Point and 5-year period prevalence of neuropsychiatric symptoms in dementia: The Cache county study

Martin Steinberg, Huibo Shao, Peter Zandi, Constantine G. Lyketsos, Kathleen A. Welsh-Bohmer, Maria C. Norton, John C S Breitner, David C. Steffens, JoAnn T. Tschanz, Kathleen Hayden, Cara Brewer, Tony Calvert, Michelle McCart, Tiffany Newman, Roxane Pfister, Nancy Sassano, Joslin Werstack, James Anthony, Erin Bigler, John BreitnerRon Brookmeyer, James Burke, Eric Christopher, Chris Corcoran, Jane Gagliardi, Robert Green, Kathleen Hayden, Michael Helms, Christine Hulette, Liz Klein, Carol Leslie, Constantine Lyketsos, Lawrence Mayer, John Morris, Ron Munger, Maria Norton, Chiadi Onyike, Truls Ostbye, Ron Petersen, Kathy Piercy, Carl Pieper, Brenda Plassman, Peter Rabins, Pritham Raj, Russell Ray, Linda Sanders, Ingmar Skoog, David Steffens, Martin Steinberg, Marty Toohill, Leslie Toone, Jeannette Townsend, Jo Ann Tschanz, Lauren Warren, Kathleen Welsh-Bohmer, Heidi Wengreen, Michael Williams, Bonita Wyse, Peter Zandi

Research output: Contribution to journalArticle

341 Citations (Scopus)

Abstract

Background: Neuropsychiatric symptoms are nearly universal in dementia, yet little is known about their longitudinal course in the community. Objective: To estimate point and 5-year period prevalence of neuropsychiatric symptoms in an incident sample of 408 dementia participants from the Cache County Study. Methods: The Neuropsychiatric Inventory assessed symptoms at baseline and at 1.5 years, 3.0 years, 4.1 years, and 5.3 years. Point prevalence, period prevalence and mean symptom severity at each time point were estimated. Results: Point prevalence for delusions was 18% at baseline and 34-38% during the last three visits; hallucinations, 10% at baseline and 19-24% subsequently; agitation/aggression fluctuated between 13% and 24%; depression 29% at baseline and 41-47% subsequently; apathy increased from 20% at baseline to 51% at 5.3 years; elation never rose above 1%; anxiety 14% at baseline and 24-32% subsequently; disinhibition fluctuated between 2% and 15%; irritability between 17% and 27%; aberrant motor behavior gradually increased from 7% at baseline to 29% at 5.3 years. Point prevalence for any symptom was 56% at baseline and 76-87% subsequently. Five-year period prevalence was greatest for depression (77%), apathy (71%), and anxiety (62%); lowest for elation (6%), and disinhibition (31%). Ninety-seven percent experienced at least one symptom. Symptom severity was consistently highest for apathy. Conclusions: Participants were most likely to develop depression, apathy, or anxiety, and least likely to develop elation or disinhibition. Give converging evidence that syndromal definitions may more accurately capture neuropsychiatric co-morbidity in dementia, future efforts to validate such syndromes are warranted.

Original languageEnglish (US)
Pages (from-to)170-177
Number of pages8
JournalInternational Journal of Geriatric Psychiatry
Volume23
Issue number2
DOIs
StatePublished - 2008
Externally publishedYes

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Dementia
Apathy
Anxiety
Depression
Delusions
Hallucinations
Aggression
Morbidity
Equipment and Supplies

Keywords

  • Dementia
  • Neuropsychiatric
  • Prevalence

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Steinberg, M., Shao, H., Zandi, P., Lyketsos, C. G., Welsh-Bohmer, K. A., Norton, M. C., ... Zandi, P. (2008). Point and 5-year period prevalence of neuropsychiatric symptoms in dementia: The Cache county study. International Journal of Geriatric Psychiatry, 23(2), 170-177. https://doi.org/10.1002/gps.1858

Point and 5-year period prevalence of neuropsychiatric symptoms in dementia : The Cache county study. / Steinberg, Martin; Shao, Huibo; Zandi, Peter; Lyketsos, Constantine G.; Welsh-Bohmer, Kathleen A.; Norton, Maria C.; Breitner, John C S; Steffens, David C.; Tschanz, JoAnn T.; Hayden, Kathleen; Brewer, Cara; Calvert, Tony; McCart, Michelle; Newman, Tiffany; Pfister, Roxane; Sassano, Nancy; Werstack, Joslin; Anthony, James; Bigler, Erin; Breitner, John; Brookmeyer, Ron; Burke, James; Christopher, Eric; Corcoran, Chris; Gagliardi, Jane; Green, Robert; Hayden, Kathleen; Helms, Michael; Hulette, Christine; Klein, Liz; Leslie, Carol; Lyketsos, Constantine; Mayer, Lawrence; Morris, John; Munger, Ron; Norton, Maria; Onyike, Chiadi; Ostbye, Truls; Petersen, Ron; Piercy, Kathy; Pieper, Carl; Plassman, Brenda; Rabins, Peter; Raj, Pritham; Ray, Russell; Sanders, Linda; Skoog, Ingmar; Steffens, David; Steinberg, Martin; Toohill, Marty; Toone, Leslie; Townsend, Jeannette; Tschanz, Jo Ann; Warren, Lauren; Welsh-Bohmer, Kathleen; Wengreen, Heidi; Williams, Michael; Wyse, Bonita; Zandi, Peter.

