Document Detail


Cognitive decline and dementia risk in older adults with psychotic symptoms: a prospective cohort study.
MedLine Citation:
PMID:  23343485     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To study the temporal association between psychotic symptoms with cognitive decline and incident dementia.
DESIGN: Population-based prospective cohort study.
SETTING: General population in England and Wales.
PARTICIPANTS: A subsample of 2,025 participants of the Medical Research Council Cognitive Function and Ageing Study, representing a study sample of 11,916 nondemented adults age 65 years or older.
MEASUREMENTS: Baseline presence of psychotic symptoms was assessed with the Geriatric Mental State. Cognitive decline (Cambridge Cognitive Examination) and incident dementia (Automated Geriatric Examination for Computer Assisted Taxonomy diagnosis) were evaluated at 2, 6, and 10 years from baseline.
RESULTS: A total of 330 participants reported baseline symptoms of paranoid delusions, misidentification, or hallucinations, estimated to represent 13.4% of the older general population without dementia. Psychotic symptoms were cross-sectionally associated with worse cognitive functioning, and individuals with psychotic symptoms displayed more rapid cognitive decline from baseline to a 6-year follow-up, especially in nonmemory functions, than people without such symptoms. They further carried an increased overall risk of later dementia (odds ratio = 2.76, 95% confidence interval = 1.75-4.36). The risk increment was observed independently of baseline cognition, depression, anxiety, and vascular risk factors, increased with increasing numbers of psychotic symptoms, and was highest in people age 65-74 years.
CONCLUSIONS: Older adults with psychotic symptoms are vulnerable to develop dementia and might be a promising target for indicated prevention strategies. Their neuropsychological functioning should be evaluated on a regular basis.
Authors:
Sebastian Köhler; Judith Allardyce; Frans R J Verhey; Ian G McKeith; Fiona Matthews; Carol Brayne; George M Savva;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-01-22
Journal Detail:
Title:  The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry     Volume:  21     ISSN:  1545-7214     ISO Abbreviation:  Am J Geriatr Psychiatry     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-24     Completed Date:  2014-01-16     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  9309609     Medline TA:  Am J Geriatr Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  119-28     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aging / psychology*
Dementia / diagnosis*,  epidemiology
Female
Follow-Up Studies
Humans
Incidence
Linear Models
Male
Mild Cognitive Impairment / diagnosis*,  epidemiology
Prevalence
Prospective Studies
Psychiatric Status Rating Scales
Psychotic Disorders / diagnosis*,  epidemiology
Risk Factors
Grant Support
ID/Acronym/Agency:
G9901400//Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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