scholarly journals Behavioral and psychological symptoms of dementia in different dementia disorders: A large-scale study of 12 000 individuals.

2021 ◽  
Author(s):  
Emilia Schwertner ◽  
Joana Braga Pereira ◽  
Hong Xu ◽  
Juraj Secnik ◽  
Bengt Winblad ◽  
...  
Keyword(s):  
Large Scale ◽  
Motor Behavior ◽  
Psychological Symptoms ◽  
Lewy Bodies ◽  
Time Behavior ◽  
Dementia Diagnosis ◽  
Night Time ◽  
Logistic Regression Models ◽  
National Quality ◽  
Behavioral And Psychological Symptoms

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.

scholarly journals Caregiver distress associated with behavioral and psychological symptoms in mild Alzheimer's disease

2010 ◽  
Vol 4 (3) ◽  
pp. 238-244 ◽  
Author(s):  
Ari Pedro Balieiro Jr. ◽  
Emmanuelle Silva Tavares Sobreira ◽  
Marina Ceres Silva Pena ◽  
José Humberto Silva-Filho ◽  
Francisco de Assis Carvalho do Vale
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Psychological Symptoms ◽  
Time Behavior ◽  
Caregiver Distress ◽  
Night Time ◽  
The Mean ◽  
The Individual ◽  
The Relationship ◽  
Behavioral And Psychological Symptoms

Abstract The aim of this study was to analyze the relationship between Caregiver Distress and Behavioral and Psychological Symptoms in Dementias (BPSD) in mild Alzheimer's disease. Methods: Fifty patients and caregivers were interviewed using the Neuropsychiatric Inventory (NPI). Results: 96.0% of the patients had at least one BPSD. The mean NPI total score was 19.6 (SD=18.05; range=0-78) whereas the mean Caregiver Distress Index (CDI) total score was 11.5 (SD=10.41; range=0-40). For the individual symptoms, the weighted mean CDI was 2.8 (SD=1.58). All symptom CDI means were higher than 2.0 except for euphoria/elation (m=1.8; SD=1.49). There were correlations between CDI and derived measures (Frequency, Severity, FxS, and Amplitude) for all symptoms, except Disinhibition and Night-time behavior. Correlations ranged between 0.443 and 0.894, with significance at p<0.05. Conclusions: All the derived measures, including amplitude, were useful in at least some cases. The data suggests that CDI cannot be inferred from symptom presence or profile. Symptoms should be systematically investigated.

scholarly journals The Holistic Impact of Using Arts-Based Intervention for Elderly With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 567-567
Author(s):  
Rainbow Tin Hun Ho
Keyword(s):  
Motor Behavior ◽  
Psychological Symptoms ◽  
Controlled Trial ◽  
Negative Mood ◽  
Community Dwelling ◽  
Creative Arts ◽  
Dance Movement ◽  
Moderate Dementia ◽  
Practical Experiences ◽  
Behavioral And Psychological Symptoms

Abstract The use of creative arts on supporting elderly with dementia has been becoming popular due to its safe and engaging process. This non-pharmacological approach can complement with other treatment methods to support elderly with dementia on various aspects, including physical, cognitive and social functioning. In our randomized controlled trial on dance movement therapy (DMT) for 204 community dwelling elders with mild dementia, we found DMT could significantly reduce the level of depression, loneliness and negative mood (β=0.33-0.42, p&lt;.01), and also the diurnal cortisol slope (β =0.30, p&lt;.01); while in another trial on 73 elderly with moderate dementia, we found music and movement could help reduce the behavioral and psychological symptoms such as agitation (β = -0.41, p&lt;.01), aberrant motor behavior (β=-1.02, p&lt;.01), and dysphonia (β=-0.61, p&lt;.05). The present presentation aims to share with the audience our practical experiences, the research procedures as well as the findings of the projects.

scholarly journals The impact of lockdown during SARS-CoV-2 outbreak on behavioral and psychological symptoms of dementia

