Behavioral and psychological symptoms of dementia: A scoping review of evidence from India.

AIM: This scoping review aims to explore the Indian literature on behavioural and psychological symptoms of dementia (BPSD) published over the past two decades, focusing on epidemiology, symptom profiles, clinical and psychosocial correlates, caregiver burden, and management strategies.

METHODS

The databases PubMed, EMBASE, and Scopus were searched for Indian studies addressing BPSD. Observational, interventional, qualitative, and mixed-methods studies were included. Data were extracted on study characteristics, dementia subtypes and severity, assessment tools, BPSD correlates, caregiver burden, and management.

RESULTS

Thirty-three studies published between 2006 and 2025 across diverse Indian regions were included. Commonly reported BPSD included sleep disturbances, apathy, irritability, agitation, and affective symptoms, with variation across dementia subtypes. Severity was highest in frontotemporal dementia and dementia with Lewy bodies. BPSD intensity was consistently associated with severity of cognitive impairment, illness duration, pain and sociodemographic factors. Caregiver burden was strongly associated with BPSD severity in addition to cognitive decline. Most interventions evaluated were non-pharmacological therapies which reduced BPSD severity and caregiver distress. Pharmacological studies were limited, largely examining prescribing patterns and providing preliminary evidence for herbal formulations.

CONCLUSION

Indian literature highlights the burden of BPSD, its subtype specific presentation and the associated caregiver burden. Although non-pharmacological approaches have shown substantial promise, the evidence base remains heterogenous, limited by majority of cross-sectional study designs, warranting further research in the form of longitudinal studies.