Behavioral and psychological symptoms of dementia and its relationship with caregiver burden: A cross-sectional study of inpatients with dementia in a tertiary center.

BACKGROUND

Behavioral and psychological symptoms of dementia (BPSD) is commonly associated with caregiver distress, and often a reason for short-term or long-term care. Very few studies have examined the pattern of the BPSD and caregiver burden in an Indian tertiary care inpatient setting.

AIMS: Our study aimed to understand the pattern of BPSD, particularly its individual domains, in different types of dementia, and its relationship with caregiver distress and burden in a geriatric inpatient setting.

METHODS

One hundred inpatients with dementia and their informal primary caregivers participated in a cross-sectional, semi-structured interview using validated tools to assess the types and severity of BPSD and the relationship with caregiver burden.

RESULTS

All inpatients had one or more BPSD, as expected, with a median of 7 (1QR 5-8). Night-time behavioral disturbances (79%), irritability (78%), and apathy (74%) were the most common ones. In Alzheimer's dementia (AD), night-time behavioral disturbances (80%), irritability/lability (74.3%), and agitation/aggression (68.6%) were the most observed. Apathy (84.4%) was the most common BPSD in frontotemporal dementia (FTD), followed by irritability (80%), aberrant motor behavior (71.2%), and night-time behavioral disturbances (71.2%). Caregiver distress varied across different BPSD, with irritability (10%), agitation (8%), and aberrant motor behavior (7%) associated with the highest levels of distress in our study. Worsening cognitive impairment was not associated with increased burden.

CONCLUSION

An individually tailored management approach targeting specific BPSD symptoms, with equal focus on both the patient and the caregiver, is key.