Prevalence and clinical correlates of neuropsychiatric symptoms in dementia

Abstract

The purpose of this research was to assess the frequency and severity of neuropsychiatric and behavioral symptoms and to examine the association between preexisting medical conditions and specific neuropsychiatric symptoms in demented individuals. We studied 211 demented subjects (87.7 percent male) who were participants in epidemiological studies of dementia. Using the Neuropsychiatric Inventory (NPI), we assessed the frequency and severity of neuropsychiatric symptoms. We collected medical history information during a structured telephone interview. Our analyses focused on determining prevalence of neuropsychiatric symptoms by dementia diagnosis and severity. We also examined the association of history of head injury, alcohol abuse, and stroke with development of neuropsychiatric symptoms. We found that neuropsychiatric symptoms were common, with approximately three-fourths of the subjects exhibiting at least one symptom during the preceding month. Apathy (39.3 percent), agitation (31.8 percent), and aberrant motor behavior (31.1 percent) were the most frequent symptoms. Frequency and severity of symptoms were similar for the all-dementia and Alzheimer's disease-only groups, neuropsychiatric symptoms varied by severity of dementia, but generally not in a consistent ordinal pattern. History of alcohol abuse, head injury, or stroke was associated with presence of specific neuropsychiatric symptoms in dementia. While psychiatric symptoms are common in dementia, they also vary by type and severity of dementia. The finding that certain medical conditions may increase risk for specific types of neuropsychiatric symptoms expands our knowledge of the natural history of dementia and should improve management of dementia in medically ill patients. Our results may also shed light on mechanisms that underlie neuropsychiatric symptoms.

Frontotemporal Dementia: Change of Familial Caregiver Burden and Partner Relation in a Dutch Cohort of 63 Patients

“…Despite the progress in dementia severity, the total load of neuropsychiatric symptoms patients presented remained stable. This contrasts with the earlier described findings that neuropsychiatric disturbance increased as dementia worsened [11,12] . A possible explanation may be that the patients in our sample were no longer capable of presenting neuropsychiatric symptoms once they reached the highest measurable levels of dementia severity.…”

“…Behavioural problems related to the frontal system seem to be particularly burdening [9,10] . The few studies focusing on the course of neuropsychiatric disturbance in FTD found an increase in these behavioural problems during the progression of FTD [11,12] , implying that as FTD severity progresses, caregiver burden in FTD might also increase as a function of behavioural disturbance. This study evaluates for the first time how caregiver burden in FTD unfolds over a period of 2 years.…”

Prevalence of Neuropsychiatric Symptoms in Elderly Patients with Dementia in Mungialde County (Basque Country, Spain)

“…Studies of patients with AD and other types of dementia from the USA and Brazil yielded very similar results, with prevalences of 74.60, 75 and 78.30% [5,18,19] . Spe- cifically, the Cardiovascular Health Study [5] indicated that 74.60% of patients exhibited 1 symptom, 55% 2 or more and 44% more than 3 symptoms.…”

“…No differences in prevalence were reported for the different stages of dementia. Steffens et al [18] found little difference in symptom prevalence according to dementia severity. As in our results, apathy was found to be the most prevalent symptom in the Nakayama study, and in a community study in Brazil.…”

Reliability and validity of the Norwegian version of the Severe Impairment Battery (SIB)

“…Several studies have used the NPI as an assessment scale for NPS, but nevertheless prevalence estimates in out-patients vary from 74% to 96%, indicating differences in the samples as well as in the dementia diagnosis (Steffens et al, 2005;Benoit et al, 1999;Petrovic et al, 2007). One of the problems with prevalence studies in clinical settings is that some of the patients have been prescribed psychotropic medication, which may alter to what extent they express their symptoms.…”