Burden of Behavioral and Psychiatric Symptoms in People Screened Positive for Dementia in Primary Care: Results of the DelpHi-Study.

Abstract

There is limited knowledge about the range and effects of neuropsychiatric symptoms shown by persons with dementia (PWD) living in the community and their related caregiver burden. To examine neuropsychiatric symptoms in PWD in primary care with regard to frequency, severity, and burden to caregiver; to compare PWD with and without symptoms with regard to sociodemographics, care-related, and disease-related variables; and to identify variables associated with symptoms. A general physician-based epidemiological cohort of 248 people screened positive for dementia over the age of 70 (living at home) and their caregivers, was assessed using the Neuropsychiatric Interview (NPI), sociodemographics, and disease-related variables. In preliminary analyses, neuropsychiatric symptoms were frequent in PWD. Prevalence numbers ofdysphoria/depression, apathy, and agitation/aggression were each more than 30% . The severity of neuropsychiatric symptoms in people screened positive for dementia in primary care is moderate with a mean NPI score of m = 11.91 (SD = 16.0). Overall, caregiver distress is low, indicated by a total distress score of m = 5.94 (SD = 7.2, range 0-39). Common or frequent symptoms are not necessarily the most distressing symptoms. Neuropsychiatric symptoms are common in people screened positive for dementia in primary care. While frequency, severity, and perceived distress might be low in the total sample, we identified the dimensions delusions, aggression, anxiety, disinhibition, and depression to be perceived "severely" to "extremely" distressing in more than 30% of the caregivers affected. The association between activities of daily living and symptoms needs further attention.