Risk Factors for Neuropsychiatric Symptoms in Dementia: The Cache County Study

Authors

M. Steinberg, John Hopkins University School of Medicine
Chris D. Corcoran, Utah State UniversityFollow
JoAnn T. Tschanz, Utah State UniversityFollow
C. Huber, Utah State University
K. Welsh-Bohmer, John Hopkins University School of Medicine
Maria C. Norton, Utah State UniversityFollow
P. Zandi, Johns Hopkins Bloomberg School ofPublic Health
J.C. S. Breitner, University of Washington School of Medicine
D. C. Steffens, John Hopkins University School of Medicine
C. G. Lykestsos, John Hopkins University School of Medicine

Document Type

Article

Journal/Book Title/Conference

International Journal of Geriatric Psychiatry

Volume

21

Issue

9

Publisher

Wiley-Blackwell

Publication Date

2006

First Page

824

Last Page

830

Abstract

Objective: To investigate the probability of individual neuropsychiatric symptoms in dementia patients as a function of eight risk factors. Methods: In the Cache County Study, we administered the Neuropsychiatric Inventory (NPI) to 328 dementia patients at baseline. Approximately 18 months later, we re-administered the NPI to 184 participants available for follow-up. Generalized estimating equation methods were used to model the probability of individual neuropsychiatric symptoms as a function of: gender, age, education, dementia type and severity, APOE status, time of observation, and general medical health. Results: Women showed increased tendency toward anxiety, [odds ratio (OR) 2.22, 95% confidence interval (CI) 1.31-3.76] and delusions (OR 2.15, CI 1.22-3.78), but older persons of both sexes showed less tendency toward anxiety. Dementia severity increased the tendency toward hallucinations and agitation (OR 2.42, CI 1.81-3.23) and decreased risk of depression. Positive APOE 4 status increased the tendency toward aberrant motor behavior (OR 1.84, CI 1.05-3.22). Among dementia diagnoses, those with Alzheimer's disease showed decreased tendency toward agitation (OR 0.58, CI 0.35-0.95), depression (OR 0.56, CI 0.33-0.96) and disinhibition (OR 0.46, CI 0.24-0.88). Later time of observation increased risk of aberrant motor behavior and delusions, and more serious medical comorbidity increased risk of, agitation, irritability, disinhibition, and aberrant motor behavior. Conclusions: Gender, age, dementia severity, APOE 4, dementia diagnosis, time of observation, and general medical health appear to influence the occurrence of individual neuropsychiatric symptoms.

Comments

Originally published by Wiley-Blackwell. Publisher's PDF available through remote link.

Recommended Citation

Steinberg M, Corcoran C, Tschanz JT, Huber C, Welsh-Bohmer K, Norton MC, Zandi P, Breitner JCS, Steffens DC, Lyketsos CG. Risk factors for neuropsychiatric symptoms in dementia: The Cache County Study. Int J Geriatr Psychiatry. 2006 Sep;21(9):824-830.