In: International Journal of Geriatric Psychiatry, Vol. 23, No. 2, 2008, p. 170-177.

Research output: Contribution to journalArticle

Steinberg, M, Shao, H, Zandi, P, Lyketsos, CG, Welsh-Bohmer, KA, Norton, MC, Breitner, JCS, Steffens, DC, Tschanz, JT, Hayden, K, Brewer, C, Calvert, T, McCart, M, Newman, T, Pfister, R, Sassano, N, Werstack, J, Anthony, J, Bigler, E, Breitner, J, Brookmeyer, R, Burke, J, Christopher, E, Corcoran, C, Gagliardi, J, Green, R, Hayden, K, Helms, M, Hulette, C, Klein, L, Leslie, C, Lyketsos, C, Mayer, L, Morris, J, Munger, R, Norton, M, Onyike, C, Ostbye, T, Petersen, R, Piercy, K, Pieper, C, Plassman, B, Rabins, P, Raj, P, Ray, R, Sanders, L, Skoog, I, Steffens, D, Steinberg, M, Toohill, M, Toone, L, Townsend, J, Tschanz, JA, Warren, L, Welsh-Bohmer, K, Wengreen, H, Williams, M, Wyse, B & Zandi, P 2008, 'Point and 5-year period prevalence of neuropsychiatric symptoms in dementia: The Cache county study', International Journal of Geriatric Psychiatry, vol. 23, no. 2, pp. 170-177. https://doi.org/10.1002/gps.1858
Steinberg, Martin ; Shao, Huibo ; Zandi, Peter ; Lyketsos, Constantine G. ; Welsh-Bohmer, Kathleen A. ; Norton, Maria C. ; Breitner, John C S ; Steffens, David C. ; Tschanz, JoAnn T. ; Hayden, Kathleen ; Brewer, Cara ; Calvert, Tony ; McCart, Michelle ; Newman, Tiffany ; Pfister, Roxane ; Sassano, Nancy ; Werstack, Joslin ; Anthony, James ; Bigler, Erin ; Breitner, John ; Brookmeyer, Ron ; Burke, James ; Christopher, Eric ; Corcoran, Chris ; Gagliardi, Jane ; Green, Robert ; Hayden, Kathleen ; Helms, Michael ; Hulette, Christine ; Klein, Liz ; Leslie, Carol ; Lyketsos, Constantine ; Mayer, Lawrence ; Morris, John ; Munger, Ron ; Norton, Maria ; Onyike, Chiadi ; Ostbye, Truls ; Petersen, Ron ; Piercy, Kathy ; Pieper, Carl ; Plassman, Brenda ; Rabins, Peter ; Raj, Pritham ; Ray, Russell ; Sanders, Linda ; Skoog, Ingmar ; Steffens, David ; Steinberg, Martin ; Toohill, Marty ; Toone, Leslie ; Townsend, Jeannette ; Tschanz, Jo Ann ; Warren, Lauren ; Welsh-Bohmer, Kathleen ; Wengreen, Heidi ; Williams, Michael ; Wyse, Bonita ; Zandi, Peter. / Point and 5-year period prevalence of neuropsychiatric symptoms in dementia : The Cache county study. In: International Journal of Geriatric Psychiatry. 2008 ; Vol. 23, No. 2. pp. 170-177.
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T1 - Point and 5-year period prevalence of neuropsychiatric symptoms in dementia

T2 - The Cache county study

AU - Steinberg, Martin

AU - Shao, Huibo

AU - Zandi, Peter

AU - Lyketsos, Constantine G.

AU - Welsh-Bohmer, Kathleen A.

AU - Norton, Maria C.

AU - Breitner, John C S

AU - Steffens, David C.

AU - Tschanz, JoAnn T.

