Prevalence of neuropsychiatric symptoms in patients with mild cognitive impairment at King Chulalongkorn Memorial Hospital

Authors

  • Angvara Vongudommongkol Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Solaphat Hemrungrojn Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Keywords:

Mild cognitive impairment, dementia, neuropsychiatric symptoms, prevalence

Abstract

Background: Thailand has already become aging society since 2005. Previous studies showed that cognitive impairment is common in the elderly. Mild cognitive impairment (MCI) is a cognitive decline condition between the normal aging and dementia population. Moreover cognitive impairment condition is commonly found with neuropsychiatric symptoms (NPS). NPS are significantly related to poor disease prognosis and can cause serious care problems.

Objective: To estimate the prevalence, severity and character of NPS in Thai patients with MCI.

Methods: A cross-sectional descriptive study conducted in 100 patients, who were diagnosed with MCI by the international working group criteria. The main outcome was the prevalence of NPS in Thai patients with MCI. This study used the Neuropsychiatric Inventory Questionnaire (NPI-Q) for the main measurement.

Results: The mean age was 71.3 years, 65.0% were females. The mean TMSE, MoCA scores and DAD-T percentage were 27.8, 21.7, and 96.6, respectively. The prevalence of at least one NPS was 65.0%. It was found that the most common NPS was irritability (33.0%), the second was sleep problems (31.0%), the third was anxiety (29.0%) whereas the lowest prevalence was hallucination (6.0%). The presence of NPS had a significant relationship with using the lipid-lowering drug and history of others noticed that the subject had memory/attention problems. The MCI patients with NPS had lower total DAD-T percent, MoCA and TMSE scores. A large part of the variance in DAD-T (43.0%), MoCA (27.0%) and TMSE (17.0%) was explained by mainly agitation and apathy.

Conclusions: NPS are very common in Thai MCI patients. Therefore, the management of patients with MCI should always be assessed for NPS.

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References

Department of Older Persons. The Ministry of Social Development and Human Security. Number and proportion of Thai elderly in overall [Interet]. 2014 [cited 2017 Jan 31]. Available from: http://www.dop.go.th/th/know/1/45.

Akpalakorn W. 4th Thai National Health Examination Survey [Internet]. 2008-2009 [cited 2010]. Available from: http://kb.hsri.or.th/dspace/handle/11228/ 2976?locale-attribute=th.

Charernboon T, Phanasathit M. Prevalence of neuropsychiatric symptoms in Alzheimer's disease: a cross-sectional descriptive study in Thailand. J Med Assoc Thai 2014;97:560-5.

Gauthier S, Reisberg B, Zaudig M, Petersen RC, Ritchie K, Broich K, et al. Mild cognitive impairment. Lancet 2006;367:1262-70. https://doi.org/10.1016/S0140-6736(06)68542-5

Monastero R, Mangialasche F, Camarda C, Ercolani S, Camarda R. A systematic review of neuropsychiatric symptoms in mild cognitive impairment. J Alzheimers Dis 2009;18:11-30.

https://doi.org/10.3233/JAD-2009-1120

Gallagher D, Fischer CE, Iaboni A. Neuropsychiatric symptoms in mild cognitive impairment. Can J Psychiatry 2017;62:161-9. https://doi.org/10.1177/0706743716648296

Edwards ER, Spira AP, Barnes DE, Yaffe K. Neuropsychiatric symptoms in mild cognitive impairment: differences by subtype and progression to dementia. Int J Geriatr Psychiatry 2009;24:716-22.

https://doi.org/10.1002/gps.2187

Trivedi SC, Subramanyam AA, Pinto C, Gambhire DD. Neuropsychiatric symptoms in mild cognitive impairment: An analysis and its impact on caregiving. Indian J Psychiatry 2013;55:154-60.

https://doi.org/10.4103/0019-5545.111454

Phanasathit M, Charernboon T, Hemrungrojn S, Tangwongchai S, Phanthumchinda K. Prevalence of neuropsychiatric symptoms in mild cognitive impairment and Alzheimer's disease. In: Mateos R, Engedal K, Franco M, eds. IPA 2010. Diversity, Collaboration, Dignity. Poster session presented at: The IPA International Meeting. Santiago De Compostela: Universidade De Santiago De Compostela; 2010.p.491-2. [in Thai]

Muangpaisan W, Assantachai P, Intalapaporn S, Pisansalakij D. Quality of life of the community-based patients with mild cognitive impairment. Geriatr Gerontol Int 2008;8:80-5.

https://doi.org/10.1111/j.1447-0594.2008.00452.x

Ready RE, Ott BR, Grace J. Patient versus informant perspectives of Quality of Life in Mild Cognitive Impairment and Alzheimer's disease. Int J Geriatr Psychiatry 2004;19:256-65.

