131n/an/a10.1002/dad2.12152Differentiating traits and states identifies the importance of chronic neuropsychiatric symptoms for cognitive prognosis in mild dementiaLasse M. Giil0Dag Aarsland1Audun Osland Vik‐Mo2Department of Internal Medicine Haraldsplass Deaconess Hospital Bergen NorwayDepartment of Old Age Psychiatry Institute of Psychiatry Psychology and Neuroscience Kings College London UKCentre for Age‐Related Diseases (SESAM) Stavanger University Hospital Stavanger NorwayAbstract Introduction Neuropsychiatric symptoms (NPS) in dementia are associated with poor cognitive outcomes in longitudinal studies. Whether this is due to differences in symptom burden between persons (BP) or changes within persons (WP) is unknown. Methods Patients with mild Alzheimer's disease (AD, n = 111) and Lewy‐body dementia (LBD, n = 85) were assessed annually for 8 years. We modelled the association between NPS assessed by the Neuropsychiatric Inventory (NPI) and Mini‐Mental State Examinations (MMSE) using Tobit mixed‐effects model with NPS as individual means over time (BP) and its deviance (WP). Results The association between higher NPS and poorer cognitive outcomes was mostly due to BP differences for the NPI‐total score, and in particular for delusions, hallucinations, agitation, aberrant motor behavior, and apathy scores. Discussion The NPS trait (BP) effect on cognitive decline is considerably stronger than the state effect (WP). Clinically, long‐term rather than episodic NPS better identifies patients with poor cognitive outcomes.https://doi.org/10.1002/dad2.12152Alzheimer's diseaseapathybehavioral disturbancesbetween‐personchroniccognitive decline |
| spellingShingle | Lasse M. Giil Dag Aarsland Audun Osland Vik‐Mo Differentiating traits and states identifies the importance of chronic neuropsychiatric symptoms for cognitive prognosis in mild dementia Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring Alzheimer's disease apathy behavioral disturbances between‐person chronic cognitive decline |
| title | Differentiating traits and states identifies the importance of chronic neuropsychiatric symptoms for cognitive prognosis in mild dementia |
| title_full | Differentiating traits and states identifies the importance of chronic neuropsychiatric symptoms for cognitive prognosis in mild dementia |
| title_fullStr | Differentiating traits and states identifies the importance of chronic neuropsychiatric symptoms for cognitive prognosis in mild dementia |
| title_full_unstemmed | Differentiating traits and states identifies the importance of chronic neuropsychiatric symptoms for cognitive prognosis in mild dementia |
| title_short | Differentiating traits and states identifies the importance of chronic neuropsychiatric symptoms for cognitive prognosis in mild dementia |
| title_sort | differentiating traits and states identifies the importance of chronic neuropsychiatric symptoms for cognitive prognosis in mild dementia |
| topic | Alzheimer's disease apathy behavioral disturbances between‐person chronic cognitive decline |
| url | https://doi.org/10.1002/dad2.12152 |
| work_keys_str_mv | AT lassemgiil differentiatingtraitsandstatesidentifiestheimportanceofchronicneuropsychiatricsymptomsforcognitiveprognosisinmilddementia AT dagaarsland differentiatingtraitsandstatesidentifiestheimportanceofchronicneuropsychiatricsymptomsforcognitiveprognosisinmilddementia AT audunoslandvikmo differentiatingtraitsandstatesidentifiestheimportanceofchronicneuropsychiatricsymptomsforcognitiveprognosisinmilddementia |