Association Between Neuropsychiatric Symptom Trajectory and Conversion to Alzheimer Disease.,Alzheimer Disease & Associated Disorders

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Association Between Neuropsychiatric Symptom Trajectory and Conversion to Alzheimer Disease.
Alzheimer Disease & Associated Disorders ( IF 2.1 ) Pub Date : 2020-04-01 , DOI: 10.1097/wad.0000000000000356
Tsz Wai Bentley Lo _{1,

2} , Wael K Karameh _{2,

3,

4} , Joseph J Barfett _{2,

5} , Luis R Fornazzari ₂ , David G Munoz _{2,

6,

7} , Tom A Schweizer _{2,

8,

9,

10,

11} , Corinne E Fischer _{2,

3,

9} ,

Affiliation

Introduction:

Neuropsychiatric symptoms (NPS) are both common in mild cognitive impairment and Alzheimer disease (AD). Studies have shown that some NPS such as apathy and depression are a key indicator for progression to AD.

Methods:

We compared Neuropsychiatric Inventory (NPI) total score and NPI subdomain score between mild cognitive impairment-converters (MCI-C) and mild cognitive impairment-nonconverters (MCI-NC) longitudinally for 6 years using the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. In addition to the NPI, Mini-Mental State Examination (MMSE) scores were also compared to find out if MMSE scores would differ between different NPI groups. Lastly, a linear regression model was done on MMSE and NPI total score to establish a relationship between MMSE and NPI total score.

Results:

The results in this study showed that NPI total scores between MCI-C and MCI-NC differed significantly throughout 6 years. MCI-C subjects had a higher mean NPI total score and lower MMSE score compared with MCI-NC subjects. In addition, MMSE scores were significantly different between the 3 groups of NPI total score. Subjects who have a high NPI score have the lowest mean MMSE score, thus demonstrating that NPI scores do indeed affect MMSE scores. Further analyses using a regression model revealed that a unit change in NPI total score lead to 0.1 to 0.3 decrease in MMSE.

Discussion:

On the basis of the findings, this study showed evidence that increase in NPS burden (reflected by increase in NPI) over time predicts conversion to AD, whereas stability of symptoms (reflected by stable NPI score) favors nonconversion. Further study should investigate the underlying mechanisms that drive both NPS burden and cognitive decline.

中文翻译：

神经精神症状的轨迹与转化为阿尔茨海默氏病之间的关联。

介绍：

神经精神症状（NPS）在轻度认知障碍和阿尔茨海默病（AD）中都很常见。研究表明，某些NPS（例如冷漠和抑郁）是进展为AD的关键指标。

方法：

我们使用阿尔茨海默氏病神经影像学倡议（ADNI）数据库纵向比较了轻度认知障碍-转化者（MCI-C）和轻度认知障碍-非转化者（MCI-NC）之间的神经精神病学量表（NPI）总分和NPI子域得分。除NPI外，还对迷你精神状态考试（MMSE）得分进行了比较，以了解不同NPI组之间的MMSE得分是否会有所不同。最后，对MMSE和NPI总分建立了线性回归模型，建立了MMSE和NPI总分之间的关系。

结果：

这项研究的结果表明，在整个6年中，MCI-C和MCI-NC之间的NPI总分存在显着差异。与MCI-NC受试者相比，MCI-C受试者的平均NPI总分较高，而MMSE分数较低。此外，三组NPI总分之间的MMSE得分显着不同。NPI得分高的受试者的MMSE平均得分最低，因此证明NPI得分确实确实会影响MMSE得分。使用回归模型进行的进一步分析显示，NPI总分的单位变化导致MMSE降低0.1至0.3。