De predictieve waarde van de Neuropsychiatric Inventory Questionnaire (NPI-Q) in het conversieproces van Mild Cognitive Impairment naar Dementie: een retrospectieve dossierstudie

Scriptie/masterproef: Master's Thesis

Uittreksel

Introduction: Mild Cognitive Impairment (MCI) is frequently associated with
progression to dementia. In addition to alterations of the cognitive and
functional status, neuropsychiatric symptoms (NPS) in MCI can be early
manifestations of such an evolving process. However, evidence about
the predictive values of these NPS is highly fragmented and consensus
is scarce. This study aimed to determine the predictive value of NPS,
measured with the NPI-Q, in the conversion process from MCI to
dementia.

Methods: This study was a retrospective longitudinal (three years) dossier study
of patients who had received an MCI diagnosis in the Day Hospital
Geriatrics of the UZ Brussel (n=235). In addition to baseline biographical
characteristics, test performance was recorded of the following: Mini
Mental State Examination (MMSE), Cambridge Disorders or the Elderly
Examination (CamCog), Memory Impairment Screen (MIS) and Visual
Association Test (VAT). Depressive characteristics were measured with
the Short Depression Scale (KDS) and the Geriatric Depression Scale
(GDS-15). Neuropsychiatric symptoms were recorded with the
Neuropsychiatric Inventory Questionnaire (NPI-Q). The data were
analyzed by means of descriptive and basic inferential statistics, and
subsequently by means of survival analysis and predictive modeling.

Results: After a study duration of three years, 22.0% of the subjects had, on
average after 1.1 years, converted to dementia and 17.0% had
remained stable. Sixty-three and a half percent of the converted subjects
had converted to Alzheimer's dementia. Neuropsychiatric symptoms
were very prevalent (82.6%) in our sample. Converters had more severe
and more burdensome signs of irritability/lability at baseline than non-
converters. We found strong predictive values for age (OR=1.12,
HR=1.12) and Camcog test performance (OR=0.90, HR=0.90). Of the
NPS only sleep wake disorders (HR=2.80) and apathy/indifference
(HR=1.87) were predictive for conversion. The total score (HR=1.02)
and total severity score (HR=1.08) of the NPI-Q were also predictive.

Discussion: This study made a valuable contribution to the clinical diagnosis and
follow-up of the MCI profiles that are most at risk of conversion through
the identification of predictive NPS. In addition, our results suggested
that the NPI-Q is a suitable tool to measure these NPS and to supplement
the cognitive and functional diagnostic evaluations. However, further
and more extensive longitudinal research is needed to confirm our study
findings.
Datum Prijs2018
TaalDutch
BegeleiderEllen Gorus (Promotor) & Patricia De Vriendt (Promotor)

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