Neuropsychiatric symptoms as risk factors for progression from CIND to dementia: The Cache County Study

M. E. Peters, P. B. Rosenberg, M. Steinberg, M. C. Norton, K. A. Welsh-Bohmer, K. M. Hayden, J. Breitner, J. T. Tschanz, C. G. Lyketsos

Research output: Contribution to journalArticlepeer-review


Objectives: To examine the association of neuropsychiatric symptom (NPS) severity with risk of transition to all-cause dementia, Alzheimer disease (AD), and vascular dementia (VaD). Design: Survival analysis of time to dementia, AD, or VaD onset. Setting: Population-based study. Participants: 230 participants diagnosed with cognitive impairment, no dementia (CIND) from the Cache County Study of Memory Health and Aging were followed for a mean of 3.3 years. Measurements: The Neuropsychiatric Inventory (NPI) was used to quantify the presence, frequency, and severity of NPS. Chi-squared statistics, t-tests, and Cox proportional hazard ratios were used to assess associations. Results: The conversion rate from CIND to all-cause dementia was 12% per year, with risk factors including an APOE å4 allele, lower Mini-Mental State Examination, lower 3MS, and higher CDR sum-of-boxes. The presence of at least one NPS was a risk factor for all-cause dementia, as was the presence of NPS with mild severity. Nighttime behaviors were a risk factor for all-cause dementia and of AD, whereas hallucinations were a risk factor for VaD. Conclusions: These data confirm that NPS are risk factors for conversion from CIND to dementia. Of special interest is that even NPS of mild severity are a risk for all-cause dementia or AD.

Original languageEnglish (US)
Pages (from-to)1116-1124
Number of pages9
JournalAmerican Journal of Geriatric Psychiatry
Issue number11
StatePublished - Nov 2013


  • Agitation
  • Anxiety
  • CIND
  • Cache County
  • Dementia
  • Depression
  • MCI
  • NPI
  • NPS

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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