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Neuropsychiatric symptoms in MCI subtypes: the importance of executive dysfunction

Paul B Rosenberg1, Michelle M Mielke, Brian Appleby

  • 1Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA. prosenb9@jhmi.edu.

International Journal of Geriatric Psychiatry
|September 17, 2010
PubMed
Abstract

Insights

Mild cognitive impairment (MCI) with executive dysfunction, not amnestic MCI, showed more neuropsychiatric symptoms like depression and anxiety. These findings suggest executive function impacts symptom severity in MCI patients.

Area of Science:

  • Neurology
  • Gerontology
  • Psychiatry

Background:

  • Mild cognitive impairment (MCI) is a potential precursor to dementia.
  • Alzheimer's dementia (AD) is linked to neuropsychiatric symptoms (NPS).
  • Subtypes of MCI, like amnestic MCI (aMCI), may specifically predict AD development.

Purpose of the Study:

  • To investigate the prevalence of NPS in MCI and its subtypes.
  • To determine if amnestic MCI (aMCI) or executive dysfunction-MCI (exMCI) are associated with NPS.

Main Methods:

  • 1,779 participants from the National Alzheimer's Coordinating Center (NACC) with MCI were analyzed.
  • Participants were subtyped based on amnestic (aMCI) and executive dysfunction (exMCI) criteria.
  • Neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q) and Geriatric Depression Scale (GDS).

Main Results:

  • 77.5% of participants met criteria for aMCI, and 34.6% for exMCI.
  • No significant difference in NPS prevalence was found between aMCI and non-aMCI groups.
  • exMCI was linked to increased severity of depression, anxiety, agitation, disinhibition, irritability, and sleep issues, though not after multiple comparison adjustments.

Conclusions:

  • Executive dysfunction in MCI, rather than amnestic MCI, is associated with a higher severity of NPS.
  • Specifically, executive dysfunction correlated with increased depression and anxiety symptoms.
  • These results may inform MCI prognosis and warrant further longitudinal investigation.

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