OBJECTIVE: To determine the occurrence of neuropsychiatric symptomatology and the relation to future development of Alzheimer disease (AD) in persons with and without mild cognitive impairment (MCI). METHOD: We followed 185 persons with no cognitive impairment and 47 with MCI(amnestic and multidomain), ages 75 to 95, from the population-based Kungsholmen Project, Stockholm, Sweden, for 3 years. Three types of neuropsychiatric symptoms were assessed at baseline: mood-related depressive symptoms, motivation-related depressive symptoms, and anxiety-related symptomatology. AD at 3-year follow-up was diagnosed according to Diagnostic and Statistical Manual for Mental Disorders-III-R criteria. RESULTS: Psychiatric symptoms occurred more frequently in persons with MCI (36.2% mood, 36.2% motivation, and 46.8% anxiety symptoms) than in cognitively intact elderly individuals (18.4% mood, 13.0% motivation, and 24.9% anxiety). Of persons with both MCI and anxiety symptoms, 83.3% developed AD over follow-up vs 6.1% of cognitively intact persons and 40.9% persons who had MCI without anxiety. Among persons with MCI, the 3-year risk of progressing to AD almost doubled with each anxiety symptom (relative risk [RR] = 1.8 [1.2 to 2.7] per symptom). Conversely, among cognitively intact subjects, only symptoms of depressive mood were related to AD development (RR = 1.9 [1.0 to 3.6] per symptom). CONCLUSIONS: The predictive validity of mild cognitive impairment (MCI) for identifying future Alzheimer disease (AD) cases is improved in the presence of anxiety symptoms. Mood-related depressive symptoms (dysphoria, suicidal ideation, etc.) in preclinical AD might be related to the neuropathologic mechanism, as they appear preclinically in persons both with and without MCI.
|Data di pubblicazione:||2007|
|Titolo:||Predictors of progression from mild cognitive impairment to Alzheimer disease|
|Autori:||PALMER, K; BERGER, AK; MONASTERO, R; WINBLAD, B; BÄCKMAN, L; FRATIGLIONI, L|
|Tipologia:||Articolo su rivista|
|Citazione:||PALMER, K., BERGER, A.K., MONASTERO, R., WINBLAD, B., BÄCKMAN, L., & FRATIGLIONI, L. (2007). Predictors of progression from mild cognitive impairment to Alzheimer disease. NEUROLOGY, 68, 1596-1602.|
|Digital Object Identifier (DOI):||10.1212/01.wnl.0000260968.92345.3f|
|Appare nelle tipologie:||01 - Articolo su rivista|