Neuropsychiatric symptoms as risk factors of dementia in a Mexican population: A 10/66 Dementia Research Group study.
Neuropsychiatric symptoms as risk factors of dementia in a Mexican population: A 10/66 Dementia Research Group study.
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神经精神症状作为墨西哥人群痴呆症的危险因素：一项 10/66 痴呆症研究小组研究。
DOI：
10.1016/j.jalz.2017.08.015
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发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
10/66 Dementia Research Group
中科院分区：
文献类型：
--
作者：
Acosta I;Borges G;Aguirre-Hernandez R;Sosa AL;Prince M;10/66 Dementia Research Group
认知和/或记忆障碍是目前用于识别有患痴呆症风险个体的主要临床标志物。本研究旨在探讨神经精神症状的存在与痴呆发病率之间的关系。
我们对来自普通人群的1355名墨西哥老年人进行了为期3年的随访，分析了神经精神症状与痴呆发病之间的关联，并使用泊松模型对累积发病率比进行建模。
五种神经精神症状与痴呆发病相关：妄想、幻觉、焦虑、异常运动行为和抑郁。在对轻度认知障碍、糖尿病、认知功能指标以及社会人口学因素进行调整后，同时出现两种症状的相对风险为1.9（95%置信区间，1.2 - 2.9），而出现三到五种症状（同样进行调整后）的相对风险为3.0（95%置信区间，1.9 - 4.8）。
神经精神症状在痴呆前状态中很常见，并且可能作为患痴呆症的风险因素独立起作用。
不仅认知障碍和认知特征对识别有患痴呆症风险的老年人有用。
在评估的12种神经精神症状中，有5种在3年的随访中与痴呆发病相关（妄想、幻觉、抑郁、焦虑和异常运动行为）。
对神经精神症状以及其他简单、实用且成本低廉的特征进行评估，可能有助于在社区卫生机构以及由全科医生识别有患痴呆症风险的个体。
Cognitive and/or memory impairment are the main clinical markers currently used to identify subjects at risk of developing dementia. This study aimed to explore the relationship between the presence of neuropsychiatric symptoms and dementia incidence. We analyzed the association between neuropsychiatric symptoms and incident dementia in a cohort of 1355 Mexican older adults from the general population over 3 years of follow-up, modeling cumulative incidence ratios using Poisson models. Five neuropsychiatric symptoms were associated with incident dementia: delusions, hallucinations, anxiety, aberrant motor behavior, and depression. The simultaneous presence of two symptoms had a relative risk, adjusted for mild cognitive impairment, diabetes, indicators of cognitive function, and sociodemographic factors, of 1.9 (95% confidence interval, 1.2–2.9), whereas the presence of three to five, similarly adjusted, had a relative risk of 3.0 (95% confidence interval, 1.9–4.8). Neuropsychiatric symptoms are common in predementia states and may independently contribute as risk factors for developing dementia. Not only cognitive impairment and cognitive features are useful in identifying older adults at risk for developing dementia. Of the 12 neuropsychiatric symptoms evaluated, 5 were associated with incident dementia (delusions, hallucinations, depression, anxiety, and aberrant motor behavior) in a 3-year follow-up. The evaluation of neuropsychiatric symptoms, along with other simple, practical, and inexpensive features, may be useful in identifying subjects at risk of dementia in community health settings and by general practitioners.
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