Abstract

AbstractBackgroundBehavioural and Psychological Symptoms of Dementia (BPSD) and Neuropsychiatric Symptoms (NPS, in people without dementia) have not been examined in the Aboriginal Australian population despite high rates of dementia and cognitive decline. BPSD/NPS contribute significantly to poorer wellbeing, institutionalisation, and adverse outcomes. This study aims to identify the characteristics and factors associated with BPSD/NPS in older Aboriginal Australians.MethodData were from the Koori Growing Old Well Study, a longitudinal, population‐based study with Aboriginal Australians from 5 partnering communities in New South Wales (n=336 baseline including n=153 with medical assessment). Participant, care person and medical interviews were carried out. Baseline BPSD/NPS were classified using the Cambridge Behavioural Inventory‐Revised (CBI‐R) and social and clinical predictors were collected. Logistic regression analyses examined associations with severe BPSD/NPS.ResultCBI‐R data were available for n=132 (mean age= 67, SD= 6.6; 46% male). The prevalence of one or more NPS was high (66%), with 74% of mild cognitive impairment (MCI) and 100% of people with dementia experiencing symptoms. Patterns of behaviour change indicated that mood symptoms were prominent in MCI/mild dementia, symptoms of apathy worsened with dementia severity, and abnormal beliefs were more prominent in moderate/severe dementia. Stroke history (OR=4.4) and living in residential aged care (RAC; OR=10.8) were associated with severe BPSD/NPS. When presence of a dementia diagnosis was added to the model, only RAC (OR=5.5) and dementia presence (OR=5.8) remained significant.ConclusionThe prevalence of BPSD/NPS is high in Aboriginal communities, linked to the high rates of cognitive decline. Characterising the pattern and predictors of BPSD/NPS is critical for early intervention and support. Future research should validate culturally‐relevant assessment and models of care for BPSD/NPS.

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