Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-22T21:52:52.288Z Has data issue: false hasContentIssue false
  • English
  • Français

The course of neuropsychiatric symptoms in community-dwelling patients with dementia: a systematic review

Published online by Cambridge University Press:  18 November 2014

Petra Borsje ,
Roland B. Wetzels ,
Peter L. Lucassen ,
Anne Margriet Pot  and
Raymond T. Koopmans
Petra Borsje*
Affiliation:
Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands Thebe, Region South-East, Goirle, Tilburg, the Netherlands
Roland B. Wetzels
Affiliation:
Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
Peter L. Lucassen
Affiliation:
Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
Anne Margriet Pot
Affiliation:
Department of Clinical Psychology, VU University Amsterdam, the Netherlands Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands School of Psychology, The University of Queensland, Australia
Raymond T. Koopmans
Affiliation:
Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands Joachim en Anna, Center for specialized geriatric care, Nijmegen
*
Correspondence should be addressed to: Petra Borsje, Radboud university medical center, Dept. of Primary and Community Care, Internal post 117 ELG, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands. Phone: +31 24 3655307. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Neuropsychiatric symptoms (NPS) often occur in patients with dementia. Understanding the course of NPS in dementia is important for healthcare professionals for psycho-educational purposes and adequate and timely interventions to prevent or diminish NPS as much as possible.

Methods:

We conducted a systematic literature search in several electronic databases. We combined search strings for the terms dementia, community-dwelling, cohort studies and NPS. Screening titles and abstracts, assessing the methodological quality and data-extraction were independently conducted by at least two authors.

Results:

This literature search revealed 6605 unique records of which 23 studies were included in data synthesis. In total 7184 patients participated in the included studies with a mean number of 312. Sixty percent of the participants were female and the mean age of all participants was 74.8 years. Follow-up varied between 1 and 6 years; in 17 studies loss to follow-up was less than 20% per year. NPS are highly prevalent, incident and persistent although frequency parameters vary considerably across studies. Delusions/delusional misidentification, wandering/agitation, aberrant motor behavior/motor hyperactivity and apathy are the most common NPS. For hallucinations, delusions/delusional misidentification, paranoia, aggression, wandering/agitation, aberrant motor behavior/motor hyperactivity, disinhibition, apathy, and sleep disturbance increasing trends in point prevalence rates have been found.

Conclusions:

NPS in community-dwelling patients are frequent and persistent. The increasing trends of several NPS in the course of dementia require a preventive approach of professional caretakers. For such an approach, a timely diagnosis and adequate professional support to prevent or diminish these problems is necessary.