2021 ◽  
Vol 42 (3) ◽  
pp. 825-833
Author(s):  
Arianna Manini ◽  
Michela Brambilla ◽  
Laura Maggiore ◽  
Simone Pomati ◽  
Leonardo Pantoni
Keyword(s):  
Logistic Regression ◽  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Community Dwelling ◽  
Caregiver Distress ◽  
Neuropsychiatric Inventory ◽  
Logistic Regression Models ◽  
The Impact ◽  
Behavioral And Psychological Symptoms

Abstract Background During Covid-19 pandemic, the Italian government adopted restrictive limitations and declared a national lockdown on March 9, which lasted until May 4 and produced dramatic consequences on people’s lives. The aim of our study was to assess the impact of prolonged lockdown on behavioral and psychological symptoms of dementia (BPSD). Methods Between April 30 and June 8, 2020, we interviewed with a telephone-based questionnaire the caregivers of the community-dwelling patients with dementia who had their follow-up visit scheduled from March 9 to May 15 and canceled due to lockdown. Among the information collected, patients’ BPSDs were assessed by the Neuropsychiatric Inventory (NPI). Non-parametric tests to compare differences between NPI scores over time and logistic regression models to explore the impact of different factors on BPSD worsening were performed. Results A total of 109 visits were canceled and 94/109 caregivers completed the interview. Apathy, irritability, agitation and aggression, and depression were the most common neuropsychiatric symptoms experienced by patients both at baseline and during Covid-19 pandemic. Changes in total NPI and caregiver distress scores between baseline and during lockdown, although statistically significant, were overall modest. The logistic regression model failed to determine predictors of BPSD worsening during lockdown. Conclusion This is one of the first studies to investigate the presence of BPSD during SARS-CoV-2 outbreak and related nationwide lockdown, showing only slight, likely not clinically relevant, differences in BPSD burden, concerning mostly agitation and aggression, anxiety, apathy and indifference, and irritability.

Caregiver-Reported Sleep Disturbances Are Associated With Behavioral and Psychological Symptoms in an Asian Elderly Cohort With Cognitive Impairment-No Dementia

2018 ◽  
Vol 31 (2) ◽  
pp. 70-75
Author(s):  
Xin Xu ◽  
Cheuk Ni Kan ◽  
Tien Yin Wong ◽  
Ching-Yu Cheng ◽  
M. Kamran Ikram ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Sleep Disturbances ◽  
Motor Behavior ◽  
Psychological Symptoms ◽  
Risk Of Progression ◽  
Elderly Cohort ◽  
Anxiety Depression ◽  
Behavioral And Psychological Symptoms ◽  
Asian Sample ◽  
Cognitive Impairment No Dementia

Objective: Sleep disturbances were found to be associated with more behavioral and psychological symptoms (BPS) in early patients with Alzheimer's disease (AD). However, data on preclinical stages of dementia are lacking. Hence, the present study sought to investigate the association between sleep disturbances and BPS in dementia-free elderly with varying severity of cognitive impairment in an Asian sample. Methods: Community-living elderly were recruited and administered a comprehensive cognitive battery (vascular dementia battery [VDB]) and the Neuropsychiatric Inventory to assess symptoms of sleep disturbances and BPS. Severity of cognitive impairment was diagnosed and classified as no cognitive impairment (NCI), cognitive impairment-no dementia (CIND) -mild (1-2 impaired domains on the VDB), and CIND-moderate (≥3 impaired domains on the VDB). Analysis of variance was conducted to assess the associations between the presence of sleep disturbances and BPS scores in each diagnostic group. Logistic regression was used to examine whether the coexistence of sleep disturbances and other BPS was associated with CIND-moderate, which is known to carry a higher risk of progression to AD. Results: Among 839 elderly, 79 (9.4%) reported sleep disturbances. Participants with sleep disturbances had higher total BPS burden than those without among CIND participants but not in NCIs. Furthermore, CIND-moderate participants with sleep disturbances had more delusions, hallucinations, anxiety, depression, irritability, aberrant motor behavior, and appetite change ( P < .05). The presence of both sleep disturbances and other BPS was associated with CIND-moderate (odds ratio: 2.5, 95% confidence interval: 1.1-5.5). Conclusions: Sleep disturbances are associated with higher total BPS burden and specific BPS among elderly patients with cognitive impairment, particularly those with CIND moderate, which carries higher risk of developing dementia.

