Browsing by Author "Elbayoumi, Heba"

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    Neuropsychiatric Symptoms and Incident Cognitive Decline and Dementia in Cognitively Normal Older Adults: A Systematic Review and Meta-Analysis
    (2022-06) Elbayoumi, Heba; Ismail, Zahinoor; Patten, Scott; Goodarzi, Zahra; Bulloch, Andrew; Pringsheim, Tamara Milka
    Objective: To determine risks of cognitive decline or dementia in cognitively normal cohorts with neuropsychiatric symptoms (NPS), stratified by mild behavioral impairment (MBI) domains. Methods: A systematic search (MEDLINE, EMBASE, and PSYCINFO) was completed up to January 2022. Pooled hazard ratios (HR) with Standard Error (SE), I2, and tau2 were determined utilizing DerSimonian-Laird random-effects models. Heterogeneity and publication bias were investigated. PRISMA and MOOSE checklists were followed. Results: Of 12,674 screened abstracts, 36 prospective studies representing 326,739 participants were included. Risks (HR) for incident cognitive decline or dementia by MBI domain were: 1) apathy 2.00 (95%CI:1.57-2.57); 2) affect 1.61 (95%CI:1.45-1.80; adjusted 1.44, 95%CI:1.30-1.61); 3) agitation 3.07 (95%CI: 2.15-4.38); 4) social inappropriateness 3.84 (95%CI:1.54-9.55); and 5) psychosis 3.99 (95%CI:3.05-5.23). Heterogeneity was most evident in affect (I2=86.56%, tau2=0.04), with time and NPS ascertainment as the main contributors. Conclusion: Cognitively normal older adults with NPS are at greater risk for mild cognitive impairment and dementia than those without NPS. Risks differ between the 5 MBI domains.