Comparison of behavioral and psychological symptoms of Alzheimer's disease among institution residents and memory clinic outpatients
Journal
International Psychogeriatrics
Journal Volume
21
Journal Issue
6
Pages
1134-1141
Date Issued
2009
Author(s)
Abstract
Background: Behavioral and psychological symptoms of dementia (BPSD) cause caregiver distress and earlier institutionalization. We compared the prevalence and characteristics of BPSD between institution residents and memory clinic outpatients with Alzheimer's disease (AD) to test the hypothesis that there is more BPSD among institution residents than among their outpatient counterparts. Methods: We assessed BPSD by interviewing the patients principal caregivers, either family or professionals, using the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). Data from 138 patients with probable AD from the memory clinic and 173 residents with possible AD living in the long-term care facilities were collected. The diagnoses followed the NINCDS-ADRDA criteria. Results: BPSD profiles of the two groups were similar but not identical. The prevalence of at least one BPSD was high in both groups (community 81.9%, institution 74.9%). Activity disturbance was the most frequently reported BPSD in both groups (community 52.2%, institution 38.7%). Delusions, hallucinations, anxiety and aggressiveness were seen more frequently in memory clinic outpatients. The outpatients also had higher scores of BEHAVE-AD subscales in delusion/paranoid ideation, affective disturbance, and global rating of severity. With the increase of disease severity there were significantly more activity disturbance, psychosis, and aggressiveness in patients with AD. Conclusions: Caregiver factor and institution effect were two possible reasons for the higher prevalence and the greater severity of BPSD in community patients. BPSD caused more distress to family caregivers than the professional caregivers. High levels of psychotropic prescriptions for patients living in the long-term care facilities may also play a role. ? 2009 International Psychogeriatric Association.
SDGs
Other Subjects
aged; aggressiveness; Alzheimer disease; anxiety disorder; article; behavior disorder; behavioral and psychological symptoms of dementia; caregiver; clinical feature; community; controlled study; delusion; dementia; disease severity; family; female; hallucination; human; interview; long term care; major clinical study; male; mood disorder; outpatient department; paranoia; phobia; prevalence; psychosis; rating scale; resident; risk factor; symptom; Aged; Aged, 80 and over; Aggression; Alzheimer Disease; Ambulatory Care; Caregivers; Cost of Illness; Cross-Sectional Studies; Female; Humans; Institutionalization; Male; Mental Disorders; Mental Status Schedule; Psychometrics; Taiwan
Type
journal article