scholarly journals Prevalence of Behavioral and Psychological Symptoms of Dementia in Community-Dwelling Dementia Patients: A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Chan-Young Kwon ◽  
Boram Lee
Keyword(s):  
Systematic Review ◽  
Eating Disorder ◽  
Sleep Disorders ◽  
Motor Behavior ◽  
Psychological Symptoms ◽  
Community Dwelling ◽  
Dementia Patients ◽  
Pooled Prevalence ◽  
Severity Of Dementia ◽  
Behavioral And Psychological Symptoms

Background: Identifying the characteristics of behavioral and psychological symptoms of dementia (BPSD) associated with different dementia types may be a promising strategy to effectively deal with BPSD. We aimed to synthesize the prevalence rates of BPSD characteristics in community-dwelling dementia patients.Methods: We searched Medline, EMBASE, and PsycARTICLES databases for original clinical studies published until December 2020 that enrolled at least 300 community-dwelling dementia patients. The methodological qualities of prevalence studies were assessed using the Joanna Briggs Institute's critical appraisal checklist.Results: Thirty studies were included. The prevalence of the BPSD characteristic ranged from 4 (elation and mania) to 32% (apathy) in the pooled samples. The prevalence of delusions, anxiety, apathy, irritability, elation and mania, and aberrant motor behavior in Alzheimer's disease patients was 1.72–2.88 times greater than that in vascular dementia (VD) patients, while the prevalence of disinhibition in VD patients was 1.38 times greater. The prevalence of anxiety, irritability, and agitation and aggression, delusion, hallucinations, apathy, disinhibition, and aberrant motor behavior tended to increase as the severity of dementia increased, while that of depression, eating disorder, sleep disorders, and elation and mania tended to stable. In community-dwelling patients with dementia, the pooled prevalence of apathy, depression, anxiety, irritability, agitation and aggression, sleep disorders, and eating disorder was higher than 20%, while that of disinhibition and elation and mania was lower than 10%.Conclusion: Overall, the pooled prevalence of apathy, depression, anxiety, irritability, agitation and aggression, sleep disorders, and eating disorder was generally high in patients with dementia. Also, the prevalence of some BPSD characteristics differed according to the type and the severity of dementia. The methodological quality of the included studies is not the best, and high heterogeneity may affect the certainty of the findings. However, the results of this review can deepen our understanding of the prevalence of BPSD.Systematic Review Registration:https://osf.io/dmj7k, identifier: 10.17605/OSF.IO/DMJ7K.

Comparison of QOL between patients with different degenerative dementias, focusing especially on positive and negative affect

2016 ◽  
Vol 28 (8) ◽  
pp. 1355-1361 ◽  
Author(s):  
Kairi Kurisu ◽  
Seishi Terada ◽  
Etsuko Oshima ◽  
Makiko Horiuchi ◽  
Nao Imai ◽  
...  
Keyword(s):  
Negative Affect ◽  
Positive Affect ◽  
Outcome Measure ◽  
Psychological Symptoms ◽  
Lewy Bodies ◽  
Positive And Negative Affect ◽  
Dementia Patients ◽  
The Difference ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground:Quality of life (QOL) has become an important outcome measure in the care of dementia patients. However, there have been few studies focusing on the difference in QOL between different dementias.Methods:Two-hundred seventy-nine consecutive outpatients with Alzheimer's disease (AD), dementia with Lewy bodies (DLB) or frontotemporal dementia (FTD) were recruited. The QOL was evaluated objectively using the QOL Questionnaire for Dementia (QOL-D).The QOL-D comprises six domains: positive affect, negative affect and actions, communication, restlessness, attachment to others, and spontaneity. General cognition, daily activities, and behavioral and psychological symptoms of dementia were also evaluated.Results:The scores of positive affect of QOL-D of AD patients were significantly higher than those of patients with DLB or FTD (AD 3.1 ± 0.8, DLB 2.6 ± 0.9, FTD 2.6 ± 0.7). The scores of negative affect and action of QOL-D of FTD patients were significantly higher than those of patients with AD or DLB (FTD 2.0 ± 0.8, AD 1.4 ± 0.5, DLB 1.5 ± 0.6). The apathy scores of FTD and DLB patients were significantly higher than those of patients with AD. The disinhibition scores of FTD patients were significantly higher than those of patients with AD or DLB.Conclusions:The apathy of FTD and DLB patients and depression of DLB patients might affect the lower positive affect of FTD and DLB patients compared to AD patients. The disinhibition of FTD patients might affect the abundance of negative affect & actions in FTD patients compared to AD and DLB patients.

