Neuropsychiatric Symptoms and Incident Cognitive Decline and Dementia in Cognitively Normal Older Adults: A Systematic Review and Meta-Analysis
Date
2022-06
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Objective: To determine risks of cognitive decline or dementia in cognitively normal cohorts with neuropsychiatric symptoms (NPS), stratified by mild behavioral impairment (MBI) domains. Methods: A systematic search (MEDLINE, EMBASE, and PSYCINFO) was completed up to January 2022. Pooled hazard ratios (HR) with Standard Error (SE), I2, and tau2 were determined utilizing DerSimonian-Laird random-effects models. Heterogeneity and publication bias were investigated. PRISMA and MOOSE checklists were followed. Results: Of 12,674 screened abstracts, 36 prospective studies representing 326,739 participants were included. Risks (HR) for incident cognitive decline or dementia by MBI domain were: 1) apathy 2.00 (95%CI:1.57-2.57); 2) affect 1.61 (95%CI:1.45-1.80; adjusted 1.44, 95%CI:1.30-1.61); 3) agitation 3.07 (95%CI: 2.15-4.38); 4) social inappropriateness 3.84 (95%CI:1.54-9.55); and 5) psychosis 3.99 (95%CI:3.05-5.23). Heterogeneity was most evident in affect (I2=86.56%, tau2=0.04), with time and NPS ascertainment as the main contributors. Conclusion: Cognitively normal older adults with NPS are at greater risk for mild cognitive impairment and dementia than those without NPS. Risks differ between the 5 MBI domains.
Description
Keywords
Dementia, Neuropsychiatric Symptoms, Mild Behavioral Impairment, Normal Cognition, Mild Cognitive Impairment
Citation
Elbayoumi, H. (2022). Neuropsychiatric symptoms and Incident cognitive decline and dementia in cognitively normal older adults: a systematic review and meta-analysis (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.