Does the neuropsychiatric inventory predict progression from mild cognitive impairment to dementia? A systematic review and meta-analysis

Sabela C Mallo; Scott B Patten; Zahinoor Ismail; Arturo X Pereiro; David Facal; Carlos Otero; Onésimo Juncos-Rabadán

doi:10.1016/j.arr.2019.101004

Does the neuropsychiatric inventory predict progression from mild cognitive impairment to dementia? A systematic review and meta-analysis

Ageing Res Rev. 2020 Mar:58:101004. doi: 10.1016/j.arr.2019.101004. Epub 2019 Dec 24.

Authors

Sabela C Mallo¹, Scott B Patten², Zahinoor Ismail³, Arturo X Pereiro⁴, David Facal⁵, Carlos Otero⁶, Onésimo Juncos-Rabadán⁷

Affiliations

¹ Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Xosé María Suárez Núñez Street, Campus Sur, Santiago de Compostela, Galicia, ES, 15782, Spain. Electronic address: sabelacarme.mallo@usc.es.
² Hotchkiss Brain Institute, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada; Department of Psychiatry, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada; Mathison Centre for Mental Health Research and Education, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6, Canada. Electronic address: patten@ucalgary.ca.
³ Hotchkiss Brain Institute, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada; Department of Psychiatry, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada; Department of Clinical Neurosciences, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada; Mathison Centre for Mental Health Research and Education, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6, Canada. Electronic address: ismailz@ucalgary.ca.
⁴ Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Xosé María Suárez Núñez Street, Campus Sur, Santiago de Compostela, Galicia, ES, 15782, Spain. Electronic address: arturoxose.pereiro@usc.es.
⁵ Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Xosé María Suárez Núñez Street, Campus Sur, Santiago de Compostela, Galicia, ES, 15782, Spain. Electronic address: david.facal@usc.es.
⁶ Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Xosé María Suárez Núñez Street, Campus Sur, Santiago de Compostela, Galicia, ES, 15782, Spain. Electronic address: coterortega@gmail.com.
⁷ Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Xosé María Suárez Núñez Street, Campus Sur, Santiago de Compostela, Galicia, ES, 15782, Spain. Electronic address: onesimo.juncos@usc.es.

PMID: 31881368
DOI: 10.1016/j.arr.2019.101004

Abstract

Background: Neuropsychiatric Symptoms (NPS) are common in Mild Cognitive Impairment (MCI). The Neuropsychiatric Inventory (NPI) and its shorter version, the Neuropsychiatric Inventory Questionnaire (NPI-Q), are the most common measures to assess NPS. Our objective was to determine if NPI/NPI-Q ratings predict conversion from MCI to dementia.

Methods: Empirical longitudinal studies published in English or Spanish, concerned with the role of NPS as a risk factor for conversion from MCI to dementia, with a diagnosis of MCI following clinical criteria, that reported NPI/NPI-Q total score in converters versus non-converters, were included. Random effects models were used, and heterogeneity was explored with stratification and a random-effects meta-regression. The overall conversion rate and the standardized mean difference (SMD) for evolution, as a function of NPI/NPI-Q scores, were calculated.

Results: The overall conversion rate was 35 %. Mean NPI/NPI-Q ratings were higher in converters versus in non-converters, with the overall SMD approaching significance. Heterogeneity was observed in studies of more than two years of follow-up and in a study with a mean age of more than 80 years. This heterogeneity concerned the size, not the direction of the difference.

Conclusions: Our results suggest that NPI/NPI-Q ratings are associated with conversion from MCI to dementia.

Keywords: Dementia; Meta-analysis; Mild cognitive impairment; Neuropsychiatric inventory; Neuropsychiatric inventory questionnaire; Neuropsychiatric symptoms.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Aged, 80 and over
Cognitive Dysfunction* / diagnosis
Dementia* / diagnosis
Disease Progression
Humans
Longitudinal Studies
Neuropsychological Tests