BPSD of Alzheimer's disease and factors that affect care burden

Abstract

Caring for demented patients markedly burdens their families, and this burden also affects the patients' QOL. In this study, we investigated behavioral psychological symptoms of dementia (BPSD) encountered in care, the severity of the burden, and factors that affect it. The subjects were 26 patents who visited the dementia clinic of the Department of Psychiatry, Jikei University School of Medicine, Kashiwa Hospital, and were diagnosed with Alzheimer's dementia. BPSD and the care burden were evaluated using a Japanese version of the Neuropsychiatric Inventory Questionnaire. Irritability (57.7%), depression (50.0%), and apathy/indifference (46.2%) were observed frequently, and irritability (15.4%), agitation/aggression (15.4%), depresssion/dysphoria (11.5%), and anxiety (11.5%) were mentioned frequently as symptoms that caused a moderate or severe burden. Concerning patients with each symptom, agitation/aggression (40.0%), irritability (26.7%), anxiety (33.3%), depression/dysphoria (23.1%), aberrant motor behavior (33.3%), delusion (28.6%), and disinhibition (25.0%) caused a moderate or severe care burden. While apathy/indifference was mentioned frequently, it did not cause a moderate or severe burden, and not all BPSD were perceived similarly as burdens by the care-givers. It is considered important to evaluate the burden felt by care-givers before taking hasty measures against BPSD. The care burden was correlated with only the clinical dementia rating (CDR) and revised Hasegawa Dementia Scale (HDS-R), and not with other neuropsychological tests or patients’ background factors. Further evaluation in a larger number of patients and from multiple viewpoints including factors on the care-givers’ side is considered necessary.