Keywords

dementianeuropsychiatric symptomscommunity-dwellingsystematic review
Type
Review Article
Information
International Psychogeriatrics , Volume 27 , Issue 3 , March 2015 , pp. 385 - 405
Copyright
Copyright © International Psychogeriatric Association 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aalten, P., de Vugt, M. E., Jaspers, N., Jolles, J. and Verhey, F. R. (2005). The course of neuropsychiatric symptoms in dementia. Part I: findings from the two-year longitudinal Maasbed study. International Journal of Geriatric Psychiatry, 20, 523–530.CrossRefGoogle ScholarPubMed
Aalten, P. et al. (2003). Behavioral problems in dementia: a factor analysis of the neuropsychiatric inventory. Dementia and Geriatric Cognitive Disorders, 15, 99–105.Google Scholar
Altman, D. G. (2001). Systematic reviews of evaluations of prognostic variables. British Medical Journal, 323, 224–228.CrossRefGoogle ScholarPubMed
Asada, T., Kinoshita, T., Morikawa, S., Motonago, T. and Kakuma, T. (1999). A prospective 5-year follow-up study on the behavioral disturbances of community-dwelling elderly people with Alzheimer disease. Alzheimer Disease and Associated Disorders, 13, 202–208.CrossRefGoogle ScholarPubMed
Asada, T., Motonaga, T. and Kinoshita, T. (2000). Predictors of severity of behavioral disturbance among community-dwelling elderly individuals with Alzheimer's disease: a 6-year follow-up study. Psychiatry and Clinical Neurosciences, 54, 673–677.Google Scholar
Ballard, C., O’Brien, J., Coope, B., Fairbairn, A., Abid, F. and Wilcock, G. (1997). A prospective study of psychotic symptoms in dementia sufferers: psychosis in dementia. International Psychogeriatrics, 9, 57–64.CrossRefGoogle ScholarPubMed
Ballard, C. G., O’Brien, J. T., Swann, A. G., Thompson, P., Neill, D. and McKeith, I. G. (2001). The natural history of psychosis and depression in dementia with Lewy bodies and Alzheimer's disease: persistence and new cases over 1 year of follow-up. Journal of Clinical Psychiatry, 62, 46–49.Google Scholar
Chow, T. W. et al. (2002). Neuropsychiatric symptoms of Alzheimer's disease differ in Chinese and American patients. International Journal of Geriatric Psychiatry, 17, 22–28.Google Scholar
Cipriani, G., Vedovello, M., Nuti, A. and Di Fiorino, M. (2011). Aggressive behavior in patients with dementia: correlates and management. Geriatrics and Gerontology International, 11, 408–413.Google Scholar
Cortes, F., Gillette-Guyonnet, S., Nourhashemi, F., Andrieu, S., Cantet, C. and Vellas, B. (2005). Recent data on the natural history of Alzheimer's disease: results from the REAL.FR study. Journal of Nutrition Health and Aging, 9, 86–93.Google ScholarPubMed
Craig, D., Mirakhur, A., Hart, D. J., McIlroy, S. P. and Passmore, A. P. (2005). A cross-sectional study of neuropsychiatric symptoms in 435 patients with Alzheimer's disease. American Journal of Geriatric Psychiatry, 13, 460–468.CrossRefGoogle ScholarPubMed
de Vugt, M. E. et al. (2003). Behavioural disturbances in dementia patients and quality of the marital relationship. International Journal of Geriatric Psychiatry, 18, 149–154.Google Scholar
de Vugt, M. E. et al. (2004). Do caregiver management strategies influence patient behaviour in dementia? International Journal of Geriatric Psychiatry, 19, 85–92.Google Scholar
Devanand, D. P. et al. (1997). The course of psychopathologic features in mild to moderate Alzheimer disease. Archives of General Psychiatry, 54, 257–263.Google Scholar
Dorenlot, P., Harboun, M., Bige, V., Henrard, J. C. and Ankri, J. (2005). Major depression as a risk factor for early institutionalization of dementia patients living in the community. International Journal of Geriatric Psychiatry, 20, 471–478.Google Scholar
Forstl, H., Besthorn, C., Geiger-Kabisch, C., Sattel, H. and Schreiter-Gasser, U. (1993). Psychotic features and the course of Alzheimer's disease: relationship to cognitive, electroencephalographic and computerized tomography findings. Acta Psychiatrica Scandinavica, 87, 395–399.Google Scholar
Froelich, L. et al. (2009). Long-term treatment of patients with Alzheimer's disease in primary and secondary care: results from an international survey. Current Medical Research and Opinion, 25, 3059–3068.CrossRefGoogle ScholarPubMed
Gaugler, J. E., Yu, F., Krichbaum, K. and Wyman, J. F. (2009). Predictors of nursing home admission for persons with dementia. Medical Care, 47, 191–198.CrossRefGoogle ScholarPubMed
Gonfrier, S., Andrieu, S., Renaud, D., Vellas, B. and Robert, P. H. (2012). Course of neuropsychiatric symptoms during a 4-year follow up in the REAL-FR cohort. Journal of Nutrition Health and Aging, 16, 134–137.Google Scholar
Haupt, M., Kurz, A. and Janner, M. (2000). A 2-year follow-up of behavioural and psychological symptoms in Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 11, 147–152.Google Scholar
Hayden, J. A., Cote, P. and Bombardier, C. (2006). Evaluation of the quality of prognosis studies in systematic reviews. Annals of Internal Medicine, 144, 427–437.Google Scholar
Hemingway, H. et al. (2013). Prognosis research strategy (PROGRESS) 1: a framework for researching clinical outcomes. British Medical Journal, 346, e5595.Google Scholar
Higgins, J. P. T. and Green, S. (2011). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. Available at: http://handbook.cochrane.org/; last accessed 21 March 2011.Google Scholar
