#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Neuropsychiatric symp­toms as early manifestation of Alzheimer’s dis­ease


Authors: V. Matušková;  T. Nikolai;  H. Marková;  K. Čechová;  J. Laczó;  J. Hort;  M. Vyhnálek
Authors‘ workplace: Mezinárodní centrum klinického výzkumu, FN u sv. Anny v Brně ;  Neurologická klinika 2. LF UK a FN Motol, Praha
Published in: Cesk Slov Neurol N 2020; 83(1): 64-72
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn202064

Neuropsychiatrické symp­tomy (NPS) jsou heterogen­ní skupina změn v osobnosti a chování, které lze pozorovat již v časných stadiích Alzheimerovy nemoci (AN). Mírná behaviorální porucha (mild behavioral impairment; MBI) je nová dia­gnostická kategorie popisující trvalé změny v osobnosti a chování s počátkem v pozdější fázi života. Na podkladě těchto kritérií byl vytvořen nový Dotazník mírné poruchy chování (Mild Behavioral Impairment Checklist; MBI-C) zaměřený na detekci NPS v časných stadiích AN. Cílem studie je představit námi adaptovanou českou verzi dotazníku MBI-C a studovat přítomnost a závažnost NPS na pilotním souboru pa­cientů.

Overview

Aim: Neuropsychiatric symp­toms (NPS) are a heterogeneous group of changes in personality and behavior that can be observed already in early stages of Alzheimer’s dis­ease (AD). Mild behavioral impairment (MBI) is a newly developed dia­gnostic category describ­­ing persistent changes in personality and behavior start­­ing later in life. Based on these criteria, a new measure, the Mild Behavioral Impairment Checklist (MBI-C) has been developed, aimed at detect­­ing NPS in early stages of AD. The aim of this study is to present the newly adapted Czech version of the MBI-C and to explore the presence of NPS in a pilot group of patients.

Patients and methods: The original MBI-C has been adapted to Czech and administered to close informants of 188 patients. The patients were divided accord­­ing to the results of a complex neuropsychological, neurological examination and brain imag­­ing into 3 groups: cognitively normal (N = 69), amnestic mild cognitive impairment (aMCI; N = 87) and dementia due to AD (N = 32).

Results: Patients with aMCI expres­sed in the MBI-C significantly more severe score compared to cognitively normal subjects and less severe compared to dementia patients. The dif­ferences were observed mainly in af­fective, motivation and impulse control domains.

Conclusion: The Czech version of the MBI-C detects the presence of NPS even before the onset of dementia syndrome and is useful in clinical practice.

Keywords:

mild cognitive impairment – neuropsychiatric symptoms – Alzheimer´s disease – mild behavioral impairment


Sources

1. Petersen RC. Mild cognitive impairment as a dia­g­nostic entity. J Intern Med 2004; 256(3): 183– 194. doi: 10.1111/ j.1365-2796.2004.01388.x.

2. Albert MS, DeKosky ST, Dickson D et al. The dia­gnosis of mild cognitive impairment due to Alzheimer’s dis­ease: recom­mendations from the National Institute on Aging-Alzheimer’s As­sociation workgroups on dia­gnostic guidelines for Alzheimer’s dis­ease. Alzheimers Dement 2011; 7(3): 270– 279. doi: 10.1016/ j.jalz.2011.03.008.

3. Dubois B, Hampel H, Feldman HH et al. Preclinical Alzheimer’s dis­ease: definition, natural history, and dia­gnostic criteria. Alzheimers Dement 2016; 12(3): 292– 323. doi: 10.1016/ j.jalz.2016.02.002.

4. Markova H, Andel R, Stepankova H et al. Subjective Cognitive complaints in cognitively healthy older adults and their relationship to cognitive performance and depres­sive symp­toms. J Alzheimers Dis 2017; 59(3): 871– 881. doi: 10.3233/ JAD-160970.

5. Jes­sen F, Amariglio RE, van Boxtel M et al. A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer’s dis­ease. Alzheimers Dement 2014; 10(6): 844– 852. doi: 10.1016/ j.jalz.2014.01.001.