https://doi.org/10.1002/gps.1075

Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund LO, et al. Mild cognitive impairmentbeyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. J Intern Med 2004;256:240-6. https://doi.org/10.1111/j.1365-2796.2004.01380.x

Perneczky R, Wagenpfeil S, Komossa K, Grimmer T, Diehl J, Kurz A. Mapping scores onto stages: minimental state examination and clinical dementia rating. Am J Geriatr Psychiatry 2006;14:139-44.

https://doi.org/10.1097/01.JGP.0000192478.82189.a8

Thai Cognitive Test Development Committee. Minimental state examination Thai-Version 2002. Bangkok: Institute of Geriatric Medicine, Department of Medical Services, Ministry of Public Health, Thailand;2002.

Tangwongchai S, Charernboon T, Phanasathit M, Akkayagorn L, Hemrungrojn S, Phanthumchinda K, et al. The validity of Thai version of the montreal cognitive assessment (MoCA-T). Dement Neuropsychol 2009;3:172. [abstract]

Charernboon T, Lerthattasilp T. Functional disabilityin dementia: A validation study of the Thai version of Disability Assessment for Dementia scale. J Clin Gerontol Geriatr 2015;6:133-6.

https://doi.org/10.1016/j.jcgg.2015.04.001

Kaufer DI, Cummings JL, Ketchel P, Smith V, MacMillan A, Shelley T, et al. Validation of the NPI-Q, a brief clinical form of the neuropsychiatric inventory. J Neuropsychiatry Clin Neurosci 2000;12:233-9.

https://doi.org/10.1176/jnp.12.2.233

Cummings JL, Mega M, Gray K, Rosenberg- Thompson S, Carusi DA, Gornbein J. The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994;44:2308-14.

https://doi.org/10.1212/WNL.44.12.2308

Forrester SN, Gallo JJ, Smith GS, Leoutsakos JM. Patterns of neuropsychiatric symptoms in mild cognitive impairment and risk of dementia. Am J Geriatr Psychiatry 2016;24:117-25.

https://doi.org/10.1016/j.jagp.2015.05.007

Peters KR, Rockwood K, Black SE, Hogan DB, Gauthier SG, Loy-English I, et al. Neuropsychiatric symptom clusters and functional disability in cognitively-impaired-not-demented individuals. Am J Geriatr Psychiatry 2008;16:136-44. https://doi.org/10.1097/JGP.0b013e3181462288

Lanctôt KL, Amatniek J, Ancoli-Israel S, Arnold SE, Ballard C, Cohen-Mansfield J, et al. Neuropsychiatric signs and symptoms of Alzheimer's disease: New treatment paradigms. Alzheimers Dement (N Y) 2017;3:440-9. https://doi.org/10.1016/j.trci.2017.07.001

Geda YE, Roberts RO, Knopman DS, Petersen RC, Christianson TJ, Pankratz VS, et al. Prevalence of neuropsychiatric symptoms in mild cognitive impairment and normal cognitive aging: populationbased study. Arch Gen Psychiatry 2008;65:1193-8. https://doi.org/10.1001/archpsyc.65.10.1193

Richard E, Schmand B, Eikelenboom P, Yang SC, Ligthart SA, Moll van Charante EP, et al. Symptoms of apathy are associated with progression from mild cognitive impairment to Alzheimer's disease in nondepressed subjects. Dement Geriatr Cogn Disord 2012;33:204-9.

https://doi.org/10.1159/000338239

Fiedorowicz JG, Coryell WH. Cholesterol and suicide attempts: a prospective study of depressed inpatients. Psychiatry Res 2007;152:11-20. https://doi.org/10.1016/j.psychres.2006.09.003

Gabriel A. Changes in plasma cholesterol in mood disorder patients: does treatment make a difference? J Affect Disord 2007;99:273-8. https://doi.org/10.1016/j.jad.2006.08.015

Deisenhammer EA, Kramer-Reinstadler K, Liensberger D, Kemmler G, Hinterhuber H, Fleischhacker WW. No evidence for an association between serum cholesterol and the course of depression and suicidality. Psychiatry Res 2004;121:253-61. https://doi.org/10.1016/j.psychres.2003.09.007

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Published

2023-07-26

How to Cite

1.
Vongudommongkol A, Hemrungrojn S. Prevalence of neuropsychiatric symptoms in patients with mild cognitive impairment at King Chulalongkorn Memorial Hospital. Chula Med J [Internet]. 2023 Jul. 26 [cited 2024 Oct. 12];64(2). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/190