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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
12:18

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment

Published on: January 11, 2020

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Neuropsychiatric Symptoms and the Diagnostic Stability of Mild Cognitive Impairment

Michael A Sugarman1,2, Michael L Alosco1,3, Yorghos Tripodis1,4

  • 1Boston University Alzheimer's Disease Center, Boston, MA, USA.

Journal of Alzheimer'S Disease : JAD
|April 5, 2018
PubMed
Abstract

Insights

Neuropsychiatric symptoms influence cognitive diagnoses. Specific symptoms are linked to progression from normal cognition to mild cognitive impairment (MCI) and a lower chance of reverting from MCI to normal cognition.

Area of Science:

  • Neurology
  • Gerontology
  • Psychiatry

Background:

  • Mild cognitive impairment (MCI) represents a transitional stage between normal cognition (NC) and dementia, such as Alzheimer's disease (AD) dementia.
  • MCI is characterized by diagnostic heterogeneity, with individuals exhibiting varying trajectories, including reversion to NC, stability, or progression to AD dementia.
  • Understanding factors contributing to MCI's temporal instability is crucial for refining clinical classifications and predicting cognitive outcomes.

Purpose of the Study:

  • To investigate the role of neuropsychiatric symptoms in the temporal instability of cognitive diagnoses.
  • To determine if symptoms measured by the Neuropsychiatric Inventory Questionnaire (NPI-Q) and Geriatric Depression Scale (GDS-15) correlate with changes in cognitive status.

Main Methods:

  • Utilized data from 6,763 participants in the National Alzheimer's Coordinating Center Uniform Data Set with NC at baseline.
  • Employed generalized linear models with generalized estimating equations to analyze associations between cognitive diagnosis changes and NPI-Q/GDS-15 symptom scores over a mean follow-up of 5.5 years.
  • Included participants with at least two follow-up visits and no recent neurological conditions.

Main Results:

  • Of 1,121 participants who converted from NC to MCI, 324 reverted to NC and 242 progressed to AD dementia.
  • Elevated GDS-15 scores and specific NPI-Q symptom domains were associated with NC to MCI conversion and reduced likelihood of MCI reversion.
  • Higher NPI-Q scores for Hyperactivity and Mood symptoms predicted progression to AD dementia.

Conclusions:

  • Neuropsychiatric symptoms partially explain the temporal instability observed in mild cognitive impairment diagnoses.
  • Specific neuropsychiatric symptoms are linked to increased risk of progressing to Alzheimer's disease dementia and decreased likelihood of recovery to normal cognition.
  • Targeting and treating these neuropsychiatric symptoms may offer a strategy to support cognitive function in older adults.
Keywords:
Alzheimer’s diseaseantidepressantsdepressionmild cognitive impairmentneuropsychiatric symptoms

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