Date Published: March 1, 2018
Publisher: Elsevier, Inc
Author(s): Isaac Acosta, Guilherme Borges, Rebeca Aguirre-Hernandez, Ana Luisa Sosa, Martin Prince.
•Not only cognitive impairment and cognitive features are useful in identifying older adults at risk for developing dementia.•Of the 12 neuropsychiatric symptoms evaluated, 5 were associated with incident dementia (delusions, hallucinations, depression, anxiety, and aberrant motor behavior) in a 3-year follow-up.•The evaluation of neuropsychiatric symptoms, along with other simple, practical, and inexpensive features, may be useful in identifying subjects at risk of dementia in community health settings and by general practitioners.
In 2015, it was estimated that there were 46.8 million people with dementia worldwide, of whom 58.0% were living in low- and middle-income countries , and that there were annually 9 million new global cases (2014–2015) of dementia. In response to the high prevalence of dementia, the aging global population (8%–9% of the population aged 60 years or older), and its important socioeconomic impact, the World Health Organization made dementia a “public health priority” that requires immediate action . While it has been estimated that if dementia care were a country, it would be the world’s 18th largest economy , it has become clear that there is a significant imbalance in the global distribution of the quantity and quality of the resources available to treat this illness.
This study concluded that 5 of the 12 NPSs evaluated with the NPI-Q (delusions, hallucinations, anxiety, aberrant motor behavior, and depression) were independent predictors of incident dementia in a 3-year follow-up of Mexican older adults from the general population. Our results agree with previous reports , , , , , which showed the usefulness of certain NPSs as risk factors in the preclinical stages of dementia , , , , , . Of the five symptoms that proved to be linked to incident dementia, depression and anxiety are the ones that have been most consistently reported in the literature , , , , , , . On the other hand, the association of incident dementia with aberrant motor behavior has only been reported in a few cross-sectional studies ,  and in one follow-up study . Regarding delusions and hallucinations, these are psychotic symptoms that are usually more prevalent in advanced stages of dementia  but they could be present in predementia stages, or be part of a depressive episode, psychotic syndrome or as isolated psychotic symptoms with late onset. Their presence in this population could also be explained by the “virgin state for treatments” of the participants, as both diagnosis and interventions (pharmacological and nonpharmacological) were almost nonexistent in our sample , .