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Neuropsychiatric symptoms and the outcome of cognitive trajectories in older adults free of dementia: The Mayo Clinic Study of Aging

OBJECTIVE: Neuropsychiatric symptoms (NPS) are associated with the risk of incident mild cognitive impairment (MCI) and dementia. We examined associations between NPS and the outcomes of global and domain‐specific cognitive trajectories. METHODS: In this longitudinal study conducted in the setting o...

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Autores principales: Krell‐Roesch, Janina, Syrjanen, Jeremy A., Machulda, Mary M., Christianson, Teresa J., Kremers, Walter K., Mielke, Michelle M., Knopman, David S., Petersen, Ronald C., Vassilaki, Maria, Geda, Yonas E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8451750/
https://www.ncbi.nlm.nih.gov/pubmed/33724517
http://dx.doi.org/10.1002/gps.5528
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author Krell‐Roesch, Janina
Syrjanen, Jeremy A.
Machulda, Mary M.
Christianson, Teresa J.
Kremers, Walter K.
Mielke, Michelle M.
Knopman, David S.
Petersen, Ronald C.
Vassilaki, Maria
Geda, Yonas E.
author_facet Krell‐Roesch, Janina
Syrjanen, Jeremy A.
Machulda, Mary M.
Christianson, Teresa J.
Kremers, Walter K.
Mielke, Michelle M.
Knopman, David S.
Petersen, Ronald C.
Vassilaki, Maria
Geda, Yonas E.
author_sort Krell‐Roesch, Janina
collection PubMed
description OBJECTIVE: Neuropsychiatric symptoms (NPS) are associated with the risk of incident mild cognitive impairment (MCI) and dementia. We examined associations between NPS and the outcomes of global and domain‐specific cognitive trajectories. METHODS: In this longitudinal study conducted in the setting of the population‐based Mayo Clinic Study of Aging, 5081 community‐dwelling, nondemented individuals aged ≥50 years (51% males) underwent NPS assessment using Neuropsychiatric Inventory Questionnaire (NPI‐Q), and Beck Depression and Anxiety Inventories (BDI‐II, BAI). Global and domain‐specific (memory, language, attention, and visuospatial skills) cognitive performance was assessed through neuropsychological testing every 15 months. Associations between baseline NPS and trajectories for individual yearly change in cognitive z‐scores were calculated using linear mixed‐effect models. RESULTS: Cognition declined regardless of NPS status over the median follow‐up of 4.5 years. Presence of NPS was associated with increased cognitive decline. Differences in annualized change in global cognition z‐scores for participants with NPS compared to without NPS ranged from −0.018 (95% CI −0.032, −0.004; p = 0.011) for irritability to −0.159 (−0.254, −0.065; p = 0.001) for hallucinations. Associations between NPS and annual decline in global cognition were significant for most NPI‐Q‐assessed NPS and clinical depression (BDI‐II≥13). Participants with NPI‐Q‐assessed depression, apathy, nighttime behavior, and clinical depression had greater decline in all domain‐specific z‐scores; presence of delusions and anxiety was associated with more pronounced decline in language, attention and visuospatial skills. CONCLUSION: NPS were associated with a more accelerated cognitive decline. Clinical assessment and potential treatment of NPS is warranted even in a community setting as NPS may impact cognitive decline in nondemented individuals.
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spelling pubmed-84517502021-09-27 Neuropsychiatric symptoms and the outcome of cognitive trajectories in older adults free of dementia: The Mayo Clinic Study of Aging Krell‐Roesch, Janina Syrjanen, Jeremy A. Machulda, Mary M. Christianson, Teresa J. Kremers, Walter K. Mielke, Michelle M. Knopman, David S. Petersen, Ronald C. Vassilaki, Maria Geda, Yonas E. Int J Geriatr Psychiatry Research Articles OBJECTIVE: Neuropsychiatric symptoms (NPS) are associated with the risk of incident mild cognitive impairment (MCI) and dementia. We examined associations between NPS and the outcomes of global and domain‐specific cognitive trajectories. METHODS: In this longitudinal study conducted in the setting of the population‐based Mayo Clinic Study of Aging, 5081 community‐dwelling, nondemented individuals aged ≥50 years (51% males) underwent NPS assessment using Neuropsychiatric Inventory Questionnaire (NPI‐Q), and Beck Depression and Anxiety Inventories (BDI‐II, BAI). Global and domain‐specific (memory, language, attention, and visuospatial skills) cognitive performance was assessed through neuropsychological testing every 15 months. Associations between baseline NPS and trajectories for individual yearly change in cognitive z‐scores were calculated using linear mixed‐effect models. RESULTS: Cognition declined regardless of NPS status over the median follow‐up of 4.5 years. Presence of NPS was associated with increased cognitive decline. Differences in annualized change in global cognition z‐scores for participants with NPS compared to without NPS ranged from −0.018 (95% CI −0.032, −0.004; p = 0.011) for irritability to −0.159 (−0.254, −0.065; p = 0.001) for hallucinations. Associations between NPS and annual decline in global cognition were significant for most NPI‐Q‐assessed NPS and clinical depression (BDI‐II≥13). Participants with NPI‐Q‐assessed depression, apathy, nighttime behavior, and clinical depression had greater decline in all domain‐specific z‐scores; presence of delusions and anxiety was associated with more pronounced decline in language, attention and visuospatial skills. CONCLUSION: NPS were associated with a more accelerated cognitive decline. Clinical assessment and potential treatment of NPS is warranted even in a community setting as NPS may impact cognitive decline in nondemented individuals. John Wiley and Sons Inc. 2021-03-24 2021-09 /pmc/articles/PMC8451750/ /pubmed/33724517 http://dx.doi.org/10.1002/gps.5528 Text en © 2021 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Research Articles
Krell‐Roesch, Janina
Syrjanen, Jeremy A.
Machulda, Mary M.
Christianson, Teresa J.
Kremers, Walter K.
Mielke, Michelle M.
Knopman, David S.
Petersen, Ronald C.
Vassilaki, Maria
Geda, Yonas E.
Neuropsychiatric symptoms and the outcome of cognitive trajectories in older adults free of dementia: The Mayo Clinic Study of Aging
title Neuropsychiatric symptoms and the outcome of cognitive trajectories in older adults free of dementia: The Mayo Clinic Study of Aging
title_full Neuropsychiatric symptoms and the outcome of cognitive trajectories in older adults free of dementia: The Mayo Clinic Study of Aging
title_fullStr Neuropsychiatric symptoms and the outcome of cognitive trajectories in older adults free of dementia: The Mayo Clinic Study of Aging
title_full_unstemmed Neuropsychiatric symptoms and the outcome of cognitive trajectories in older adults free of dementia: The Mayo Clinic Study of Aging
title_short Neuropsychiatric symptoms and the outcome of cognitive trajectories in older adults free of dementia: The Mayo Clinic Study of Aging
title_sort neuropsychiatric symptoms and the outcome of cognitive trajectories in older adults free of dementia: the mayo clinic study of aging
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8451750/
https://www.ncbi.nlm.nih.gov/pubmed/33724517
http://dx.doi.org/10.1002/gps.5528
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