title: Trajectories of Neuropsychiatric Symptoms and Cognitive Decline in Mild Cognitive Impairment.
abstract: OBJECTIVE
  To characterize the course of neuropsychiatric symptoms (NPS) in adults with mild cognitive impairment (MCI), and to examine baseline individual-level predictors and associated cognitive and functional outcomes.
  
  
  METHODS
  A 2-year prospective cohort study.
  
  
  METHODS
  Multicenter clinical settings.
  
  
  METHODS
  Five hundred sixty individuals with MCI at baseline.
  
  
  METHODS
  NPS severity (measured using Neuropsychiatric Inventory Questionnaire) and cognitive and functional outcomes were assessed at baseline and every 6 months thereafter. Potential individual-level predictors were collected at baseline.
  
  
  RESULTS
  Three latent classes of NPS courses were identified using growth mixture modeling: a stable class in which a low NPS burden remained relatively unchanged over time (N = 503, 89.8%); a worsened class in which an initially moderate NPS burden increased (N = 39, 7.0%); and an improved class in which an initially high NPS burden decreased (N = 18, 3.2%). There were no associations between class membership and baseline individual characteristics. Members of the worsened class were 1.74 times more likely to be diagnosed with incident Alzheimer disease (AD) than members of the stable class (95% confidence interval: 1.07-2.84). The worsened class also showed significantly more rapid declines in cognitive and functional outcomes than the stable class. Class membership did not predict rate of brain atrophy.
  
  
  CONCLUSIONS
  Patients with MCI may experience different trajectories of NPS over time. Patients with worsening NPS may be at greater risk of developing AD and severe cognitive and functional impairment.
authors.affiliation: University of Rochester School of Medicine and Dentistry, Rochester, NY.
authors.forename: Nicholas D
authors.initials: ND
authors.lastname: David
authors.affiliation: University of Rochester School of Medicine and Dentistry, Rochester, NY; University of Rochester School of Nursing, Rochester, NY.
authors.forename: Feng
authors.initials: F
authors.lastname: Lin
authors.affiliation: University of Rochester School of Medicine and Dentistry, Rochester, NY. Electronic address: anton_porsteinsson@urmc.rochester.edu.
authors.forename: Anton P
authors.initials: AP
authors.lastname: Porsteinsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D001921:Brain / Q000473:pathology; D003071:Cognition; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000523:psychology*; D016208:Databases, Factual; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors
keywords: Neuropsychiatric symptoms; latent class analysis; mild cognitive impairment