Interaction of neuropsychiatric symptoms with APOE ?4 and conversion to dementia in MCI patients in a Memory Clinic.

ABSTRACT: To date, very few studies have been focused on the impact of the convergence of neuropsychiatric symptoms (NPS) and APOE ?4 on the conversion to dementia in patients with Mild Cognitive Impairment patients (MCI), and none has been based in a clinical setting. The objective of the study is to determine the predictive value of additive and multiplicative interactions of NPS and APOE ?4 status on the prediction of incident dementia among MCI patients monitored in a Memory Clinic. 1512 patients (aged 60 and older) with prevalent MCI were followed for a mean of 2 years. Neuropsychiatric symptoms were assessed at baseline using the Neuropsychiatric Inventory Questionnaire. Cox proportional hazards models were calculated. Additive interactions for depression, apathy, anxiety, agitation, appetite, or irritability and a positive ?4 carrier status were obtained, significantly increasing the hazard ratios of incident dementia (HR range 1.3-2.03). Synergistic interactions between NPS and APOE ?4 are identified among MCI patients when predicting incident dementia. The combination of the behavioral status and the genetic trait could be considered a useful strategy to identify the most vulnerable MCI patients to dementia conversion in a Memory Clinic.

SUBMITTER: Valero S 

PROVIDER: S-EPMC7674479 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature