Determinants of behavioral and psychological symptoms of dementia: A scoping review of the evidence

Ann Kolanowski; Marie Boltz; Elizabeth Galik; Laura N Gitlin; Helen C Kales; Barbara Resnick; Kimberly S Van Haitsma; Amy Knehans; Jane E Sutterlin; Justine S Sefcik; Wen Liu; Darina V Petrovsky; Lauren Massimo; Andrea Gilmore-Bykovskyi; Margaret MacAndrew; Glenna Brewster; Vycki Nalls; Ying-Ling Jao; Naomi Duffort; Danny Scerpella

doi:10.1016/j.outlook.2017.06.006

Determinants of behavioral and psychological symptoms of dementia: A scoping review of the evidence

Nurs Outlook. 2017 Sep-Oct;65(5):515-529. doi: 10.1016/j.outlook.2017.06.006. Epub 2017 Jun 16.

Authors

Ann Kolanowski¹, Marie Boltz², Elizabeth Galik³, Laura N Gitlin⁴, Helen C Kales⁵, Barbara Resnick³, Kimberly S Van Haitsma⁶, Amy Knehans⁷, Jane E Sutterlin⁸, Justine S Sefcik⁹, Wen Liu¹⁰, Darina V Petrovsky⁹, Lauren Massimo², Andrea Gilmore-Bykovskyi¹¹, Margaret MacAndrew¹², Glenna Brewster¹³, Vycki Nalls¹⁴, Ying-Ling Jao², Naomi Duffort¹⁵, Danny Scerpella¹⁶

Affiliations

¹ College of Nursing, Penn State, University Park, PA. Electronic address: amk20@psu.edu.
² College of Nursing, Penn State, University Park, PA.
³ School of Nursing, University of Maryland, Baltimore, MD.
⁴ Department of Community-Public Health, Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD; Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD.
⁵ The Program for Positive Aging, University of Michigan, Ann Arbor, MI; VA Center for Clinical Management Research, Ann Arbor, MI.
⁶ Program for Person Centered Living Systems of Care, College of Nursing, The Pennsylvania State University, University Park, PA; Polisher Research Institute, Madlyn & Leonard Abramson Center for Jewish Life, North Wales, PA.
⁷ Penn State College of Medicine, Harrell Health Sciences Library, Research & Learning Commons, Hershey, PA.
⁸ Penn State, University Park, PA.
⁹ School of Nursing, University of Pennsylvania, Philadelphia, PA.
¹⁰ College of Nursing, The University of Iowa, Iowa City, IA.
¹¹ School of Nursing, University of Wisconsin-Madison, Madison, WI.
¹² Queensland University of Technology, Kelvin Grove, Queensland, Australia.
¹³ Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, School of Nursing, University of Pennsylvania, Philadelphia, PA.
¹⁴ Optum Health, Rockville, MD.
¹⁵ Johns Hopkins School of Nursing, Baltimore, MD.
¹⁶ Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, MD.

Abstract

Background: Behavioral and psychological symptoms of dementia (BPSD) are prevalent in people with neurodegenerative diseases.

Purpose: In this scoping review the Kales, Gitlin and Lykestos framework is used to answer the question: What high quality evidence exists for the patient, caregiver and environmental determinants of five specific BPSD: aggression, agitation, apathy, depression and psychosis?

Method: An a priori review protocol was developed; 692 of 6013 articles retrieved in the search were deemed eligible for review. Gough's Weight of Evidence Framework and the Cochrane Collaboration's tool for assessing risk of bias were used. The findings from 56 high quality/low bias articles are summarized.

Discussion: Each symptom had its own set of determinants, but many were common across several symptoms: neurodegeneration, type of dementia, severity of cognitive impairments, and declining functional abilities, and to a lesser extent, caregiver burden and communication.

Conclusion: Research and policy implications are relevant to the National Plan to Address Alzheimer's Disease.

Keywords: Behavioral and psychological symptoms of dementia; Determinants; Scoping review.

Publication types

Review

MeSH terms

Aged
Aged, 80 and over
Aggression*
Alzheimer Disease / complications
Alzheimer Disease / physiopathology*
Apathy*
Dementia / complications
Dementia / physiopathology*
Depression / etiology
Depression / physiopathology*
Female
Humans
Male
Middle Aged
Psychomotor Agitation / etiology
Psychomotor Agitation / physiopathology*
Psychotic Disorders / etiology
Psychotic Disorders / physiopathology*

Abstract

Publication types

MeSH terms

Grants and funding