Associations between neuropsychiatric symptoms, cognitive function, and daily functioning in elderly with early dementia

Abstract

Background: Elderly with early dementia suffer from progressive deteriorations in cognitive functioning such as memory, spatial navigation, movement and language, leading to interferences in daily functioning. The present study aims to examine the associations between neuropsychiatric symptoms, psychosocial well-being, cognitive functioning, and daily functioning in elderly with early dementia. Methods: The study sample was 86 elderly who were diagnosed with early dementia via a clinical dementia rating rating of 0.5 to 1. The mean age of the sample was 81.1 years old and the majority of them were female (83%), widowed (58.8%), and had at most primary education (75%). Data on neuropsychiatric symptoms, psychosocial well-being, cognitive functioning, and daily functioning were collected from the participants via cognitive tests (Digit Span Test, Fuld Object Memory Evaluation and Trail Making Test) and self-reported scales (Geriatric Depression Scale, Neuropsychiatric Inventory, Loneliness Scale, and Instrumental Activities of Daily Living). Results: Male participants showed greater neuropsychiatric symptoms and older participants showed worse digit spans, memory storage and recall, and daily functioning. Controlling for gender and age, neuropsychiatric symptoms were negatively correlated with backward digit span, memory storage and recall. Loneliness was positively associated with depression but not with any other variables. Digit spans, particularly backward digit span, were correlated with memory storage, memory recall, trail making time and daily functioning. Higher memory storage and recall and shorter trail making time were associated with better daily functioning among the participants. Discussions: The study findings suggest that better episodic memory, executive functioning, and visuospatial construction are linked to fewer neuropsychiatric symptoms and better functioning in daily lives. Further studies could explore the effects of non-pharmacological interventions on ameliorating cognitive impairments and improving prognosis of dementia.