Background
Methods
Study participants
Informed Consent and Confidentiality
Assessment of behavioural and psychological symptoms
Assessment of cognitive function and definition for 'mild cognitive impairment' criteria
Covariates
Statistical analysis
Results
Characteristics of study participants
No Cognitive Impairment | MCI | OCIND | |
---|---|---|---|
Age mean(se) | 73.5 (0.28) | 73.8 (0.43) | 73.5 (0.31) |
MMSE mean(se) | 27.4 (0.08) | 25.4 (0.14) | 24.4 (0.18) |
Female N(%) | 389 (58) | 242 (62) | 439 (65) |
Living in institutions N(%) | 8 (1.2) | 11 (2.8) | 23 (3.4) |
Vascular disease N(%) | 134 (20) | 111 (29) | 164 (24) |
Taking anti-depressant medication | 20 (3.0) | 23 (5.9) | 29 (4.3) |
Taking anti-psychotic medication | 2 (0.3) | 1 (0.3) | 5 (0.7) |
Impaired activities of daily living N(%) | 66 (10) | 69 (18) | 140 (21) |
More than 9 years education N(%) | 310 (46) | 108 (28) | 153 (23) |
Regular contact with family N(%) | 374 (73) | 222 (83) | 397 (79) |
Poor self-rated health N(%) | 178 (27) | 168 (44) | 256 (38) |
Lower social class N(%) | 365 (54) | 278 (71) | 493 (73) |
Prevalence of symptoms across MMSE cognitive classifications
MMSE 18-21 (N = 316) | MMSE 22-25 (N = 659) | MMSE 26-30 (N = 806) | p-value | All without dementia or severe cognitive impairment (N = 1781) | |
---|---|---|---|---|---|
Depression | 58 (17.6) | 67 (8.3) | 73 (7.4) | 0.001 | 198 (8.4) |
Apathy | 78 (25.2) | 98 (13.5) | 88 (9.6) | 0.000 | 264 (11.8) |
Anxiety | 22 (7.2) | 29 (4.0) | 56 (6.7) | 0.147 | 107 (6.0) |
Persecution | 44 (12.7) | 76 (9.5) | 61 (6.8) | 0.012 | 181 (8.0) |
Hallucinations | 24 (6.7) | 27 (3.0) | 29 (3.4) | 0.046 | 80 (3.5) |
Agitation | 23 (7.5) | 28 (3.6) | 28 (2.9) | 0.013 | 79 (3.4) |
Elation | 18 (4.7) | 20 (2.8) | 29 (3.1) | 0.252 | 67 (3.2) |
Irritability | 61 (17.4) | 107 (14.6) | 93 (10.8) | 0.021 | 261 (12.3) |
Sleep problems | 131 (40.3) | 302 (45.4) | 360 (42.4) | 0.366 | 793 (43.0) |
Wandering | 3 (0.6) | 5 (0.4) | 3 (0.2) | 0.817 | 11 (0.3) |
Confabulation | 2 (0.6) | 3 (0.2) | 2 (0.1) | 0.734 | 7 (0.2) |
Misidentification | 18 (6.5) | 20 (2.9) | 19 (2.8) | 0.219 | 57 (3.1) |
No Cognitive Impairment
(N = 670)
|
All MCI
(N = 389)
|
OCIND
(N = 676)
|
p-value
|
Dementia
| |
Depression | 48 (6.0) | 61 (14.5) | 79 (8.5) | 0.002 | 20.5 |
Apathy | 67 (9.0) | 79 (17.8) | 110 (13.1) | 0.004 | 50.3 |
Anxiety | 35 (5.4) | 33 (8.0) | 36 (5.9) | 0.427 | 8.9 |
Persecution | 41 (5.5) | 61 (13.5) | 76 (9.3) | 0.001 | 25.4 |
Hallucinations | 17 (2.3) | 25 (5.2) | 34 (4.3) | 0.148 | 15.1 |
Agitation | 20 (2.6) | 20 (5.2) | 37 (3.9) | 0.228 | 9.0 |
Elation | 21 (2.8) | 17 (5.0) | 27 (2.6) | 0.221 | 9.5 |
