Correlates Of Neuropsychiatric Symptoms Research Articles

Neuropsychiatric Symptoms by Cognitive Status for Mexican-Americans Aged 85 and Older

Older adults with dementia and cognitive impairment often experience neuropsychiatric symptoms (NPS). Few studies have investigated the presence of NPS among older Mexican-American adults. Our objective was to describe the NPS of Mexican-Americans 85 years and older according to cognitive status. Data came from wave 9 (conducted in 2016) of the Hispanic Established Populations for the Epidemiological Study of the Elderly. The final sample consisted of 381 care recipients aged 85 years and older, along with their caregivers. The 12-item Neuropsychiatric Inventory (NPI-12) was administered to measure behavioral and psychiatric symptoms among the care recipients. Cognitive impairment was defined as a score of 18 or less on the Mini Mental Status Exam (MMSE). Care recipients with a diagnosis of dementia as reported by the caregiver were also classified as cognitively impaired. Overall, 259 (68.0%) participants had one or more NPS. Logistic regression models were used to estimate the average marginal effect (range = -1 to 1) of cognitive impairment on NPS, controlling for care-recipient characteristics. Approximately 87% of care recipients with cognitive impairment had at least one NPS compared to 55.8% of those without cognitive impairment (p<0.01). The predicted probability of having one or more NPI symptoms was 0.25 percentage points (95% CI=0.14-0.35) higher for participants with cognitive impairment than those without. NPS are present in the majority of older Mexican American adults, particularly in those with cognitive impairment. Future research could also investigate sociodemographic correlates of NPS.

Prevalence and Correlates of Neuropsychiatric Symptoms in Nursing Home Patients With Young-Onset Dementia: The BEYOnD Study

ObjectiveYoung-onset dementia (YOD) is defined as dementia that develops before the age of 65. Neuropsychiatric symptoms (NPS) have important clinical consequences for patients and their family members. To date, knowledge about the prevalence and correlates of NPS in YOD is limited, but essential to establish specific tailored care for patients with YOD. The aim of this study was to explore the prevalence and correlates of NPS in nursing home residents with YOD. Design/SettingCross-sectional cohort study in Dutch long-term care facilities providing specialized care for YOD. ParticipantsParticipants included 230 institutionalized patients with YOD. MeasurementsNPS were assessed using the Cohen-Mansfield Agitation Inventory (CMAI) and the Neuropsychiatric Inventory-Nursing Home version (NPI-NH). The influence of gender, dementia severity, type of dementia, and disease awareness on clusters of relevant NPS was investigated using multivariate logistic regression analysis and subsequently corrected for the possible confounders of age, duration of institutionalization, and psychoactive medication use. ResultsNinety percent of the nursing home residents with YOD showed 1 or more neuropsychiatric symptoms, 88% showed significant agitation, and 56% showed relevant apathy. No gender differences were found. Although physically aggressive behavior, non–physically aggressive behavior, and apathy were more common in patients with (very) severe cognitive decline (Global Deterioration Scale [GDS] stage 6–7), verbally agitated behavior was common in patients in all except the most severe stages of dementia (GDS 2–6). Apathy was more prevalent in alcohol-related dementia. Low levels of awareness were associated with more physically aggressive behavior and aberrant motor behavior. ConclusionThe prevalence of NPS was high and was associated with the severity and type of dementia and disease awareness. Agitation and apathy are the most important symptoms to focus on in YOD. The high prevalence of NPS supports the idea of care delivery in special care units. Further research is needed on potentially influencing environmental correlates of NPS in YOD.