Neuropsychiatric symptoms as a confounding factor in the detection of dementia

Objective: The aim of the study was to evaluate whether the neuropsychiatric symptoms interfere with cognitive impairment detection in primary care and to describe which of them generate more confusion. Design: Descriptive and observational study. Location: Mobile psychiatric unit in collaboration with primary healthcare centers in Barcelona. Participants: A total of 104 patients over 65 years referred to mobile psychiatric unit from primary healthcare clinicians suspecting mental disease. Main measurements: All patients received a DSM-IV-TR diagnosis. We included in the study the Mini Mental State Examination (MMSE), Neuropsichiatric Inventory, Severe Psychiatric Illness scale, Global Assessment of Functioning, Clinical Global Impression and Word Health Organisation Dissability Assessment Schedule. Results: 55.8% of patients referred from primary care had altered MMSE score. Neuropsychiatric symptoms more frequently associated with suspected cognitive impairment were delusions, hallucinations, agitation, disinhibition, irritability and purposeless motor behavior. Conclusions: When psychiatric symptoms of Severe Mental Disorder (SMD) are detected in elderly individuals with no history of SMD, cognitive impairment should be suspected and a screening test be done. (C) 2017 Elsevier Espana, S.L.U.