Association Between Neuropsychiatric Symptom Trajectory and Conversion to Alzheimer Disease.

Autor:	Lo TWB; Faculty of Psychology, University of Toronto Scarborough, Scarborough.; Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute., Karameh WK; Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute.; Department of Psychiatry, Faculty of Medicine, University of Toronto.; Centre for Addiction and Mental Health, Toronto, ON, Canada., Barfett JJ; Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute.; Department of Medical Imaging., Fornazzari LR; Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute., Munoz DG; Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute.; Division of Pathology.; Department of Laboratory Medicine and Pathobiology., Schweizer TA; Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute.; Division of Neurosurgery, St. Michael's Hospital.; Institute of Medical Sciences.; Institute of Biomaterials and Biomedical Engineering.; Department of Surgery, Division of Neurosurgery., Fischer CE; Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute.; Institute of Medical Sciences.; Department of Psychiatry, Faculty of Medicine, University of Toronto.
Jazyk:	angličtina
Zdroj:	Alzheimer disease and associated disorders [Alzheimer Dis Assoc Disord] 2020 Apr-Jun; Vol. 34 (2), pp. 141-147.
DOI:	10.1097/WAD.0000000000000356
Abstrakt:	Introduction: Neuropsychiatric symptoms (NPS) are both common in mild cognitive impairment and Alzheimer disease (AD). Studies have shown that some NPS such as apathy and depression are a key indicator for progression to AD. Methods: We compared Neuropsychiatric Inventory (NPI) total score and NPI subdomain score between mild cognitive impairment-converters (MCI-C) and mild cognitive impairment-nonconverters (MCI-NC) longitudinally for 6 years using the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. In addition to the NPI, Mini-Mental State Examination (MMSE) scores were also compared to find out if MMSE scores would differ between different NPI groups. Lastly, a linear regression model was done on MMSE and NPI total score to establish a relationship between MMSE and NPI total score. Results: The results in this study showed that NPI total scores between MCI-C and MCI-NC differed significantly throughout 6 years. MCI-C subjects had a higher mean NPI total score and lower MMSE score compared with MCI-NC subjects. In addition, MMSE scores were significantly different between the 3 groups of NPI total score. Subjects who have a high NPI score have the lowest mean MMSE score, thus demonstrating that NPI scores do indeed affect MMSE scores. Further analyses using a regression model revealed that a unit change in NPI total score lead to 0.1 to 0.3 decrease in MMSE. Discussion: On the basis of the findings, this study showed evidence that increase in NPS burden (reflected by increase in NPI) over time predicts conversion to AD, whereas stability of symptoms (reflected by stable NPI score) favors nonconversion. Further study should investigate the underlying mechanisms that drive both NPS burden and cognitive decline.
Databáze:	MEDLINE
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