Abstract
Background: Identifying the characteristics of behavioral and psychological symptoms of dementia (BPSD) associated with different dementia types may be a promising strategy to effectively deal with BPSD. We aimed to synthesize the prevalence rates of BPSD characteristics in community-dwelling dementia patients.Methods: We searched Medline, EMBASE, and PsycARTICLES databases for original clinical studies published until December 2020 that enrolled at least 300 community-dwelling dementia patients. The methodological qualities of prevalence studies were assessed using the Joanna Briggs Institute's critical appraisal checklist.Results: Thirty studies were included. The prevalence of the BPSD characteristic ranged from 4 (elation and mania) to 32% (apathy) in the pooled samples. The prevalence of delusions, anxiety, apathy, irritability, elation and mania, and aberrant motor behavior in Alzheimer's disease patients was 1.72–2.88 times greater than that in vascular dementia (VD) patients, while the prevalence of disinhibition in VD patients was 1.38 times greater. The prevalence of anxiety, irritability, and agitation and aggression, delusion, hallucinations, apathy, disinhibition, and aberrant motor behavior tended to increase as the severity of dementia increased, while that of depression, eating disorder, sleep disorders, and elation and mania tended to stable. In community-dwelling patients with dementia, the pooled prevalence of apathy, depression, anxiety, irritability, agitation and aggression, sleep disorders, and eating disorder was higher than 20%, while that of disinhibition and elation and mania was lower than 10%.Conclusion: Overall, the pooled prevalence of apathy, depression, anxiety, irritability, agitation and aggression, sleep disorders, and eating disorder was generally high in patients with dementia. Also, the prevalence of some BPSD characteristics differed according to the type and the severity of dementia. The methodological quality of the included studies is not the best, and high heterogeneity may affect the certainty of the findings. However, the results of this review can deepen our understanding of the prevalence of BPSD.Systematic Review Registration: https://osf.io/dmj7k, identifier: 10.17605/OSF.IO/DMJ7K.
Highlights
Dementia is a common neurodegenerative disease in the elderly, causing a worldwide public health burden
This study systematically reviewed large-scale studies of community-based populations for the first time to understand the characteristics of behavioral and psychological symptoms of dementia (BPSD) incidence in dementia patients
This systematic review tried to analyze the prevalence of BPSD in community-dwelling samples from 13 previously published large-scale studies
Summary
Dementia is a common neurodegenerative disease in the elderly, causing a worldwide public health burden. AD is a representative cause of dementia, and once it occurs, there is no known treatment to return it to the pre-morbid state, and the gradual and irreversible decline in cognitive function adversely affects the lives of patients and their caregivers, incurring significant economic and social burdens in our society [2]. BPSD, in particular, is related to poor prognosis in dementia patients, but it increases the care burden for informal caregivers and worsens their quality of life (QoL) [4]. The increased prevalence of BPSD and care burden are related to the worsening of caregivers’ mental health [5]. We aimed to synthesize the prevalence rates of BPSD characteristics in community-dwelling dementia patients
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