Neuropsychiatric symptoms in mild cognitive impairment: differences by subtype and progression to dementia
Neuropsychiatric symptoms in mild cognitive impairment: differences by subtype and progression to dementia
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DOI：
10.1002/gps.2187
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发表时间：
2009-07-01
影响因子：
4
通讯作者：
Yaffe, Kristine
中科院分区：
文献类型：
--
作者：
Edwards, Emily R.;Spira, Adam P.;Yaffe, Kristine
背景
神经精神症状（NPS）在轻度认知障碍（MCI）患者中很常见。然而，对于NPS如何因MCI亚型（即遗忘型、单领域非记忆型和多领域型）而异知之甚少。此外，尚不清楚NPS是否会增加进展为痴呆的风险。我们研究了NPS在MCI亚型中的分布情况，并确定NPS是否会增加进展为痴呆的风险。
方法
研究对象为1988年至1999年间在加利福尼亚州阿尔茨海默病研究中心被诊断为MCI的521名患者。在基线时，患者被分类为MCI亚型，并对NPS进行评估。
结果
NPS的平均数量为2.3（范围为0 - 9.6；74%的患者有≥1个NPS）。有≥4个NPS的患者有更多的合并疾病且功能损害更严重（p＜0.001）。有≥4个NPS的患者比有0 - 3个NPS的患者更有可能是遗忘型MCI（分别为81%对71%，p = 0.03），并且遗忘型MCI患者比其他亚型患者更有可能出现抑郁症状。有≥4个NPS的患者在随访时患痴呆的几率几乎是有0 - 3个NPS患者的2.5倍（调整后的比值比 = 2.44，95%置信区间为1.07，5.55）。
结论
NPS在MCI患者中很常见。NPS数量较多的患者可能更有可能是遗忘型MCI，并且抑郁在遗忘型MCI中可能比在其他亚型中更常见。NPS数量增多可能会增加MCI患者进展为痴呆的风险。
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Background Neuropsychiatric symptoms (NPS) are common in patients with mild cognitive impairment (MCI). Little is known, however, about how NPS vary by MCI subtype (i.e. amnestic, single domain non-memory, and multiple domain). In addition, it is unclear whether NPS increase risk of progression to dementia. We investigated the distribution of NPS across MCI subtypes and determined whether NPS increase risk of progression to dementia.Method Participants were 521 patients diagnosed with MCI at the Alzheimer's Research Centers of California between 1988 and 1999. At baseline, patients were classified into MCI subtypes and were assessed for NPS.Results The mean number of NPS was 2.3 (range 0-9.6; 74% had >= 1 NPS). Patients with >= 4 NPS had more medical comorbidities and greater functional impairment (p = 4 NIPS were more likely than patients with 0-3 NPS to have amnestic MCI (81% vs 71%, respectively, p = 0.03), and patients with amnestic MCI were more likely than those with other subtypes to exhibit depressive symptoms. Patients with >= 4 NPS had nearly 2.5 times the odds of developing dementia at follow-up than patients with 0-3 NPS (adjusted O R= 2.44, 95% CI 1.07, 5.55).Conclusion NPS are common in MCI patients. Those with an elevated number of NPS may be more likely to have the amnestic subtype of MCI, and depression may be more common in amnestic MCI than in other subtypes. An elevated number of NPS may increase risk of progression to dementia for patients with MCI. Copyright (C) 2009 John Wiley & Sons, Ltd.