6. McKhann GM, Knopman DS, Chertkow H et al. The dia­gnosis of dementia due to Alzheimer’s dis­ease: recom­mendations from the National Institute on Aging-Alzheimer’s As­sociation workgroups on dia­g­-nostic guidelines for Alzheimer’s dis­ease. Alzheimers Dement J Alzheimers As­soc 2011; 7(3): 263– 269. doi: 10.1016/ j.jalz.2011.03.005.

7. Rascovsky K, Hodges JR, Knopman D et al. Sensitivity of revised dia­gnostic criteria for the behavioural variant of frontotemporal dementia. Brain J Neurol 2011; 134(Pt 9): 2456– 2477. doi: 10.1093/ brain/ awr179.

8. McKeith IG, Boeve BF, Dickson DW et al. Dia­gnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB Consortium. Neurology 2017; 89(1): 88– 100. doi: 10.1212/ WNL.0000000000004058.

9. Res­sner P, Hort J, Rektorová I et al. Doporučené postupy pro dia­gnostiku Alzheimerovy nemoci a dalších onemocnění spojených s demencí. Cesk Slov Neurol N 2008; 71/ 104(4): 494– 501.

10. Cerejeira J, Lagarto L, Mukaetova-Ladinska EB. Behavioral and psychological symp­toms of dementia. Front Neurol 2012; 3: 73. doi: 10.3389/ fneur.2012.00073.

11. Apostolova LG, Cum­mings JL. Neuropsychiatric mani­festations in mild cognitive impairment: a systematic review of the literature. Dement Geriatr Cogn Disord 2008; 25(2): 115– 126. doi: 10.1159/ 000112509.

12. Geda YE, Roberts RO, Knopman DS et al. Prevalence of neuropsychiatric symp­toms in mild cognitive impairment and normal cognitive aging: population-based study. Arch Gen Psychiatry 2008; 65(10): 1193– 1198. doi: 10.1001/ archpsyc.65.10.1193.

13. Okura T, Plas­sman BL, Stef­fens DC et al. Prevalence of neuropsychiatric symp­toms and their as­sociation with functional limitations in older adults in the United States: the aging, demographics, and memo­ry study. J Am Geriatr Soc 2010; 58(2): 330– 337. doi: 10.1111/ j.1532-5415.2009.02680.x.

14. Gal­lagher D, Fischer CE, Iaboni A. Neuropsychiatric symp­toms in mild cognitive impairment. Can J Psychiatry Rev Can Psychiatr 2017; 62(3): 161– 169. doi: 10.1177/ 0706743716648296.

15. Desmarais P, Lanctôt KL, Masel­lis M et al. Social inappropriateness in neurodegenerative disorders. Int Psychogeriatr 2018; 30(2): 197– 207. doi: 10.1017/ S10416102 17001260.

16. Fischer CE, Agüera-Ortiz L. Psychosis and dementia: risk factor, prodrome, or cause? Int Psychogeriatr 2018; 30(2): 209– 219. doi: 10.1017/ S1041610217000874.

17. Ismail Z, Gatchel J, Bateman DR et al. Af­fective and emotional dysregulation as pre-dementia risk markers: explor­­ing the mild behavioral impairment symp­toms of depres­sion, anxiety, ir­ritability, and euphoria. Int Psychogeriatr 2018; 30(2): 185– 196. doi: 10.1017/ S1041610217001880

18. Krel­l-Roesch J, Lowe VJ, Neureiter J et al. Depres­sive and anxiety symp­toms and cortical amyloid depo­sition among cognitively normal elderly persons: the Mayo Clinic Study of Aging. Int Psychogeriatr 2018; 30(2): 245– 251. doi: 10.1017/ S1041610217002368.

19. Sherman C, Liu CS, Her­rmann N et al. Prevalence, neurobio­logy, and treatments for apathy in prodromal dementia. Int Psychogeriatr 2018; 30(2): 177– 184. doi: 10.1017/ S1041610217000527.

20. Geda YE, Roberts RO, Mielke MM et al. Baseline neuropsychiatric symp­toms and the risk of incident mild cognitive impairment: a population-based study. Am J Psychiatry 2014; 171(5): 572– 581. doi: 10.1176/ appi.ajp.2014.13060821.

21. Donovan NJ, Amariglio RE, Zol­ler AS et al. Subjective cognitive concerns and neuropsychiatric predictors of progres­sion to the early clinical stages of Alzheimer dis­ease. Am J Geriatr Psychiatry 2014; 22(12): 1642– 1651. doi: 10.1016/ j.jagp.2014.02.007.

