Behavioral and psychological symptoms of dementia in different dementia disorders: A large-scale study of 10 000 individuals

Abstract

Objective: To characterize behavioral and psychological symptoms of dementia (BPSD) in different dementia diagnoses: Alzheimer's disease (AD), dementia with Lewy bodies (DLB), Parkinson's disease dementia (PDD), vascular dementia (VaD), frontotemporal dementia (FTD), mixed (Mixed) and unspecified dementia. Design: Registry-based cohort study. Setting and participants: 12,137 individuals with dementia registered in two national quality registries, the Swedish registry for cognitive/dementia disorders (SveDem) and the Swedish BPSD registry, during 2010 - 2016. Methods: BPSD was assessed with the Neuropsychiatric Inventory - Nursing Home Version (NPI-NH). Multivariate logistic regression models were used to evaluate the associations between dementia diagnoses and different BPSDs in reference to a) the AD group and b) each of the other diagnostic groups. All models were adjusted for age, gender, the severity of cognitive impairment at the time of dementia diagnosis, and time between dementia diagnosis and BPSD assessment. Results: In all individuals, the three most common symptoms were aberrant motor behaviour (35,1%), agitation (32,3%), and irritability (28,7%), while euphoria (5,9%) was the least frequent. Compared to AD, we found a lower risk of delusions (in VaD, FTD, unspecified dementia), hallucinations (in VaD and FTD), agitation (in PDD, unspecified dementia), elation/euphoria (in DLB), anxiety (in PDD, unspecified dementia), disinhibition (in PDD); irritability (in DLB, PDD, unspecified dementia), aberrant motor behavior (in Mixed, VaD, unspecified dementia) and sleep and night-time behavior changes (in unspecified dementia). Higher risks of delusions (in DLB), hallucinations (in DLB, PDD), apathy (VaD, FTD), disinhibition (in FTD) and appetite and eating abnormalities (in FTD) were found compared to AD. Conclusions and Implications: In this large contemporary cohort, BPSD was common in all types of dementia, with the most common symptoms being aberrant motor behavior, agitation, and irritability. Additionally, BPSD differed depending on the dementia type.

Association between Hematopoietic Function and Physical Activity in Caregivers

“…Caregivers may be in poor health due to long hours of care [1], including nighttime care [2]. The health [3] and psychological status [4] of caregivers vary and can be accompanied by problematic behaviors. This results in different physical [5] and psychological burdens [6] among caregivers, a major social problem.…”