Abstract
ObjectiveAlthough behavioral changes are common in nursing home residents with dementia and caffeine is known to influence behavior in healthy adults, the effects of caffeine on the behavior of persons with dementia has received little attention. In this study we assessed the relationship of caffeine and behavioral symptoms in older persons with dementia.DesignA multicenter sub-cohort study embedded in the Elderly Care Physicians (ECP) training program.SettingDutch nursing homes associated with the ECP training program.ParticipantsA total of 206 individuals with both diabetes and dementia resident in Dutch nursing homes.MeasurementsTrainee ECPs collected data on caffeine consumption, cognition and behavioral symptoms using the NPI-NH, MDS-DRS and AES-C. Data on factors known to influence behavior in persons with dementia (e.g. marital status, kidney function, urinary tract infection and medication) were also collected.ResultsOf the 206 participants, 70% showed behavioral symptoms. An increase in caffeine consumption was associated with a decrease in the presence of behavioral symptoms in the NPI-NH cluster affect and NPI-NH item agitation. Caffeine consumption groups also differed on the presence of disinhibition and depression. In addition, the severity of dementia influenced agitation, anxiety and the clusters affect and psychomotor.ConclusionIn a large group of older persons with dementia resident in nursing homes, a low daily consumption of caffeine was associated with greater behavioral symptoms.
Highlights
By our definition, behavior is an ‘observable response to a particular situation’
A small negative correlation was seen between the total Neuropsychiatric Inventory-Nursing Home edition (NPI-NH) score and the daily consumption of caffeine (r = -0.179, n = 142, p = 0.033*)
We found no association between caffeine consumption and the total NPI-NH score when adjusted for the ‘in nursing home’ clustered design (p = 0.572)
Summary
Behavior is an ‘observable response to a particular situation’. The mechanisms underlying behavior are mostly unconscious, complex and are probably shaped by a range of factors. The consumption of coffee and other caffeinated beverages is known to influence behavior. Reviews show that normal caffeine consumption increases alertness and attention [1,2,3], elevates mood [2], and reduces fatigue [3]. At higher dosages (usually ≥ 300 mg) caffeine is known to increase anxiety [2, 3], induce psychotic or manic symptoms [2], and impair sleep [3]. Effects differ between individuals and people usually adjust their caffeine consumption to minimize adverse effects
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