Behavioral and Psychological Symptoms of Dementia in Different Dementia Disorders: A Large-Scale Study of 10,000 Individuals

Emilia Schwertner; Joana B Pereira; Hong Xu; Juraj Secnik; Bengt Winblad; Maria Eriksdotter; Katarina Nägga; Dorota Religa

doi:10.3233/JAD-215198

Behavioral and Psychological Symptoms of Dementia in Different Dementia Disorders: A Large-Scale Study of 10,000 Individuals

J Alzheimers Dis. 2022;87(3):1307-1318. doi: 10.3233/JAD-215198.

Authors

Emilia Schwertner¹, Joana B Pereira^{1

2}, Hong Xu¹, Juraj Secnik¹, Bengt Winblad^{3

4}, Maria Eriksdotter^{1

4}, Katarina Nägga^{2

5}, Dorota Religa^{1

4}

Affiliations

¹ Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Department of Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
² Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
³ Center for Alzheimer Research, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden.
⁴ Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden.
⁵ Department of Acute Internal Medicine and Geriatrics, Linköping University, Linköping, Sweden.

Abstract

Background: The majority of individuals with dementia will suffer from behavioral and psychological symptoms of dementia (BPSD). These symptoms contribute to functional impairment and caregiver burden.

Objective: To characterize BPSD in Alzheimer's disease (AD), vascular dementia (VaD), mixed (Mixed) dementia, Parkinson's disease dementia (PDD), dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), and unspecified dementia in individuals residing in long-term care facilities.

Methods: We included 10,405 individuals with dementia living in long-term care facilities from the Swedish registry for cognitive/dementia disorders (SveDem) and the Swedish BPSD registry. 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.

Results: The most common symptoms were aberrant motor behavior, agitation, and irritability. Compared to AD, we found a lower risk of delusions (in FTD, unspecified dementia), hallucinations (FTD), agitation (VaD, PDD, unspecified dementia), elation/euphoria (DLB), anxiety (Mixed, VaD, unspecified dementia), disinhibition (in PDD), irritability (in DLB, FTD, unspecified dementia), aberrant motor behavior (Mixed, VaD, unspecified dementia), and sleep and night-time behavior changes (unspecified dementia). Higher risk of delusions (DLB), hallucinations (DLB, PDD), apathy (VaD, FTD), disinhibition (FTD), and appetite and eating abnormalities (FTD) were also found in comparison to AD.

Conclusion: Although individuals in our sample were diagnosed with different dementia disorders, they all exhibited aberrant motor behavior, agitation, and irritability. This suggests common underlying psychosocial or biological mechanisms. We recommend prioritizing these symptoms while planning interventions in long-term care facilities.

Keywords: Aberrant motor behavior; Alzheimer’s disease; Neuropsychiatric Inventory; aging; agitation; behavioral and psychological symptoms of dementia; behavioral problem; dementia; irritability; nursing homes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Alzheimer Disease* / psychology
Behavioral Symptoms / etiology
Dementia, Vascular* / psychology
Frontotemporal Dementia* / epidemiology
Frontotemporal Dementia* / psychology
Hallucinations
Humans
Parkinson Disease* / psychology