22. Pink A, Stokin GB, Bartley MM et al. Neuropsychiatric symp­toms, APOE ε4, and the risk of incident dementia: a population-based study. Neurology 2015; 84(9): 935– 943. doi: 10.1212/ WNL.0000000000001307.

23. Wise EA, Rosenberg PB, Lyketsos CG et al. Time course of neuropsychiatric symp­toms and cognitive dia­g­-nosis in National Alzheimer’s Coordinat­­ing Centers volunteers. Alzheimers Dement (Amst) 2019; 11: 333– 339. doi: 10.1016/ j.dadm.2019.02.006.

24. Rosenberg PB, Mielke MM, Appleby BS et al. The as­sociation of neuropsychiatric symp­toms in MCI with incident dementia and Alzheimer dis­ease. Am J Geriatr Psychiatry Off J Am As­soc Geriatr Psychiatry 2013; 21(7): 685– 695. doi: 10.1016/ j.jagp.2013.01.006.

25. Sugarman MA, Alosco ML, Tripodis Y et al. Neuropsychiatric symp­toms and the dia­gnostic stability of mild cognitive impairment. J Alzheimers Dis 2018; 62(4): 1841– 1855. doi: 10.3233/ JAD-170527.

26. Singh-Manoux A, Dugravot A, Fournier A et al. Trajectories of depres­sive symp­toms before dia­gnosis of dementia. JAMA Psychiatry 2017; 74(7): 712– 718. doi: 10.1001/ jamapsychiatry.2017.0660.

27. Steenland K, Karnes C, Seals R et al. Late-life depres­sion as a risk factor for mild cognitive impairment or Alzheimer’s dis­ease in 30 US Alzheimer’s dis­ease centers. J Alzheimers Dis 2012; 31(2): 265– 275. doi: 10.3233/ JAD-2012-111922.

28. Tapiainen V, Hartikainen S, Taipale H et al. Hospital-treated mental and behavioral disorders and risk of Alzheimer’s dis­ease: a nationwide nested case-control study. Eur Psychiatry 2017; 43: 92– 98. doi: 10.1016/ j.eurpsy.2017.02.486.

29. Andrews SJ, Ismail Z, Anstey KJ et al. As­sociation of Alzheimer’s genetic loci with mild behavioral impairment. Am J Med Genet Part B Neuropsychiatr Genet 2018; 177(8): 727– 735. doi: 10.1002/ ajmg.b.32684.

30. Wool­ley JD, Khan BK, Murthy NK et al. The dia­gnostic chal­lenge of psychiatric symp­toms in neurodegenerative dis­ease: rates of and risk factors for prior psychiatric dia­gnosis in patients with early neurodegenerative dis­ease. J Clin Psychiatry 2011; 72(2): 126– 133. doi: 10.4088/ JCP.10m06382oli.

31. Ismail Z, Smith EE, Geda Y et al. Neuropsychiatric symp­toms as early manifestations of emergent dementia: Provisional dia­gnostic criteria for mild behavioral impairment. Alzheimers Dement J Alzheimers As­soc 2016; 12(2): 195– 202. doi: 10.1016/ j.jalz.2015.05.017.

32. Taragano F, Al­legri R, Krupitzki H et al. Mild behavioral impairment and risk of dementia. J Clin Psychiatry 2009; 70(4): 584– 592. doi: 10.4088/ jcp.08m04181.

33. Cum­mings JL. The Neuropsychiatric Inventory: as­ses­s­­ing psychopathology in dementia patients. Neurology 1997; 48 (5 Suppl 6): S10– S16. doi: 10.1212/ wnl.48.5_suppl_6.10s.

34. Kaufer DI, Cum­mings JL, Ketchel P et al. Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. J Neuropsychiatry Clin Neurosci 2000; 12(2): 233– 239. doi: 10.1176/ jnp.12.2.233.

35. de Medeiros K, Robert P, Gauthier S et al. The Neuropsychiatric Inventory-Clinician rat­­ing scale (NPI-C): reliability and validity of a revised as­ses­sment of neuropsychiatric symp­toms in dementia. Int Psychogeriatr 2010; 22(6): 984– 994. doi: 10.1017/ S1041610210000876.

