Objective: Many studies have evaluated the cognitive aspects of MCI, possibly a prodromal condition of Alzheimer's disease. However, much less attention has been paid to the behavioral and psychological changes that may accompany MCI. The objective of this study was to evaluate the prevalence of neuropsychiatric symptoms in a relatively small cohort of MCI patients.
Design: Cross sectional study using informant based assessments of behavioral and psychological symptoms in elderly patients who were consecutively referred for neuropsychological evaluation during January till June 2001.
Materials and Methods: Participants were six male and four female (n=10) patients with a mean age of 73 years (SD 5.4) and a level of education score of 5 (on a scale of 1-7). Patients met the Mayo clinic MCI criteria and had a MMSE score higher than 26 (out of 30), showed evidence of memory impairment on verbal learning tests but not on semantic fluency, visual constructional ability (copy drawing) nor on Luria's Meander (alternating). Cognitive decline was confirmed by informant ratings. Behavioral and psychological symptoms were assessed with the Neuropsychiatric Inventory Questionnaire (NPI-Q), 15 items Geriatric Depression Scale (GDS-15), and the 16 items Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) was used as an informant based measure of cognitive decline.
Results: The average NPI-Q score in this sample was 6.4 (SD 6.5). Nine out of ten patients showed evidence of neuropsychiatric symptoms and in seven out of ten these symptoms were judged to be moderate to severe (any NPI-Q symptom score 2 or 3). Five patients reported depressive symptoms (a score greater than three on the GDS-15). When these patients were excluded from the analysis neuropsychiatric symptoms were present in four out of five of the remaining patients.
Conclusion: Behavioral and psychological symptoms are prevalent in MCI. We need to expand our knowledge of these symptoms as they can be clinically relevant in some cases and in others may herald future cognitive decline.
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