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Behavioral and psychological symptoms and cognitive decline in patients with amnestic MCI and mild AD: a two-year follow-up study

Published online by Cambridge University Press:  16 January 2015

Cornelia Pocnet ,
Jean-Philippe Antonietti ,
Alessia Donati ,
Julius Popp ,
Jérôme Rossier  and
Armin von Gunten
Cornelia Pocnet*
Affiliation:
Institute of Psychology, University of Lausanne, Lausanne, Switzerland
Jean-Philippe Antonietti
Affiliation:
Institute of Psychology, University of Lausanne, Lausanne, Switzerland
Alessia Donati
Affiliation:
Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
Julius Popp
Affiliation:
Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
Jérôme Rossier
Affiliation:
Institute of Psychology, University of Lausanne, Lausanne, Switzerland
Armin von Gunten
Affiliation:
Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
*
Correspondence should be addressed to: Cornelia Pocnet, Institute of Psychology, University of Lausanne, Géopolis, 1015 Lausanne, Switzerland. Email: [email protected].
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Abstract

Background:

Mild cognitive impairment (MCI) has been defined as a transitional state between normal aging and dementia. In many cases, MCI represents an early stage of developing cognitive impairment. Patients diagnosed with MCI do not meet the criteria for dementia as their general intellect and everyday activities are preserved, although minor changes in instrumental activities of daily living (ADL) may occur. However, they may exhibit significant behavioral and psychological signs and symptoms (BPS), also frequently observed in patients with Alzheimer's disease (AD). Hence, we wondered to what extent specific BPS are associated with cognitive decline in participants with MCI or AD.

Methods:

Our sample consisted of 164 participants, including 46 patients with amnestic (single or multi-domain) MCI and 54 patients with AD, as well as 64 control participants without cognitive disorders. Global cognitive performance, BPS, and ADL were assessed using validated clinical methods at baseline and at two-year follow-up.

Results:

The BPS variability over the follow-up period was more pronounced in the MCI group than in patients with AD: some BPS improve, others occur newly or worsen, while others still remain unchanged. Moreover, specific changes in BPS were associated with a rapid deterioration of the global cognitive level in MCI patients. In particular, an increase of euphoria, eating disorders, and aberrant motor behavior, as well as worsened sleep quality, predicted a decline in cognitive functioning.

Conclusions:

Our findings confirm a higher variability of BPS over time in the MCI group than in AD patients. Moreover, our results provide evidence of associations between specific BPS and cognitive decline in the MCI group that might suggest a risk of conversion of individuals with amnestic MCI to AD.

Keywords

behavioral and psychological symptomscognitive leveldaily living functioning
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 8 , August 2015 , pp. 1379 - 1389
Copyright
Copyright © International Psychogeriatric Association 2015 

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