Neuropsychiatric symptom clusters and functional disability in cognitively-impaired-not-demented individuals
Neuropsychiatric symptom clusters and functional disability in cognitively-impaired-not-demented individuals
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DOI：
10.1097/jgp.0b013e3181462288
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发表时间：
2008-02-01
影响因子：
7.2
通讯作者：
Feldman, Howard H.
中科院分区：
文献类型：
--
作者：
Peters, Kevin R.;Rockwood, Kenneth;Feldman, Howard H.
目的：先前的研究表明，至少有一种神经精神症状（NPSs）的认知受损非痴呆（CIND）个体比没有任何NPSs的个体有更多的功能障碍。本研究的目的是确定是否有一致的集群CIND的个人和某些集群是否更强的相关性比其他集群的功能障碍的措施，在这一人群中的CIND。研究方法：这是一项使用神经精神量表（NPI）的横断面基线研究，在一项基于临床的国家观察性队列研究（加拿大认知障碍和相关痴呆队列研究）中进行。本调查重点关注CIND受试者的一个子集（73%），其线人认可至少一个NPI项目的存在。结果：系统聚类分析确定了两个聚类。一个是情绪因素（i。例如，抑郁、焦虑、冷漠、易怒和睡眠问题）和另一组捕获额叶症状（即，例如，异常运动行为、抑制解除、激动和食欲问题）。在情绪集群中分组的NPS比额叶集群更常见（95%的受试者在情绪集群中至少有一个NPS，而在额叶集群中为53%）。然而，即使在控制了认知状态（即，简易精神状态检查）和情绪聚类评分。结论：NPSs的额叶簇与功能障碍的相关性比心境簇更强。
Objective: Previous research has shown that cognitively-impaired-not-demented (CIND) individuals with at least one neuropsychiatric symptom (NPS) have more functional disability than individuals without any NPSs. The objectives of the present study were to determine whether there are consistent clusters of NPS in CIND individuals and whether certain NPS clusters are more strongly associated with measures of functional disability than other NPS clusters in this population. Methods: This was a cross-sectional baseline study of NPS using the Neuropsychiatric Inventory (NPI) in a national clinic-based observational cohort study (the Canadian Cohort Study of Cognitive Impairment and Related Dementias study). The present investigation focuses on a subset of CIND subjects (73%) whose informant endorsed the presence of at least one NPI item. Results: A hierarchical cluster analysis identified two NPS clusters. One consisted of mood factors (i. e., depression, anxiety, apathy, irritability, and problems with sleep) and the other cluster captured frontal symptoms (i. e., aberrant motor behavior, disinhibition, agitation, and problems with appetite). NPSs grouped within the mood cluster were more common than the frontal cluster (95% of subjects had at least one NPS within the mood cluster versus 53% in the frontal cluster). However, the frontal cluster was more strongly associated with functional disability measures even after controlling for cognitive status (i.e., the Mini-Mental State Exam) and the mood cluster score. Conclusion: The frontal cluster of NPSs was more strongly associated with functional disability than the mood cluster.