journal articles
NEUROPSYCHIATRIC SYMPTOMS AND DEMENTIA DEVELOPMENT: A 15-YEAR POPULATION-BASED STUDY
Francesca Remelli, Giulia Grande, Serhiy Dekhtyar, Erika J Laukka, Caterina Trevisan, Stefano Volpato, Laura Fratiglioni, Federico Triolo
BACKGROUND: Mild Behavioral Impairment (MBI) has been proposed to detect neuropsychiatric symptoms (NPS) associated with dementia development, but evidence from population-based settings is limited.
OBJECTIVES: To (i) investigate the association between NPS in late life and the onset of dementia over 15 years in community-dwelling older adults, and (ii) test the interplay of NPS and Cognitive Impairment, No Dementia (CIND) in dementia development.
METHODS: 2597 dementia-free individuals aged 60+ from a longitudinal population-based cohort underwent cognitive assessments over 15 years. Thirty clinically-assessed NPS were mapped into five domains and, within each domain, a z-score was computed from the sum of the NPS’s points. MBI was identified when the z-score was above 1.5 standard deviations (SDs) in at least one of 5 neuropsychiatric domains. Based on a cognitive battery, CIND was defined as scoring ≥1.5 SDs below age-specific means in at least one cognitive domain. Dementia was diagnosed by DSM-IV criteria following standardized procedures.
RESULTS: MBI, present in 16.1% of the sample, was associated with a higher hazard of incident dementia over 15 years (multi-adjusted hazard ratio [HR] 1.68, 95% confidence interval [CI] 1.31–2.17). Decreased motivation and social inappropriateness were the domains associated with incident dementia (HR 2.23, 95%CI 1.59–3.14 and HR 3.29, 95%CI 1.83–5.94, respectively). Compared to those with neither, individuals with either MBI (HR 1.37, 95%CI 1.00–1.90) or CIND (HR 2.22, 95%CI 1.73–2.84) had increased dementia incidence, especially when co-occurring (HR 4.41, 95%CI 3.04–6.39).
CONCLUSIONS: Late life NPS, especially with co-occurring cognitive impairment, was associated with a higher dementia incidence.
CITATION:
Francesca Remelli ; Giulia Grande ; Serhiy Dekhtyar ; Erika J Laukka ; Caterina Trevisan ; Stefano Volpato ; Laura Fratiglioni ; Federico Triolo (2025): Neuropsychiatric symptoms and dementia development: a 15-year population-based study. The Journal of Prevention of Alzheimer’s Disease (JPAD). https://doi.org/10.1016/j.tjpad.2026.100596