AU - Hayden, Kathleen

AU - Brewer, Cara

AU - Calvert, Tony

AU - McCart, Michelle

AU - Newman, Tiffany

AU - Pfister, Roxane

AU - Sassano, Nancy

AU - Werstack, Joslin

AU - Anthony, James

AU - Bigler, Erin

AU - Breitner, John

AU - Brookmeyer, Ron

AU - Burke, James

AU - Christopher, Eric

AU - Corcoran, Chris

AU - Gagliardi, Jane

AU - Green, Robert

AU - Hayden, Kathleen

AU - Helms, Michael

AU - Hulette, Christine

AU - Klein, Liz

AU - Leslie, Carol

AU - Lyketsos, Constantine

AU - Mayer, Lawrence

AU - Morris, John

AU - Munger, Ron

AU - Norton, Maria

AU - Onyike, Chiadi

AU - Ostbye, Truls

AU - Petersen, Ron

AU - Piercy, Kathy

AU - Pieper, Carl

AU - Plassman, Brenda

AU - Rabins, Peter

AU - Raj, Pritham

AU - Ray, Russell

AU - Sanders, Linda

AU - Skoog, Ingmar

AU - Steffens, David

AU - Steinberg, Martin

AU - Toohill, Marty

AU - Toone, Leslie

AU - Townsend, Jeannette

AU - Tschanz, Jo Ann

AU - Warren, Lauren

AU - Welsh-Bohmer, Kathleen

AU - Wengreen, Heidi

AU - Williams, Michael

AU - Wyse, Bonita

AU - Zandi, Peter

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N2 - Background: Neuropsychiatric symptoms are nearly universal in dementia, yet little is known about their longitudinal course in the community. Objective: To estimate point and 5-year period prevalence of neuropsychiatric symptoms in an incident sample of 408 dementia participants from the Cache County Study. Methods: The Neuropsychiatric Inventory assessed symptoms at baseline and at 1.5 years, 3.0 years, 4.1 years, and 5.3 years. Point prevalence, period prevalence and mean symptom severity at each time point were estimated. Results: Point prevalence for delusions was 18% at baseline and 34-38% during the last three visits; hallucinations, 10% at baseline and 19-24% subsequently; agitation/aggression fluctuated between 13% and 24%; depression 29% at baseline and 41-47% subsequently; apathy increased from 20% at baseline to 51% at 5.3 years; elation never rose above 1%; anxiety 14% at baseline and 24-32% subsequently; disinhibition fluctuated between 2% and 15%; irritability between 17% and 27%; aberrant motor behavior gradually increased from 7% at baseline to 29% at 5.3 years. Point prevalence for any symptom was 56% at baseline and 76-87% subsequently. Five-year period prevalence was greatest for depression (77%), apathy (71%), and anxiety (62%); lowest for elation (6%), and disinhibition (31%). Ninety-seven percent experienced at least one symptom. Symptom severity was consistently highest for apathy. Conclusions: Participants were most likely to develop depression, apathy, or anxiety, and least likely to develop elation or disinhibition. Give converging evidence that syndromal definitions may more accurately capture neuropsychiatric co-morbidity in dementia, future efforts to validate such syndromes are warranted.

AB - Background: Neuropsychiatric symptoms are nearly universal in dementia, yet little is known about their longitudinal course in the community. Objective: To estimate point and 5-year period prevalence of neuropsychiatric symptoms in an incident sample of 408 dementia participants from the Cache County Study. Methods: The Neuropsychiatric Inventory assessed symptoms at baseline and at 1.5 years, 3.0 years, 4.1 years, and 5.3 years. Point prevalence, period prevalence and mean symptom severity at each time point were estimated. Results: Point prevalence for delusions was 18% at baseline and 34-38% during the last three visits; hallucinations, 10% at baseline and 19-24% subsequently; agitation/aggression fluctuated between 13% and 24%; depression 29% at baseline and 41-47% subsequently; apathy increased from 20% at baseline to 51% at 5.3 years; elation never rose above 1%; anxiety 14% at baseline and 24-32% subsequently; disinhibition fluctuated between 2% and 15%; irritability between 17% and 27%; aberrant motor behavior gradually increased from 7% at baseline to 29% at 5.3 years. Point prevalence for any symptom was 56% at baseline and 76-87% subsequently. Five-year period prevalence was greatest for depression (77%), apathy (71%), and anxiety (62%); lowest for elation (6%), and disinhibition (31%). Ninety-seven percent experienced at least one symptom. Symptom severity was consistently highest for apathy. Conclusions: Participants were most likely to develop depression, apathy, or anxiety, and least likely to develop elation or disinhibition. Give converging evidence that syndromal definitions may more accurately capture neuropsychiatric co-morbidity in dementia, future efforts to validate such syndromes are warranted.

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KW - Neuropsychiatric

KW - Prevalence

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