title: Neuropsychiatric symptoms as risk factors for progression from CIND to dementia: the Cache County Study.
abstract: OBJECTIVE
  To examine the association of neuropsychiatric symptom (NPS) severity with risk of transition to all-cause dementia, Alzheimer disease (AD), and vascular dementia (VaD).
  
  
  METHODS
  Survival analysis of time to dementia, AD, or VaD onset.
  
  
  METHODS
  Population-based study.
  
  
  METHODS
  230 participants diagnosed with cognitive impairment, no dementia (CIND) from the Cache County Study of Memory Health and Aging were followed for a mean of 3.3 years.
  
  
  METHODS
  The Neuropsychiatric Inventory (NPI) was used to quantify the presence, frequency, and severity of NPS. Chi-squared statistics, t-tests, and Cox proportional hazard ratios were used to assess associations.
  
  
  RESULTS
  The conversion rate from CIND to all-cause dementia was 12% per year, with risk factors including an APOE ε4 allele, lower Mini-Mental State Examination, lower 3MS, and higher CDR sum-of-boxes. The presence of at least one NPS was a risk factor for all-cause dementia, as was the presence of NPS with mild severity. Nighttime behaviors were a risk factor for all-cause dementia and of AD, whereas hallucinations were a risk factor for VaD.
  
  
  CONCLUSIONS
  These data confirm that NPS are risk factors for conversion from CIND to dementia. Of special interest is that even NPS of mild severity are a risk for all-cause dementia or AD.
authors.affiliation: The Johns Hopkins University, Baltimore, MD.
authors.forename: M E
authors.initials: ME
authors.lastname: Peters
authors.forename: P B
authors.initials: PB
authors.lastname: Rosenberg
authors.forename: M
authors.initials: M
authors.lastname: Steinberg
authors.forename: M C
authors.initials: MC
authors.lastname: Norton
authors.forename: K A
authors.initials: KA
authors.lastname: Welsh-Bohmer
authors.forename: K M
authors.initials: KM
authors.lastname: Hayden
authors.forename: J
authors.initials: J
authors.lastname: Breitner
authors.forename: J T
authors.initials: JT
authors.lastname: Tschanz
authors.forename: C G
authors.initials: CG
authors.lastname: Lyketsos
mesh_terms: D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000523:psychology; D003072:Cognition Disorders / Q000150:complications / Q000523:psychology*; D003704:Dementia / Q000150:complications / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D015233:Models, Statistical; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors
keywords: Agitation; CIND; Cache County; MCI; NPI; NPS; anxiety; dementia; depression