Risk factors for neuropsychiatric symptoms in dementia: the Cache County Study.
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 epsilon4 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 epsilon4, dementia diagnosis, time of observation, and general medical health appear to influence the occurrence of individual neuropsychiatric symptoms.
Steinberg
M
M
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA. martins@jhmi.edu
Corcoran
C
C
Tschanz
J T
JT
Huber
C
C
Welsh-Bohmer
K
K
Norton
M C
MC
Zandi
P
P
Breitner
J C S
JC
Steffens
D C
DC
Lyketsos
C G
CG
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology; D001007:Anxiety / Q000209:etiology; D003702:Delusions / Q000209:etiology; D003704:Dementia / Q000523:psychology*; D003863:Depression / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods; D006212:Hallucinations / Q000209:etiology; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000209:etiology; D012307:Risk Factors; D012737:Sex Factors