The effect of exercise on behavioral and psychological symptoms of dementia: towards a research agenda

2011 ◽  
Vol 24 (7) ◽  
pp. 1046-1057 ◽  
Author(s):  
I. C. V. Thuné-Boyle ◽  
S. Iliffe ◽  
A. Cerga-Pashoja ◽  
D. Lowery ◽  
J. Warner
Keyword(s):  
Physical Activity ◽  
Psychological Symptoms ◽  
Repetitive Behaviors ◽  
Night Time ◽  
Interpretive Approach ◽  
Need To Evaluate ◽  
Exercise Type ◽  
Person With Dementia ◽  
Core Symptoms ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground:Behavioral and psychological symptoms of dementia (BPSD) are common and are core symptoms of the condition. They cause considerable distress to the person with dementia and their carers and predict early institutionalization and death. Historically, these symptoms have been managed with anxiolytic and antipsychotic medication. Although potentially effective, such medication has been used too widely and is associated with serious adverse side-effects and increased mortality. Consequently, there is a need to evaluate non-pharmacological therapies for behavioral and psychological symptoms in this population. One such therapy is physical activity, which has widespread health benefits. The aim of this review is to summarize the current findings of the efficacy of physical activity on BPSD.Method:Published articles were identified using electronic and manual searches. Rather than systematically aggregating data, this review adopted a rapid critical interpretive approach to synthesize the literature.Results:Exercise appears to be beneficial in reducing some BPSD, especially depressed mood, agitation, and wandering, and may also improve night-time sleep. Evidence of the efficacy of exercise on improving other symptoms such as anxiety, apathy, and repetitive behaviors is currently weak or lacking.Conclusion:The beneficial effect of exercise type, its duration, and frequency is unclear although some studies suggest that walking for at least 30 minutes, several times a week, may enhance outcome. The methodological shortcomings of current work in this area are substantial. The research and clinical implications of current findings are discussed.

Emerging treatments for the behavioral and psychological symptoms of dementia

CNS Spectrums ◽  
2017 ◽  
Vol 23 (6) ◽  
pp. 361-369 ◽  
Author(s):  
Abhinav Anand ◽  
Puneet Khurana ◽  
Jasneet Chawla ◽  
Neha Sharma ◽  
Navneet Khurana
Keyword(s):  
Motor Behavior ◽  
Psychological Symptoms ◽  
Significant Development ◽  
Emerging Treatments ◽  
Mental Abilities ◽  
Cholinergic Agents ◽  
Clinically Significant ◽  
Underlying Pathophysiology ◽  
Behavioral And Psychological Symptoms ◽  
Research Avenue

Dementia is referred to a loss of memory and decline in other mental abilities at levels critical enough to hinder performance of daily activities. It can be of several types, depending on the underlying pathophysiology. The behavioral and psychological symptoms of dementia (BPSD) are various, but the most clinically significant are depression, apathy, and anxiety. Other BPSD include agitation, aberrant motor behavior, elation, hallucinations, and alterations in sleep and appetite. About 90% of sufferers of dementia are affected by BPSD during the course of the illness. These symptoms occur in demented patients irrespective of the dementia subtype. However, there has not been significant development in the areas of disease-modifying pharmacotherapeutics for dementia. Therefore, tackling BPSD has emerged as a research avenue in the recent past. Existing antidepressants, antipsychotics, and cholinergic agents have been extensively used in the treatment of BPSD, independently and in different combinations. However, these agents have not successful in completely alleviating such symptoms. Research in this field is going on globally, but it is still limited by various factors. There is a strong need to develop new entities and test them clinically. This review focuses on emerging treatments for the management of clinically significant BPSD.

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