Brief Report| Volume 30, ISSUE 5, P619-623, May 2022

Longitudinal Changes in Neuropsychiatric Symptoms: Impact of Discrepancy in Everyday Preferences Between Persons With Cognitive Impairment and Their Care Partners

Published:October 24, 2021DOI:


      • What is the primary question addressed by this study? How does baseline discrepancy in assessment of everyday preferences between persons with cognitive impairment and proxy ratings of care partners predict longitudinal changes in neuropsychiatric symptoms for persons with cognitive impairment?
      • What is the main finding of this study? In this longitudinal study, baseline discrepancy in assessment of importance of “social engagement” preferences between persons with cognitive impairment and their care partners, where the care partner underestimates preferences importance, is associated with an average higher burden of neuropsychiatric symptoms across follow-up time.
      • What is the meaning of the finding? This study yields new insights into understanding neuropsychiatric symptoms for persons across the spectrum of severity of cognitive impairment and suggests that resolving unmet needs around “social engagement” may have implications in reducing severity of neuropsychiatric symptoms across time.



      Neuropsychiatric symptoms (NPS) of dementia are common and may be driven by inability of persons with cognitive impairment (CI) to communicate needs. We addressed the relevance of this unmet-needs model to burden of NPS among persons with milder CI.


      The sample included 48 dyads of persons with CI and their care partners. NPS were measured at baseline and follow-up (mean 486 days +/-107 SD). Mixed random and fixed effects longitudinal models were used to evaluate impact of discrepancies between persons with CI and their care partners in everyday preferences (baseline) on changes in NPS over time.


      Higher levels of underestimation of “social engagement” preferences of persons with CI by care partners were associated with a higher average burden of NPS across all follow-up.


      This study suggests that unmet-needs may be a useful construct for understanding etiology for NPS across the spectrum of severity of cognitive impairment.


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