Holtzer, R. et al. (2003). Psychopathological features in Alzheimer's disease: course and relationship with cognitive status. Journal of the American Geriatrics Society, 51, 953–960.Google Scholar
Holtzer, R. et al. (2005). Depressive symptoms in Alzheimer's disease: natural course and temporal relation to function and cognitive status. Journal of the American Geriatrics Society, 53, 2083–2089.Google Scholar
Hudak, P. L., Cole, D. C. and Frank, J. W. (1998). Perspectives on prognosis of soft tissue musculoskeletal disorders. International Journal of Rehabilitation Research, 21, 29–40.Google Scholar
Ikeda, M. et al. (2004). Dementia associated mental and behavioural disturbances in elderly people in the community: findings from the first Nakayama study. Journal of Neurology, Neurosurgery, and Psychiatry, 75, 146–148.Google Scholar
Juva, K., Makela, M., Sulkava, R. and Erkinjuntti, T. (1997). One-year risk of institutionalization in demented outpatients with caretaking relatives. International Psychogeriatrics, 9, 175–182.Google Scholar
Keene, J. and Hope, T. (1998). Natural history of hyperphagia and other eating changes in dementia. International Journal of Geriatric Psychiatry, 13, 700–706.Google Scholar
Kuijpers, T., van der Windt, D. A., van der Heijden, G. J. and Bouter, L. M. (2004). Systematic review of prognostic cohort studies on shoulder disorders. Pain, 109, 420–431.CrossRefGoogle ScholarPubMed
Kunik, M. E. et al. (2010). Consequences of aggressive behavior in patients with dementia. Journal of neuropsychiatry and clinical neurosciences, 22, 40–47.CrossRefGoogle ScholarPubMed
Landis, J. R. and Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.CrossRefGoogle ScholarPubMed
Li, Y. S., Meyer, J. S. and Thornby, J. (2001). Longitudinal follow-up of depressive symptoms among normal versus cognitively impaired elderly. International Journal of Geriatric Psychiatry, 16, 718–727.Google Scholar
Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J. and DeKosky, S. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. Journal of the American Medical Association, 288, 1475–1483.CrossRefGoogle ScholarPubMed
McShane, R., Gedling, K., Reading, M., McDonald, B., Esiri, M. M. and Hope, T. (1995). Prospective study of relations between cortical Lewy bodies, poor eyesight, and hallucinations in Alzheimer's disease. Journal of Neurology, Neurosurgery, and Psychiatry, 59, 185–188.Google Scholar
McShane, R., Keene, J., Fairburn, C., Jacoby, R. and Hope, T. (1998). Psychiatric symptoms in patients with dementia predict the later development of behavioural abnormalities. Psychological Medicine, 28, 1119–1127.Google Scholar
Moher, D., Liberati, A., Tetzlaff, J. and Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Journal of Clinical Epidemiology, 62, 1006–1012.CrossRefGoogle ScholarPubMed
Olde Hartman, T. C., Borghuis, M. S., Lucassen, P. L., van de Laar, F. A., Speckens, A. E. and van Weel, C. (2009). Medically unexplained symptoms, somatisation disorder and hypochondriasis: course and prognosis. A systematic review. Journal of Psychosomatic Research, 66, 363–377.Google Scholar
Paulsen, J. S. et al. (2000). Incidence of and risk factors for hallucinations and delusions in patients with probable AD. Neurology, 54, 1965–1971.Google Scholar
Robert, P. H. et al. (2005). Grouping for behavioral and psychological symptoms in dementia: clinical and biological aspects. Consensus paper of the European Alzheimer disease consortium. European Psychiatry, 20, 490–496.Google Scholar
Rosen, J. and Zubenko, G. S. (1991). Emergence of psychosis and depression in the longitudinal evaluation of Alzheimer's disease. Biological Psychiatry, 29, 224–232.Google Scholar
Selbaek, G., Engedal, K. and Bergh, S. (2013). The prevalence and course of neuropsychiatric symptoms in nursing home patients with dementia: a systematic review. Journal of the American Medical Directors Association, 14, 161–169.Google Scholar
Shin, I. S., Carter, M., Masterman, D., Fairbanks, L. and Cummings, J. L. (2005). Neuropsychiatric symptoms and quality of life in Alzheimer disease. American Journal of Geriatric Psychiatry, 13, 469–474.Google Scholar
Swearer, J. M., Hoople, N. E., Kane, K. J. and Drachman, D. A. (1996). Predicting aberrant behavior in Alzheimer's disease. Neuropsychiatry, Neuropsychology and Behavioral Neurology, 9, 162–170.Google Scholar
Wetzels, R., Zuidema, S., Jansen, I., Verhey, F. and Koopmans, R. (2010). Course of neuropsychiatric symptoms in residents with dementia in long-term care institutions: a systematic review. International Psychogeriatrics, 22, 1040–1053.Google Scholar
WHO (2012). Dementia: A Public Health Priority. United Kingdom.Google Scholar
Wilson, R. S., Gilley, D. W., Bennett, D. A., Beckett, L. A. and Evans, D. A. (2000). Hallucinations, delusions, and cognitive decline in Alzheimer's disease. Journal of Neurology, Neurosurgery, and Psychiatry, 69, 172–177.Google Scholar
Zhu, C. W. et al. (2006). Clinical characteristics and longitudinal changes of informal cost of Alzheimer's disease in the community. Journal of the American Geriatrics Society, 54, 1596–1602.Google Scholar
Zuidema, S., Koopmans, R. and Verhey, F. (2007). Prevalence and predictors of neuropsychiatric symptoms in cognitively impaired nursing home patients. Journal of Geriatric Psychiatry and Neurology, 20, 41–49.Google Scholar
Supplementary material: File

Borsje Supplementary Material

Table S1

Download Borsje Supplementary Material(File)
File 18.6 KB