Patterns and persistence of behavioural and psychological symptoms in those with cognitive impairment: the importance of apathy

van der Linde, Rianne M.; Matthews, Fiona E.; Dening, Tom; Brayne, Carol

Abstract

Objective: To study the stability and emergence of a range of behavioural and psychological symptoms (BPS), their association with mortality and the effect of covariates on these transitions in a population-based study of cognitively impaired older people with a long follow-up period and large sample size, with a particular focus on apathy. Methods: Data were from a population-based, longitudinal cohort study of ageing. Interviews were conducted at 0, 2, 6, 8 and 10 years with 3626 participants aged 65+. The persistence of 11 BPS and their association with mortality in those with cognitive impairment (MMSE 25 or below) was investigated using multi-state models, allowing us to take into account estimations of the probability of transitions that occurred in the time between interviews. Results: Most BPS were persistent. Apathy was one of the most stable symptoms; in those with apathy, the probability of still having apathy after 1 year is 62%. Apathy, sleep problems, depression, irritability and wandering were most likely to develop. BPS are associated with mortality; in those with apathy, mortality is 3.1 times more likely than in those without apathy. Low cognitive function and dementia were associated with emergence of new symptoms. Conclusions: This population-based, multi-centre study with a follow-up period of 10 years showed that BPS are associated with mortality and most symptoms are persistent. Apathy was characterised by a high prevalence, a high persistence and a strong association with mortality, and has a negative impact on disability, management of other disease and caregiver burden.

Citation

van der Linde, R. M., Matthews, F. E., Dening, T., & Brayne, C. (2017). Patterns and persistence of behavioural and psychological symptoms in those with cognitive impairment: the importance of apathy. International journal of geriatric psychiatry, 32(3), 306-315. https://doi.org/10.1002/gps.4464

• Journal Article Type: Article
• Publication Date: Mar 1, 2017
• Deposit Date: Dec 8, 2023
• Journal: International Journal of Geriatric Psychiatry
• Print ISSN: 0885-6230
• Electronic ISSN: 1099-1166
• Publisher: Wiley
• Volume: 32
• Issue: 3
• Pages: 306-315
• DOI: https://doi.org/10.1002/gps.4464
• Public URL: https://hull-repository.worktribe.com/output/4453297