36. Beck AT, Steer RA, Ball R et al. Comparison of Beck Depres­sion Inventories -IA and -II in psychiatric outpatients. J Pers As­sess 1996; 67(3): 588– 597. doi: 10.1207/ s15327752jpa6703_13.

37. Sheikh JI, Yesavage JA. Geriatric Depres­sion Scale (GDS): recent evidence and development of a shorter version. Clin Gerontol J Ag­­ing Ment Health 1986; 5(1– 2): 165– 173. doi: 10.1300/ J018v05n01_09.

38. Beck AT, Epstein N, Brown G et al. An inventory for measur­­ing clinical anxiety: psychometric properties. J Consult Clin Psychol 1988; 56(6): 893– 897. doi: 10.1037/ / 0022-006x.56.6.893.

39. The State-Trait Anxiety Inventory (STAI). [online]. Available from URL: https:/ / www.apa.org/ pi/ about/ publications/ caregivers/ practice-settings/ as­ses­sment/ tools/ trait-state.

40. Ismail Z, Agüera-Ortiz L, Brodaty H et al. The Mild Behavioral Impairment Checklist (MBI-C): a rat­­ing scale for neuropsychiatric symp­toms in pre-dementia populations. J Alzheimers Dis 2017; 56(3): 929– 938. doi: 10.3233/ JAD-160979.

41. Mal­lo SC, Ismail Z, Pereiro AX et al. As­ses­s­­ing mild behavioral impairment with the mild behavioral impairment-checklist in people with mild cognitive impairment. J Alzheimers Dis 2018; 66(1): 83– 95. doi: 10.3233/ JAD-180131.

42. Mal­lo SC, Ismail Z, Pereiro AX et al. As­ses­s­­ing mild behavioral impairment with the mild behavioral impairment checklist in people with subjective cognitive decline. Int Psychogeriatr 2019; 31(2): 231– 239. doi: 10.1017/ S1041610218000698.

43. Štěpánková H, Nikolai T, Lukavský J et al. Mini‑Mental State Examination –  česká normativní studie. Cesk Slov Neurol N 2015; 78/ 111(1): 57– 63.

44. Nikolai T, Stepankova H, Kopecek M et al. The uniform data set, Czech version: normative data in older adults from an international perspective. J Alzheimers Dis 2018; 61(3): 1233– 1240. doi: 10.3233/ JAD-170595.

45. Nikolai T, Štěpánková H, Michalec J et al. Testy verbální fluence, česká normativní studie pro osoby vyššího věku. Cesk Slov Neurol N 2015; 78/ 111(3): 292– 299. doi: 10.14735/ amcsn­n2015292.

46. Bezdicek O, Stepankova H, Moták L et al. Czech version of Rey Auditory Verbal Learn­­ing test: normative data. Neuropsychol Dev Cogn B Ag­­ing Neuropsychol Cogn 2014; 21(6): 693– 721. doi: 10.1080/ 13825585.2013.865699.

47. Drozdová K, Štěpánková H, Lukavský J et al. Normativní studie testu Reyovy-Oster­riethovy komplexní figu­ry v populaci českých seniorů. Cesk Slov Neurol N 2015; 78/ 111(5): 542– 549.

48. Sheikh F, Ismail Z, Mortby ME et al. Prevalence of mild behavioral impairment in mild cognitive impairment and subjective cognitive decline, and its as­sociation with caregiver burden. Int Psychogeriatr 2018; 30(2): 233– 244. doi: 10.1017/ S104161021700151X.

49. Mortby ME, Ismail Z, Anstey KJ. Prevalence estimates of mild behavioral impairment in a population-based sample of pre-dementia states and cognitively healthy older adults. Int Psychogeriatr 2018; 30(2): 221– 232. doi: 10.1017/ S1041610217001909.

50. Hill NL, Mogle J, Wion R et al. Subjective cognitive impairment and af­fective symp­toms: a systematic review. Gerontologist 2016; 56(6): e109– e127. doi: 10.1093/ geront/ gnw091

51. MBItest. [online]. Available from URL: https:/ / mbitest.org/ .

Labels
Paediatric neurology Neurosurgery Neurology Psychiatry

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 1

2020 Issue 1

Most read in this issue
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#