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Volume 08
Journal of Alzheimers Disease & Parkinsonism
Alzheimer's Congress 2018
May 30-31, 2018
May 30-31, 2018 Osaka, Japan
10
th
World Congress on
Alzheimer's Disease & Dementia
Neuropsychiatric and cognitive subtypes among community-dwelling older persons and the association
with DSM-5 mild neurocognitive disorder: Latent class analysis
Tau Ming Liew
Institute of Mental Health, Singapore
Background:
Neuro Psychiatric Symptoms (NPS) have been shown to increase the risk of Neurocognitive Disorders (NCD),
leading to the recently-published criteria of Mild Behavioral Impairment (MBI) to identify pre-dementia using NPS alone.
However, MBI drew concerns about over-diagnosing subclinical psychiatric disorders.
Objective:
We hypothesized that the specificity of NPS in predicting NCD may be improved by considering NPS together with
various domains of cognitive deficits. We tested this hypothesis by identifying subtypes based on the combination of NPS and
cognitive deficits among community-dwelling older persons and evaluating how the identified subtypes were associated with
mild NCD.
Method:
Our participants were from a community-based cohort study. They completed assessments such as Geriatric
Depression Scale (GDS), Geriatric Anxiety Inventory (GAI) and Montreal Cognitive Assessment (MoCA). Those with possible
cognitive impairment underwent further evaluations for mild NCD. Latent class analysis was conducted using GDS, GAI and
MoCA domains. Logistic regression was performed to investigate the association between the latent-classes and mild NCD.
Result:
We included 825 participants and identified four distinct subtypes: Subtype-1 (no NPS or cognitive deficits); subtype-2
(NPS alone); subtype-3 (cognitive deficits alone) and subtype-4 (both NPS and cognitive deficits). Subtype-1 and 2 had low
risk of prevalent mild NCD (OR 0.92-1.00), while subtype-3 conferred a moderate risk (OR 4.47-4.85) and subtype-4 had the
highest risk (OR 7.95-8.63).
Conclusion:
We demonstrated the benefits of combining NPS and cognitive deficits to predict those at highest risk of prevalent
mild NCD. Our findings highlighted the relevance of subclinical psychiatric symptoms in predicting NCD and indirectly
supported the need for longer durations of NPS to improve its specificity.
tau_ming_liew@imh.com.sgJ Alzheimers Dis Parkinsonism 2018, Volume 8
DOI: 10.4172/2161-0460-C4-046