Irritability | 73 (10.5) | 82 (17.4) | 100 (12.6) | 0.041 | 28.8 |
Sleep problems | 297 (43.0) | 198 (49.0) | 276 (38.6) | 0.036 | 42.0 |
Wandering | 2 (0.3) | 4 (0.4) | 3 (0.2) | 0.665 | 12.8 |
Confabulation | 2 (0.1) | 2 (0.2) | 3 (0.3) | 0.483 | 5.8 |
Misidentification | 22 (3.5) | 12 (2.4) | 21 (2.4) | 0.524 | 20.3 |
Amnestic MCI
(N = 75)
|
Non-amnestic MCI
(N = 185)
|
Multiple MCI
(N = 129)
|
p-value
| ||
Depression | 7 (9.3) | 29 (14.8) | 25 (18.7) | 0.586 | |
Apathy | 11 (10.8) | 34 (17.9) | 34 (23.8) | 0.202 | |
Anxiety | 7 (12.2) | 12 (5.6) | 14 (9.2) | 0.374 | |
Persecution | 10 (12.7) | 25 (12.3) | 26 (16.9) | 0.723 | |
Hallucinations | 5 (7.6) | 10 (2.4) | 10 (8.8) | 0.042 | |
Agitation | 1 (2.9) | 10 (5.5) | 9 (6.4) | 0.807 | |
Elation | 5 (12.7) | 7 (3.0) | 5 (2.2) | 0.011 | |
Irritability | 20 (24.7) | 35 (15.8) | 27 (14.0) | 0.240 | |
Sleep problems | 31 (44.1) | 97 (48.5) | 70 (54.3) | 0.649 | |
Wandering | 1 (0.4) | 1 (0.2) | 2 (0.8) | 0.682 | |
Confabulation | 1 (0.7) | 0 (0.0) | 1 (0.2) | 0.603 | |
Misidentification | 3 (3.6) | 6 (1.5) | 3 (3.4) | 0.496 |
Prevalence across MCI classifications
Effects of health-related, sociodemographic and cognitive characteristics on presence of symptoms
Co-occurrence of symptoms
Symptom | Factor1 | Factor2 | Factor 3 | Factor 4 | Uniqueness |
---|---|---|---|---|---|
Agitation | -0.03 | 0.06 | -0.02 | 0.16 | 0.96 |
Anxiety | 0.11 |
0.40
| 0.01 | -0.02 | 0.83 |
Apathy | 0.14 |
0.33
| 0.18 | 0.02 | 0.84 |
Confabulation | -0.04 | 0.10 | 0.02 | -0.05 | 0.97 |
Depression | 0.22 |
0.42
| 0.11 | 0.02 | 0.76 |
Elation | 0.17 | 0.00 | 0.22 | 0.21 | 0.88 |
Hallucinations |
0.53
| 0.08 | 0.11 | 0.03 | 0.70 |
Irritability | 0.08 | 0.18 |
0.39
| -0.01 | 0.81 |
Misidentification |
0.49
| 0.12 | 0.00 | -0.01 | 0.74 |
Persecution | 0.07 | 0.09 |
0.42
| 0.01 | 0.81 |
Sleep problems | -0.01 | 0.17 | 0.11 | 0.09 | 0.95 |
Wandering | 0.18 | -0.06 |
0.32
| 0.11 | 0.85 |
MMSE groups
|
Factor 1
|
Factor 2
|
Factor 3
|
Factor 4
|
MMSE 18-21 | mis/hal/wan/ela | apa/mis/anx/dep | per/irr | |
MMSE 22-25 | mis/hal | apa/anx/dep | per/irr | |
MMSE 26-30 | mis/hal | anx/dep/(apa) | per/wan/irr | |
MCI classification
| ||||
Normal | mis/hal | anx/dep | per/wan/irr | |
MCI | mis/hal | apa/anx/dep/sle | per/wan/ela/irr | |
OCIND | mis/hal | apa/anx/dep | per/irr | wan/(ela) |
MCI Subtypes
| ||||
A-MCI | mis/hal | apa/anx/dep/sle | per/wan/ela/irr | agi/irr |
N-MCI | mis/hal/anx/dep | apa/sle | per/irr | ela/agi |
M-MCI | mis/hal/wan/ela | apa/anx/dep | irr/(per) | |
Dementia (adapted from Savva et al 2009 [4]) | mis/hal/con/apa/per/wan | anx/dep/hal | irr/per/agi | agi/ela/hal/sle/wan |