Risk factors for neuropsychiatric symptoms in dementia: The Cache County Study

Martin Steinberg, C. Corcoran, J. T. Tschanz, C. Huber, K. Welsh-Bohmer, M. C. Norton, P. Zandi, J. C.S. Breitner, D. C. Steffens, C. G. Lyketsos

Research output: Contribution to journalArticlepeer-review

85 Scopus citations


Objective: To investigate the probability of individual neuropsychiatric symptoms in dementia patients as a function of eight risk factors. Methods: In the Cache County Study, we administered the Neuropsychiatric Inventory (NPI) to 328 dementia patients at baseline. Approximately 18 months later, we re-administered the NPI to 184 participants available for follow-up. Generalized estimating equation methods were used to model the probability of individual neuropsychiatric symptoms as a function of: gender, age, education, dementia type and severity, APOE status, time of observation, and general medical health. Results: Women showed increased tendency toward anxiety, [odds ratio (OR) 2.22, 95% confidence interval (CI) 1.31-3.76] and delusions (OR 2.15, CI 1.22-3.78), but older persons of both sexes showed less tendency toward anxiety. Dementia severity increased the tendency toward hallucinations and agitation (OR 2.42, CI 1.81-3.23) and decreased risk of depression. Positive APOE ε4 status increased the tendency toward aberrant motor behavior (OR 1.84, CI 1.05-3.22). Among dementia diagnoses, those with Alzheimer's disease showed decreased tendency toward agitation (OR 0.58, CI 0.35-0.95), depression (OR 0.56, CI 0.33-0.96) and disinhibition (OR 0.46, CI 0.24-0.88). Later time of observation increased risk of aberrant motor behavior and delusions, and more serious medical comorbidity increased risk of, agitation, irritability, disinhibition, and aberrant motor behavior. Conclusions: Gender, age, dementia severity, APOE ε4, dementia diagnosis, time of observation, and general medical health appear to influence the occurrence of individual neuropsychiatric symptoms.

Original languageEnglish (US)
Pages (from-to)824-830
Number of pages7
JournalInternational journal of geriatric psychiatry
Issue number9
StatePublished - Sep 2006


  • Alzheimer
  • Dementia
  • Neuropsychiatric
  • Risk factors

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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