Behavioral and psychological symptoms of dementia and mortality risk among people with cognitive impairment: an 8-year longitudinal study from the NCGG-STORIES

IF 3.7 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Epidemiology Pub Date : 2024-03-23 DOI:10.2188/jea.je20230343

Taiji Noguchi, Takeshi Nakagawa, Taiki Sugimoto, Ayane Komatsu, Yujiro Kuroda, Kazuaki Uchida, Rei Ono, Hidenori Arai, Takashi Sakurai, Tami Saito

{"title":"Behavioral and psychological symptoms of dementia and mortality risk among people with cognitive impairment: an 8-year longitudinal study from the NCGG-STORIES","authors":"Taiji Noguchi, Takeshi Nakagawa, Taiki Sugimoto, Ayane Komatsu, Yujiro Kuroda, Kazuaki Uchida, Rei Ono, Hidenori Arai, Takashi Sakurai, Tami Saito","doi":"10.2188/jea.je20230343","DOIUrl":null,"url":null,"abstract":"Background: Behavioral and psychological symptoms of dementia (BPSD) are common among people with dementia from the early stages and can appear even in mild cognitive impairment (MCI). However, the prognostic impact of BPSD is unclear. This study examined the association between BPSD and mortality among people with cognitive impairment.Methods: This longitudinal study involved 1,065 males and 1,681 females (mean age: males = 77.1 years; females = 78.6 years) with MCI or dementia diagnosis, from the National Center for Geriatrics and Gerontology-Life Stories of People with Dementia (NCGG-STORIES), a single-center memory clinic-based cohort study in Japan that registered first-time outpatients from 2010–2018. Information about death was collected through a mail survey returned by participants or their close relatives, with an up to 8-year follow-up. BPSD was assessed using the Dementia Behavior Disturbance Scale (DBD) at baseline.Results: During the follow-up period, 229 (28.1%) male and 254 (15.1%) female deaths occurred. Cox proportional hazards regression analysis showed that higher DBD scores were significantly associated with increased mortality risk among males, but not females (compared with the lowest quartile score group, hazard ratios [95% confidence intervals] for the highest quartile score group = 1.59 [1.11–2.29] for males and 1.06 [0.66–1.70] for females). Among the DBD items, lack of interest in daily living, excessive daytime sleep, and refusal to receive care had a higher mortality risk.Conclusions: The findings suggest a potential association between BPSD and poor prognosis among males with cognitive impairment.\n","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":"17 1","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2188/jea.je20230343","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Behavioral and psychological symptoms of dementia (BPSD) are common among people with dementia from the early stages and can appear even in mild cognitive impairment (MCI). However, the prognostic impact of BPSD is unclear. This study examined the association between BPSD and mortality among people with cognitive impairment.

Methods: This longitudinal study involved 1,065 males and 1,681 females (mean age: males = 77.1 years; females = 78.6 years) with MCI or dementia diagnosis, from the National Center for Geriatrics and Gerontology-Life Stories of People with Dementia (NCGG-STORIES), a single-center memory clinic-based cohort study in Japan that registered first-time outpatients from 2010–2018. Information about death was collected through a mail survey returned by participants or their close relatives, with an up to 8-year follow-up. BPSD was assessed using the Dementia Behavior Disturbance Scale (DBD) at baseline.

Results: During the follow-up period, 229 (28.1%) male and 254 (15.1%) female deaths occurred. Cox proportional hazards regression analysis showed that higher DBD scores were significantly associated with increased mortality risk among males, but not females (compared with the lowest quartile score group, hazard ratios [95% confidence intervals] for the highest quartile score group = 1.59 [1.11–2.29] for males and 1.06 [0.66–1.70] for females). Among the DBD items, lack of interest in daily living, excessive daytime sleep, and refusal to receive care had a higher mortality risk.

Conclusions: The findings suggest a potential association between BPSD and poor prognosis among males with cognitive impairment.

查看原文本刊更多论文

痴呆症的行为和心理症状与认知障碍患者的死亡风险：来自 NCGG-STORIES 的一项为期 8 年的纵向研究

背景：痴呆症的行为和心理症状（BPSD）在痴呆症早期患者中很常见，甚至在轻度认知障碍（MCI）患者中也会出现。然而，BPSD 对预后的影响尚不明确。本研究探讨了 BPSD 与认知障碍患者死亡率之间的关系：这项纵向研究涉及1065名男性和1681名女性（平均年龄：男性=77.1岁；女性=78.6岁）MCI或痴呆诊断患者，这些患者来自日本国家老年医学中心（National Center for Geriatrics and Gerontology）--痴呆患者的生活故事（NCGG-STORIES），这是一项基于单中心记忆诊所的队列研究，登记了2010-2018年的首次门诊患者。死亡信息是通过参与者或其近亲寄回的邮件调查表收集的，随访期长达 8 年。基线时使用痴呆行为紊乱量表（DBD）评估BPSD：随访期间，男性死亡 229 例（28.1%），女性死亡 254 例（15.1%）。Cox比例危险回归分析表明，DBD得分越高，男性的死亡风险就越高，而女性则不然（与最低四分位值组相比，最高四分位值组的危险比[95%置信区间]男性为1.59 [1.11-2.29]，女性为1.06 [0.66-1.70]）。在DBD项目中，对日常生活缺乏兴趣、白天睡眠过多和拒绝接受护理的死亡风险较高：研究结果表明，在患有认知障碍的男性患者中，BPSD与预后不良之间存在潜在联系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.50

自引率

4.30%

发文量

172

审稿时长

6-12 weeks

期刊介绍： The Journal of Epidemiology is the official open access scientific journal of the Japan Epidemiological Association. The Journal publishes a broad range of original research on epidemiology as it relates to human health, and aims to promote communication among those engaged in the field of epidemiological research and those who use epidemiological findings.