Table 1 .
Associations between the NPSs in early dementia and the risk of progression to severe dementia, stratified by those with AD (n = 6,221) and those with non-AD (n = 1,373)
| NPSs in mild dementia | Risk of progression to severe dementia | |||
|---|---|---|---|---|
| Participants with AD | Participants with non-AD | |||
| HR (95% CI)a | P-valuea | HR (95% CI)a | P-valuea | |
| Presence of any NPS | ||||
| No | 1.0 (Ref) | Ref | 1.0 (Ref) | Ref |
| Yes | 1.4 (1.1–1.6) | 0.001 | 0.9 (0.5–1.5) | 0.661 |
| Severity of NPSsb | ||||
| No NPS | 1.0 (Ref) | Ref | 1.0 (Ref) | Ref |
| Mild | 1.2 (1.0–1.5) | 0.049 | 0.8 (0.5–1.5) | 0.526 |
| Moderate | 1.4 (1.1–1.7) | 0.001 | 1.0 (0.6–1.7) | 0.916 |
| Severe | 1.6 (1.2–2.0) | <0.001 | 0.8 (0.4–1.5) | 0.467 |
| NPI–Q total scorec | ||||
| 0–2 | 1.0 (Ref) | Ref | 1.0 (Ref) | Ref |
| 3–4 | 1.2 (1.0–1.4) | 0.100 | 1.2 (0.8–1.9) | 0.449 |
| 5–7 | 1.3 (1.1–1.6) | 0.001 | 1.1 (0.7–1.7) | 0.749 |
| ≥8 | 1.4 (1.1–1.7) | 0.001 | 1.0 (0.6–1.6) | 0.968 |
| Number of NPSsd | ||||
| 0–1 | 1.0 (Ref) | Ref | 1.0 (Ref) | Ref |
| 2–3 | 1.2 (1.0–1.5) | 0.013 | 0.8 (0.5–1.3) | 0.410 |
| 4–5 | 1.3 (1.0–1.5) | 0.020 | 0.9 (0.6–1.4) | 0.617 |
| ≥6 | 1.5 (1.2–1.9) | <0.001 | 0.9 (0.6–1.5) | 0.718 |
| Presence of individual NPS | ||||
| Depression | 1.2 (1.1–1.4) | 0.004 | 1.0 (0.7–1.4) | 0.987 |
| Anxiety | 1.2 (1.1–1.4) | 0.005 | 0.9 (0.7–1.3) | 0.711 |
| Apathy | 1.2 (1.0–1.3) | 0.020 | 0.9 (0.7–1.3) | 0.634 |
| Sleep | 1.1 (0.9–1.2) | 0.500 | 1.2 (0.8–1.6) | 0.333 |
| Appetite | 1.1 (1.0–1.3) | 0.172 | 1.0 (0.7–1.5) | 0.800 |
| Delusions | 1.4 (1.1–1.7) | 0.002 | 1.7 (1.1–2.5) | 0.008 |
| Hallucinations | 1.6 (1.2–2.0) | 0.002 | 1.9 (1.3–2.7) | 0.002 |
| Agitation | 1.1 (0.9–1.3) | 0.241 | 1.1 (0.8–1.5) | 0.590 |
| Irritability | 1.2 (1.0–1.3) | 0.037 | 0.6 (0.5–0.9) | 0.005 |
| Motor disturbance | 1.4 (1.1–1.6) | <0.001 | 1.1 (0.8–1.6) | 0.580 |
| Disinhibition | 1.1 (0.9–1.2) | 0.490 | 0.8 (0.6–1.1) | 0.097 |
| Elation | 1.0 (0.7–1.3) | 0.860 | 0.4 (0.2–0.8) | 0.014 |
Ref, reference group.
aModel adjusted for baseline covariates of age, sex, ethnicity, years of education, APOE e4 genotype, MMSE score, CDR sum of boxes score, use of cognitive enhancers, use of antidepressants, use of antipsychotics and use of sedatives. Significant risk-estimates (with P ≤ 0.05) are highlighted in bold.
bThe NPSs were split into 4 levels of severity based on responses on the 12 items in NPI-Q: No NPS was defined if all items in NPI-Q were scored 0, Mild NPS was defined if at least one item in NPI-Q was scored 1 but no items scored ≥2, Moderate NPS was defined if at least one item in NPI-Q was scored 2 but no items scored 3, and Severe NPS was defined if at least one item in NPI-Q was scored 3.
cThe NPI-Q total score was split into 4 quartiles.
dThe number of NPSs was split into 4 quartiles.