Behavioral and psychological symptoms in dementia in Hong Kong Chinese

Abstract

Behavioral and psychological symptoms of dementia (BPSD) constitute an integral component of cognitive impairment including, vascular dementia. They could contribute significantly not to caregiver stress but also to escalating healthcare costs. Method: 100 consecutive patients attending a Memory Clinic, located in a district hospital in Hong Kong diagnosed to have vascular dementia were reviewed. The National Institute of Neurological Disorders and Stroke Association Internationale pour la Recherche et I’Enseignement en Neurosciences (NINDS-AIREN) criteria were used to establish the diagnosis of vascular dementia. The Global Deterioration Scale (GDS) was used to stage the severity of the disease. The assessment of BPSD was based on collateral clinical history, patients’ subjective experiences and objective behavior. Neuropsychiatric Inventorywas adopted as the assessment tool. Results: 62% were GDS stage and 38% stage 5. About 91% of stage 5 patients had BPSD and 8% in stage 4 patients. The prevalence of BPSD was about 40%. Amongst these, the pattern of various domains reviewed: individual behaviors include delusion (20%), hallucination (12%), depression (42%), apathy (21%), anxiety (16%), elation (12%), disinhibition (8%), aggression (11%), irritability (13%), aberrant motor behavior (11%), sleep and nighttime behavioral disorders (26%) and eating disorders (19%). Conclusion: BPSD are frequent in vascular dementia of mild-to-moderate severity.Like other types of dementia, correct identification and evaluation of these symptoms is a crucial component of the clinical approach to vascular dementia.