Original StudyThe Course of Neuropsychiatric Symptoms in Dementia: A 3-Year Longitudinal Study
Section snippets
Design
Participants were drawn from the Prospective Research In MEmory clinics (PRIME) study,16 a 3-year nonprescriptive, observational study examining relationships between predictors and outcome variables in 970 patients with either dementia or mild cognitive impairment (MCI) who were attending 1 of 9 memory clinics in Australia. These memory clinics were in 4 of the 8 states and territories of Australia and included both regional and capital centers. Patients were eligible for inclusion if they had
Patient Demographics
Of the 779 patients with dementia at baseline, 514 (66.0%) patients had complete NPI data for 4 or more occasions and were included in the analyses. Their demographics and clinical information are summarized in Table 1.
At baseline, the patients who completed NPI data for 4 or more occasions were younger, t(777) = 2.09, P = .04, and had lower NPI scores, t(660) = 2.56, P = .01, higher Mini-Mental State Examination scores, t(770) = 3.82, P < .01, and lower CDR scores, t(770) = 2.96, P < .01, than
Discussion
Overall levels of neuropsychiatric symptoms increased significantly and consistently over the 3-year period. In particular, delusions, hallucinations, agitation, anxiety, apathy, disinhibition, irritability, aberrant motor behavior, and appetite disturbances increased over the 3 years. By contrast, depression, euphoria, and night time behavior did not increase significantly over this period. Different symptoms displayed different trajectories: delusions, euphoria, and disinhibition increased
Acknowledgments
The Dementia Collaborative Research Center is funded by the National Health and Medical Research Council. The authors thank all the Australian investigators, study nurses, staff, and hospitals who comprise the PRIME study group: Prince of Wales Hospital (Marika Donkin, Kim Burns, Katrin Seeher); The Queen Elizabeth Hospital (Shelley Casey, Trish Steventon); St George's Hospital (Maree Mastwyk, Alissa Westphal, Nicola Lautenschlager, Olga Yastrubetskaya, Marilyn Kemp, Edmond Chiu and Jennifer
References (43)
- et al.
The course of psychiatric and behavioral symptoms and the use of psychotropic medication in patients with dementia in Norwegian nursing homes—A 12-month follow-up study
Am J Geriatr Psychiatry
(2008) - et al.
Course of neuropsychiatric symptoms in residents with dementia in nursing homes over 2-year period
Am J Geriatr Psychiatry
(2010) - et al.
“Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician
J Psychiatr Res
(1975) - et al.
Anxiety, depression and psychosis in vascular dementia: Prevalence and associations
J Affect Disord
(2000) - et al.
Sertraline or mirtazapine for depression in dementia (HTA-SADD): a randomised, multicentre, double-blind, placebo-controlled trial
Lancet
(2011) Antidepressant treatment in Alzheimer's disease
Lancet
(2011)- et al.
Outcome instruments to measure frailty: A systematic review
Ageing Res Rev
(2011) - et al.
Behavioural changes and psychological symptoms in dementia disorders
Lancet Neurol
(2005) - et al.
Behavioral and psychological symptoms of dementia
Front Neurol
(2012) - et al.
Neuropsychiatric aspects of dementia
A systematic review of the association between the behavioral and psychological symptoms of dementia and burden of care
Int Psychogeriatr
Associations of stressors and uplifts of caregiving with caregiver burden and depressive mood: A meta-analysis
J Gerontol B Psychol Sci Soc Sci
Predictors of nursing home admission for persons with dementia
Med Care
Predictors of institutionalization in dementia: A three-year longitudinal study
J Alzheimers Dis
The neuropsychiatry of Alzheimer's disease and related dementias
The course of neuropsychiatric symptoms in dementia. Part I: Findings from the two-year longitudinal Maasbed study
Int J Geriatr Psychiatry
The course of neuropsychiatric symptoms in nursing-home patients with dementia over a 53-month follow-up period
Int Psychogeriatr
The course of neuropsychiatric symptoms in patients with dementia in Norwegian nursing homes
Int Psychogeriatr
Relationship between cognitive impairment and behavioural disturbances in Alzheimer's disease patients
Behav Neurol
The course of psychopathologic features in mild to moderate Alzheimer disease
Arch Gen Psychiatry
The interrelations between psychosis, behavioral disturbance, and depression in Alzheimer disease
Alzheimer Dis Assoc Disord
Cited by (0)
Data collection was funded by Janssen-Cilag Pty Limited. Janssen-Cilag had no input into data analysis or writing of the manuscript. H.B. and M.W. have worked on drug trials for patients with MCI and AD sponsored by major pharmaceutical companies including Eisai Pharmaceuticals, Eli Lilly and Company, GlaxoSmithKline, H Lundbeck A/S, Janssen-Cilag Pty Limited, Medivation Inc, Novartis Pharmaceuticals, Nutricia, Pfizer, Prana Biotechnology Limited, Sanofi-Aventis, Servier, Voyager Pharmaceutical Corporation, and Wyeth Limited. M.W. has also worked on trials sponsored by Servier, Forest, Merck Sharp and Dohme, Takeda, the Buck Institute, and Tau Rx. H.B. has been a consultant, advisory board member, and sponsored speaker for Baxter, H Lundbeck A/S, Janssen-Cilag Pty Limited, Medivation Inc, Novartis Pharmaceuticals, Pfizer, Prana Biotechnology Limited, Voyager Pharmaceutical Corporation, and Wyeth Limited. M.W. has been a consultant and speaker for these companies as well as bioCSL, Prana Biotechnology, Eli Lilly and Company, and Merck Sharp and Dohme. D.A. has served as a paid consultant to Janssen-Cilag and has also received payment for consultancies from Baxter, Eli Lilly, Lundbeck, Prana, Pfizer, and Novartis. M.C. and J.X. have no conflicts of interest to declare.