The course of neuropsychiatric symptoms in community-dwelling patients with dementia: a systematic review. (18th November 2014)

• Record Type: Journal Article
• Authors: Borsje, Petra; Wetzels, Roland B.; Lucassen, Peter L.; Pot, Anne Margriet; Koopmans, Raymond T.
• Is Part Of: International psychogeriatrics. Volume 27:Number 3(2015:Mar.)
• Page Start: 385
• Page End: 405
• Publication Date: 2014-11-18
• Subjects: dementia, -- neuropsychiatric symptoms, -- community-dwelling, -- systematic review; Geriatric psychiatry -- Periodicals; 618.9768905
• DOI: 10.1017/S1041610214002282
• Languages: English
• ISSNs: 1041-6102

Abstract

ABSTRACT: Background: Neuropsychiatric symptoms (NPS) often occur in patients with dementia. Understanding the course of NPS in dementia is important for healthcare professionals for psycho-educational purposes and adequate and timely interventions to prevent or diminish NPS as much as possible. Methods: We conducted a systematic literature search in several electronic databases. We combined search strings for the terms dementia, community-dwelling, cohort studies and NPS. Screening titles and abstracts, assessing the methodological quality and data-extraction were independently conducted by at least two authors. Results: This literature search revealed 6605 unique records of which 23 studies were included in data synthesis. In total 7184 patients participated in the included studies with a mean number of 312. Sixty percent of the participants were female and the mean age of all participants was 74.8 years. Follow-up varied between 1 and 6 years; in 17 studies loss to follow-up was less than 20% per year. NPS are highly prevalent, incident and persistent although frequency parameters vary considerably across studies. Delusions/delusional misidentification, wandering/agitation, aberrant motor behavior/motor hyperactivity and apathy are the most common NPS. For hallucinations, delusions/delusional misidentification, paranoia, aggression, wandering/agitation, aberrant motor behavior/motor hyperactivity, disinhibition, apathy, and sleep disturbance increasing trends in point prevalence rates have been found. Conclusions: NPS in community-dwelling patients are frequent and persistent. The increasing trends of several NPS in the course of dementia require a preventive approach of professional caretakers. For such an approach, a timely diagnosis and adequate professional support to prevent or diminish these problems is necessary.