Evaluation of neuropsychiatric symptoms in patients with mild cognitive impairment and Alzheimer’s disease from the Memory Disorder Clinic

Abstract:

Objective：To examine the prevalence of neuropsychiatric symptoms（NPSs） in patients with mild cognitive impairment （MCI） and Alzheimer’s disease（AD） from the Memory Disor－der Clinic of the Department of Geriatrics，The First Affiliated Hospital of Chongqing Medical University. Methods：A total of 169 patients with MCI（diagnosed according to the Petersen cri－teria） and 308 patients with AD（diagnosed according to the NINCDS-ADRDA criteria；192 were classified as mild，84 as moderate，and 32 as severe），who attended the Memory Disor－der Clinic of the Department of Geriatrics，The First Affiliated Hospital of Chongqing Medical University，from January 2014 to June 2017，were included in this study. Neuropsychological examination was conducted for all patients and their caregivers，and the demographics of all patients were recorded. NPSs and the severity of AD were assessed by the Neuropsychiatric Inventory and Clinical Dementia Rating，respectively. Results：One or more NPSs were identified in 49.1% of patients with MCI，79.7% of patients with mild AD，96.4% of patients with moderate AD，and 100.0% of patients with severe. Delusion，hallucination，anxiety，apathy，irritability，and aberrant motor activity were significantly more prevalent in the mild AD group than in the MCI group（ χ2=19.448，7.873，12.386，11.756，7.743，and 13.390，respectively，all P<0.016 7）. These differences remained statistically significant after adjust－ment for age，sex，and education level by logistic regression analysis[odds ratio（OR）（95% confidence interval（CI））=3.54（1.91-6.54），2.87（1.32-6.26），2.37（1.37-4.10），2.34（1.37-4.00），2.15（1.28-3.58），and 9.41（2.12-41.71），respectively，all P<0.05]. All NPSs except irritability were significantly more prevalent in the moderate AD group than in the mild AD group（all P<0.016 7）. These dif－ferences remained statistically significant after adjustment for age，sex，and education level by logistic regression analysis（all P<0.05）. Furthermore，disinhibition，aberrant motor activity，and sleep disturbance were significantly more prevalent in the severe AD group than in the moderate AD group（χ2=17.673，9.995，and 16.987，respectively，all P<0.016 7）. These differences remained statistically significant after adjustment for age and education level by logistic regression analysis[OR（95%CI）=6.93（2.55-18.80），4.85（1.71-13.78），and 9.63（3.17-29.27），respectively，all P<0.05]. There was no significant difference in the prevalence of NPSs between female and male patients with MCI（P>0.05）. However，delusion and depression were significantly more prevalent among female than among male patients with AD（ χ2=8.609 and 23.560，respectively，both P<0.05）. These differences remained statistically signifi－cant after adjustment for age and education level by logistic regression analysis[OR（95%CI）=2.18（1.32-3.58） and 3.22（1.83-5.66），respectively，both P<0.05]. Conclusion：NPSs become more prevalent as disease progresses in patients with cognitive impairment，and female AD patients have higher risk of developing delusion and depression than male AD patients.