Persistence of neuropsychiatric symptoms over six months in mild cognitive impairment in community-dwelling Korean elderly

Background: Several studies of patients with mild cognitive impairment (MCI) have revealed that this population, like people with dementia, have neuropsychiatric symptoms (NPS) as well as memory impairment. No study has reported on the natural history and course of NPS in MCI although this is important in terms of management. We aimed to determine the persistence of NPS over six months in participants with MCI. Method: The Neuropsychiatric Inventory (NPI) was used to rate the severity of NPS in 241 consecutive referrals with MCI from a Korean clinic at baseline and in 220 patients at 6-month follow-up. We also collected information about the cognition and quality of life of patients and their caregivers. Results: Ninety-seven (44.1%) MCI participants who completed the 6-month follow-up exhibited at least one NPS at baseline; 60 (27.3%) were clinically significant NPS. Seventy (72.1%) of those with any symptom had at least one persistent NPS at 6-month follow-up, and 44 (73.3%) of those with clinically significant symptoms had at least one significant and persistent NPS at 6-month follow-up. Those with persistent symptoms had more severe baseline symptoms. Both patients and caregivers had a poorer quality of life when the patient had at least one clinically significant symptom. Conclusions: NPS were highly persistent overall in older people with MCI. Persistence was predicted by having more severe symptoms at baseline. Clinically significant levels of NPS were associated with decreased quality of life. We conclude that clinicians should be aware that NPS symptoms in MCI usually persist.