Characteristics of behavioral and psychological symptoms of dementia, severity and levels of distress on caregivers.

OBJECTIVE

To describe the characteristics of the Behavioral and Psychological Symptoms of Dementia (BPSD) and its severity among patients with dementia and their caregivers' stress.

MATERIAL AND METHOD

A cross-sectional descriptive study of 158 patients with Alzheimer's disease, mixed vascular dementia and Alzheimer's disease, and unspecified dementia and caregivers in Songkhla Rajanakarindra Psychiatric Hospital were selected by a consecutive sampling. The BPSD and severity of dementia was assessed with the Neuropsychiatric Inventory Questionnaire - Thai version (NPI-Q Thai), the Global Clinical Dementia Rating Scale (CDR), the Mini Mental Status Thai version 2002 (MMSE Thai 2002), and a clinical diagnosis. Consensus of a psychiatrist and a neurologist according to diagnostic criteria of DSMIV-TR was achieved for every patient.

RESULTS

Overall, 90.5% had at least one BPSD symptom. Common symptoms were irritability (60.8%), sleep problems (57%), depression (54.5%), anxiety (52%), and agitation/aggression (44.9%). The least common symptom was eating problems (23.5%). The caregivers rated the patient's physical symptoms as more severe than psychological symptoms. The symptom that caused the highest burden to caregivers was agitation/aggression, followed by dis-inhibition, aberrant motor behaviors, and sleep problems. The less burdensome symptoms included irritability, depression, and anxiety.

CONCLUSION

BPSD were commonly found among patients with dementia. The top five symptoms were irritability, sleep problems, depression, anxiety, and agitation/aggression. Not only assessment of BPSD, but also feeling and suffering of the caregivers should be assessed by using the NPI-Q. This would help the clinician plan appropriate treatment. Physical symptoms were perceived by caregivers as causing the most anguish and distress, while psychological symptoms were perceived as less severe. Further studies should be done, such as the factors related to burden of caregivers of dementia with BPSD.