Neuropsychiatric Symptoms Among Hispanics: Results of the Maracaibo Aging Study

Issue title: Translational Research and Drug Discovery for Neurodegeneration: Challenges for Latin America

Guest editors: K.S. Jagannatha Rao, Gabrielle B. Britton, Luisa Lilia Rocha Arrieta, Norberto Garcia-Cairasco, Alberto Lazarowski, Adrián Palacios, Antoni Camins Espuny and Ricardo B. Maccioni

Article type: Research Article

Authors: Gil, Mario^{a; b; c; d} | Alliey-Rodriguez, Ney^{e; f; g} | Lopez-Alvarenga, Juan Carlos^{c; h; i} | Diego, Vincent^{c; h; i} | Gaona, Ciro A.^g | Mata, Ledys^g | Pirela, Rosa V.^{c; g; h} | Chavez, Carlos A.^g | de Erausquin, Gabriel A.^{k; l} | Melgarejo, Jesus D.^{g; j} | Maestre, Gladys E.^{b; c; d; g; h; *}

Affiliations: [a] Department of Psychological Science, University of Texas Rio Grande Valley, Brownsville, TX, USA | [b] Department of Neuroscience, School of Medicine, University of Texas Rio Grande Valley, Harlingen, TX, USA | [c] Rio Grande Valley Alzheimer’s Disease Resource Center for Minority Aging Research (RGV AD-RCMAR), University of Texas Rio Grande Valley, Brownsville, TX, USA | [d] Institute for Neuroscience, School of Medicine, University of Texas Rio Grande Valley, Harlingen, TX, USA | [e] Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA | [f] Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA | [g] Laboratory of Neurosciences, School of Medicine, University of Zulia, Maracaibo, Venezuela | [h] Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Brownsville, TX, USA | [i] SOM South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, USA | [j] Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium | [k] Department of Neurology, Long School of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX, USA | [l] Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health San Antonio, San Antonio, TX, USA

Correspondence: [*] Correspondence to: Gladys E. Maestre, University of Texas Rio Grande Valley, One West University Blvd, BROBL rm. 106, Brownsville, TX, USA. Tel.: +1 956 882 7495; Fax: +1 956 882 6834; E-mails: [email protected] and [email protected].

Abstract: Background:Neuropsychiatric symptoms play an important role in diagnosing and clinical follow-up of cognitive impairment and dementia. Objective:We investigated the relationship between neuropsychiatric symptoms, cognitive impairment, and dementia in Hispanics. Methods: We included 529 participants (age ≥40 years) from the Maracaibo Aging Study with standardized neuropsychiatric assessments, including the Neuropsychiatric Inventory (NPI). Based on the Clinical Dementia Rating and the Mini-Mental State Examination scores, participants’ cognitive status was categorized into normal cognition, mild/moderate, and severe cognitive impairment. Diagnosis of dementia was established in a consensus conference. Statistical analyses included multivariable logistic regression models and area under the curve (AUC). Results:The mean age of participants was 59.3 years, and 71.8%were women. The proportion of dementia was 6.8%. Disturbed sleep, anxiety, and depression were the most common neuropsychiatric symptoms in the study sample. In crude analyses, the proportions of hallucinations, aberrant motor behavior, agitation/aggression, apathy, delusions, irritability, eating disturbance, depression, and euphoria were differently distributed among cognitive status groups (p < 0.05). After accounting for confounders, aberrant motor behavior and agitation/aggression remained significantly associated with cognitive impairment and dementia (p < 0.05). The inclusion of the NPI domains significantly improved the AUC to discriminate severe cognitive impairment and dementia compared to a basic model that included sex, age, education, alcohol, obesity, serum glucose, total cholesterol, hypertension, and stroke. Conclusion:Neuropsychiatric symptoms are associated with severe cognitive impairment and dementia. The addition of NPI items to the global cognitive assessment might help early detection of dementia in primary care settings.

Keywords: Aging, Alzheimer’s disease, cognitive impairment, dementia, Hispanics, neuropsychiatric inventory

DOI: 10.3233/JAD-201144

Journal: Journal of Alzheimer's Disease, vol. 82, no. s1, pp. S251-S261, 2021