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Depression in Mild Cognitive Impairment is associated with Progression to Alzheimer's Disease: A Longitudinal Study

Article type: Research Article

Authors: Van der Mussele, Stefana; b | Fransen, Erikc | Struyfs, Hannea | Luyckx, Jilla | Mariën, Peterd; e | Saerens, Josd | Somers, Nored | Goeman, Johand | De Deyn, Peter P.a; d; f; g | Engelborghs, Sebastiaana; d; *

Affiliations: [a] Reference Center for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium | [b] Department of Nursing and Midwifery Sciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium | [c] StatUa Center for Statistics, University of Antwerp, Antwerp, Belgium | [d] Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA), Middelheim and Hoge Beuken, Antwerp, Belgium | [e] Department of Clinical and Experimental Neurolinguistics (CLIN), Vrije Universiteit Brussel, Brussels, Belgium | [f] Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium | [g] Department of Neurology and Alzheimer Research Center, University Medical Center Groningen, University of Groningen, The Netherlands

Correspondence: [*] Correspondence to: Dr. Sebastiaan Engelborghs, MD, PhD, University of Antwerp/Institute Born-Bunge; Reference Center for Biological Markers of Dementia (BIODEM), Universiteitsplein 1, BE-2610 Antwerp, Belgium. Tel.: +32 3 265 25 96; Fax: +32 3 265 26 18; E-mail: Sebastiaan.Engelborghs@uantwerpen.be.

Keywords: Alzheimer's disease, association, BPSD, Cox proportional hazard, dementia, depression, depressive symptoms, mild cognitive impairment, predictor, prognostic value

DOI: 10.3233/JAD-140405

Journal: Journal of Alzheimer's Disease, vol. 42, no. 4, pp. 1239-1250, 2014

Accepted 8 May 2014
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Published: 10 October 2014
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Abstract

Background:

Behavioral and psychological signs and symptoms of dementia (BPSD) belong to the core symptoms of dementia and are also common in mild cognitive impairment (MCI).

Objective:

This study would like to contribute to the understanding of the prognostic role of BPSD in MCI for the progression to dementia due to Alzheimer’s disease (AD).

Methods:

Data were generated through an ongoing prospective longitudinal study on BPSD. Assessment was performed by means of the Middelheim Frontality Score, Behave-AD, Cohen-Mansfield Agitation Inventory, Cornell Scale for Depression in Dementia (CSDD), and Geriatric Depression Scale 30-questions (GDS-30). Cox proportional hazard models were used to test the hypothesis that certain BPSD in MCI are predictors of developing AD.

Results:

The study population consisted of 183 MCI patients at baseline. At follow-up, 74 patients were stable and 109 patients progressed to AD. The presence of significant depressive symptoms in MCI as measured by the CSDD (HR: 2.06; 95% CI: 1.23–3.44; p = 0.011) and the GDS-30 (HR: 1.77; 95% CI: 1.10–2.85; p = 0.025) were associated with progression to AD. The severity of depressive symptoms as measured by the GDS-30 was a predictor for progression too (HR: 1.06; 95% CI: 1.01–1.11; p = 0.020). Furthermore, the severity of agitated behavior, especially verbal agitation and the presence of purposeless activity, was also associated with progression, whereas diurnal rhythm disturbances were associated with no progression to AD.

Conclusion:

Depressive symptoms in MCI appear to be predictors for progression to AD.

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