Premium
P2‐096: Mild behavioral impairment associated to higher prevalence of dementia in community‐dwelling elderly subjects
Author(s) -
Barcelos-Ferreira Ricardo,
Folquitto Jefferson Cunha,
Santos Tascone Lyssandra Dos,
Campos Bottino Cassio M.
Publication year - 2015
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2015.06.633
Subject(s) - apathy , dementia , irritability , psychiatry , disinhibition , depression (economics) , anxiety , medicine , psychology , clinical psychology , disease , cognition , economics , macroeconomics
Background:Neuropsychiatric Symptoms (NPS) are common in dementia and in pre-dementia syndromes such as Mild Cognitive Impairment (MCI). Mild Behavioral Impairment (MBI) has been proposed as a diagnostic construct aimed to identify early, patients with an increased risk of developing dementia, but who may or may not have manifested cognitive symptoms. Apathy, depression, anxiety, disinhibition, agitation, irritability, delusion and hallucination are common NPS that could define a syndrome comparable to MCI of new onset psychiatric and behavioural changes that are early symptoms of neurodegenerative disease, like Alzheimer’s. Methods: A cross-sectional study of a randomized community-based sample of 1,563 elderly subjects aged 60 years or older was performed. Instruments applied: CambridgeMental Disorders of the Elderly Examination (CAMDEX), Neuropsychiatric Inventory (NPI) and a socio-economic questionnaire. Instruments were applied to the subjects at home (phase I). The dementia and MCI diagnosis were made at hospital in a second wave (phase II) according to DSM-IV criteria. The diagnosis of MBI was based on the presence of any of the NPS and on the absence of dementia. Results: The prevalence of MCI was 5.8% (95% CI; 3,2%-7.6%) and 16% (95% CI; 14%-17.6%) were diagnosed with dementia. 589 subjects were evaluated in the phase II. The investigated NPS were delusion (13.7%), disinhibition (15.7%), irritability (23.5%), agitation (17.6%), hallucination (7.8%), depression (35.3%), anxiety (41.2%), and apathy (39.2%). The initial multivariate analysis indicated sociodemographic factors associated to MCI and dementia. After adjusting for all the variables, the multivariate analysis showed an association of age group 80-84 (OR1⁄41.2; p1⁄40.03); delusion (OR1⁄45.7; p<0.001); and disinhibition (OR1⁄43.4; p<0.001) with higher rates of dementia, compared to MCI. There was no association with irritability, anxiety, depression, gender, socioeconomic class, marital status and educational level. Conclusions: In our sample, the presence of MBI in elderly subjects was related to greater risk of having dementia. On the other hand, apathy, depression, anxiety and hallucination were probably less harmful for cognitive function. Our findings suggest that NPS associated with MBI could confer higher risk of dementia onset, and should be investigated in older patients with MCI.