04046nas a2200421 4500008004100000022001400041245013300055210006900188260001600257300001200273490000800285520283600293653000903129653001503138653001203153653002403165653002403189653001603213653002803229653001403257653001303271653001503284653003303299653001103332653001103343653002503354653000903379653002903388653001503417653002503432100002903457700001703486700001903503700002803522700001903550700002003569856003503589 2002 eng d a0098-748400aPrevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study.0 aPrevalence of neuropsychiatric symptoms in dementia and mild cog c2002 Sep 25 a1475-830 v2883 a

CONTEXT: Mild cognitive impairment (MCI) may be a precursor to dementia, at least in some cases. Dementia and MCI are associated with neuropsychiatric symptoms in clinical samples. Only 2 population-based studies exist of the prevalence of these symptoms in dementia, and none exist for MCI.

OBJECTIVE: To estimate the prevalence of neuropsychiatric symptoms in dementia and MCI in a population-based study.

DESIGN: Cross-sectional study derived from the Cardiovascular Health Study, a longitudinal cohort study.

SETTING AND PARTICIPANTS: A total of 3608 participants were cognitively evaluated using data collected longitudinally over 10 years and additional data collected in 1999-2000 in 4 US counties. Dementia and MCI were classified using clinical criteria and adjudicated by committee review by expert neurologists and psychiatrists. A total of 824 individuals completed the Neuropsychiatric Inventory (NPI); 362 were classified as having dementia, 320 as having MCI; and 142 did not meet criteria for MCI or dementia.

MAIN OUTCOME MEASURE: Prevalence of neuropsychiatric symptoms, based on ratings on the NPI in the previous month and from the onset of cognitive symptoms.

RESULTS: Of the 682 individuals with dementia or MCI, 43% of MCI participants (n = 138) exhibited neuropsychiatric symptoms in the previous month (29% rated as clinically significant) with depression (20%), apathy (15%), and irritability (15%) being most common. Among the dementia participants, 75% (n = 270) had exhibited a neuropsychiatric symptom in the past month (62% were clinically significant); 55% (n = 199) reported 2 or more and 44% (n = 159) 3 or more disturbances in the past month. In participants with dementia, the most frequent disturbances were apathy (36%), depression (32%), and agitation/aggression (30%). Eighty percent of dementia participants (n = 233) and 50% of MCI participants (n = 139) exhibited at least 1 NPI symptom from the onset of cognitive symptoms. There were no differences in prevalence of neuropsychiatric symptoms between participants with Alzheimer-type dementia and those with other dementias, with the exception of aberrant motor behavior, which was more frequent in Alzheimer-type dementia (5.4% vs 1%; P =.02).

CONCLUSIONS: Neuropsychiatric symptoms occur in the majority of persons with dementia over the course of the disease. These are the first population-based estimates for neuropsychiatric symptoms in MCI, indicating a high prevalence associated with this condition as well. These symptoms have serious adverse consequences and should be inquired about and treated as necessary. Study of neuropsychiatric symptoms in the context of dementia may improve our understanding of brain-behavior relationships.

10aAged10aAggression10aAnxiety10aBehavioral Symptoms10aCognition Disorders10aComorbidity10aCross-Sectional Studies10aDelusions10aDementia10aDepression10aFeeding and Eating Disorders10aFemale10aHumans10aLongitudinal Studies10aMale10aNeuropsychological Tests10aPrevalence10aSleep Wake Disorders1 aLyketsos, Constantine, G1 aLopez, Oscar1 aJones, Beverly1 aFitzpatrick, Annette, L1 aBreitner, John1 aDeKosky, Steven uhttps://chs-nhlbi.org/node/70202544nas a2200397 4500008004100000022001400041245011400055210006900169260001600238300001100254490000800265520141500273653000901688653002201697653002201719653002201741653001301763653002301776653001101799653001301810653001101823653000901834653001901843653003201862653002401894653001701918653001801935100002601953700002001979700002101999700002002020700002002040700002202060700002902082856003502111 2005 eng d a0002-926200aPhysical activity, APOE genotype, and dementia risk: findings from the Cardiovascular Health Cognition Study.0 aPhysical activity APOE genotype and dementia risk findings from  c2005 Apr 01 a639-510 v1613 a

Physical activity may help preserve cognitive function and decrease dementia risk, but epidemiologic findings are inconsistent. The authors conducted a prospective study to determine the association between physical activity and risk of dementia, Alzheimer's disease, and vascular dementia. The US study population comprised 3,375 men and women aged 65 years or older, free of dementia at baseline, who participated in the Cardiovascular Health Cognition Study in 1992-2000. Leisure-time energy expenditure and an activity index reflecting number of different physical activities were calculated. Analyses were based on Cox proportional hazards models. There were 480 incident cases of dementia over an average of 5.4 years of follow-up. After multivariate adjustment, participants in the highest quartile of physical energy expenditure had a relative risk of dementia of 0.85 (95% confidence interval: 0.61, 1.19) compared with those in the lowest quartile, and participants engaging in >or=4 activities had a relative risk of dementia of 0.51 (95% confidence interval: 0.33, 0.79) compared with those engaging in 0-1 activity. These associations were more marked in apolipoprotein E genotype (APOE) epsilon4 allele noncarriers but were absent in carriers. A similar pattern was observed for Alzheimer's disease and vascular dementia. Mechanisms to explain the observed relations deserve further study.

10aAged10aAged, 80 and over10aAlzheimer Disease10aApolipoproteins E10aDementia10aDementia, Vascular10aFemale10aGenotype10aHumans10aMale10aMotor Activity10aProportional Hazards Models10aProspective Studies10aRisk Factors10aUnited States1 aPodewils, Laura, Jean1 aGuallar, Eliseo1 aKuller, Lewis, H1 aFried, Linda, P1 aLopez, Oscar, L1 aCarlson, Michelle1 aLyketsos, Constantine, G uhttps://chs-nhlbi.org/node/824