Characteristics of Behavioral and Psychological
Symptoms of Dementia, Severity and
Levels of Distress on Caregivers
Unchulee Taemeeyapradit MD*,
Dussadee Udomittipong MSc*, Nualsakol Tepparak MD*
Affiliation :
* Songkhla Rajanakarindra Psychiatric Hospital, Songkhla, Thailand
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 DSM IV-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.
Keywords : BPSD, Dementia, Caregivers stress, NPI-Q Thai
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