Neurology: Identifying late-onset neuropsychiatric symptoms in elderly patients may benefit clinical outcomes!

The global prevalence of dementia is projected to more than triple by 2050
.

Given that neurodegeneration in people who later develop dementia occurs as early as 20 years before cognitive symptoms appear, the current research focus is shifting to biomarkers for early detection and treatment

The global prevalence of dementia is projected to more than triple by 2050

Mild cognitive impairment (MCI) is a pre-dementia risk factor that manifests as a transitional state of objective cognitive impairment but remains functionally independent

Neuropsychiatric symptoms (NPS) in the elderly are associated with cognitive decline in NC and MCI populations

One possibility is that incorporating NPS into the case finding of non-dementia populations may improve the specificity of MCI

MCI patients included in the unified dataset of the National Alzheimer's Disease Coordinating Center
.

Neuropsychiatric symptoms were manipulated with the Neuropsychiatry Questionnaire (NPI-Q) to identify participants without NPS and those with MBI (persistent, late-onset NPS)

MCI patients included in the unified dataset of the National Alzheimer's Disease Coordinating Center

• The original sample consisted of 739 cases (NPS-n=409 cases, MBI+n=330 cases; age 75.
  16±8.
  6 years, female 40.
  5%)
  .
  
• After 3 years, 238 participants (33.
  6%) developed dementia and 90 (12.
  2%) returned to normal controls
  .
  
• Compared with participants without NPS, participants with MBI were more likely to progress to dementia (adjusted odds ratio [AOR] = 2.
  13, 95% CI 1.
  52-2.
  99), with an annual progression rate of 14.
  7% ( 8.
  3% of MCI participants without NPS)
  .
  
• MBI participants were less likely to revert to NC than participants without NPS (AOR=0.
  48, 95% CI 0.
  28-0.
  83, 2.
  5% vs 5.
  3%)
  .
  
• NPS_NOT_MBI group (n=331, 76.
  5±8.
  6 years, female 45.
  9%) was more likely to progress to dementia than non-NPS group (AOR=2.
  18, 95%CI 1.
  56-3.
  03, annual progression rate 14.
  3%), but recovered to NC Likelihood is not lower than the no-NPS group
  .
  
• After 3 years, both NPS_NOT_MBI and MBI+ participants had lower MMSE scores than NPS participants
  .
  

The original sample consisted of 739 cases (NPS-n=409 cases, MBI+n=330 cases; age 75.
16±8.
6 years, female 40.
5%)
.

The original sample consisted of 739 cases (NPS-n=409 cases, MBI+n=330 cases; age 75.
16±8.
6 years, female 40.
5%)
.

After 3 years, 238 participants (33.

Late-onset NPS improves the specificity of MCI as a high-risk state for progression to dementia

Source: McGirr A, Nathan S, Ghahremani M, Gill S, Smith E, Ismail Z.
Progression to Dementia or Reversion to Normal Cognition in Mild Cognitive Impairment as a Function of Late Onset Neuropsychiatric Symptoms [published online ahead of print, 2022 Mar 29].
Neurology.
2022;10.
1212/WNL.
0000000000200472.
doi:10.
1212/WNL.
0000000000200256 McGirr A, Nathan S, Ghahremani M, Gill S, Smith E, Ismail Z.
Progression to Dementia or Reversion to Normal Cognition in Mild Cognitive Impairment as a Function of Late Onset Neuropsychiatric Symptoms [published online ahead of print, 2022 Mar 29].
Neurology.
2022;10.
1212/WNL.
0000000000200472.
doi:10.
1212/WNL.
0000000000200256 Leave a comment here