Behavioral and Psychological Symptoms of Dementia: Factor Analysis and Relationship with Cognitive Impairment

Abstract

Background/Aims: Behavioral and psychological symptoms of dementia (BPSD) affect almost all people with dementia at some stage during the progression of disease. The current study aimed at replicating previous findings on BPSD clustering in behavioral sub-syndromes. Methods: One hundred and sixty-six consecutive outpatients with dementia attending a dementia outpatient clinic were enrolled and evaluated with the Neuropsychiatric Inventory and the Mini Mental State Examination. Results: BPSD were reported in 157 patients included in the final sample: 140 patients (89.17%) had Alzheimer’s disease (AD), while 17 patients had frontotemporal dementia or vascular dementia. The most frequent BPSD were depression in the whole sample and irritability in the AD subgroup. The severity of cognitive impairment was predicted by two BPSD in the whole sample (apathy and motor disturbance) and only by nighttime behavior in the AD subgroup. Factor analyses identified 4 factors, accounting for about 60% of variance in the whole group and in the AD subgroup of patients. Conclusions: The current study confirmed findings of previous studies on BPSD clustering, regarding the number of BPSD clusters and the total variance explained. This study has some limitations, including the small number of non-ADs and its monocentric character.

Personality and Dementia

“…BPSD include mood disorders (Poletti et al, 2013), psychotic symptoms (Cipriani et al, 2013b(Cipriani et al, , 2014a2014d), which are unusual too (Cipriani et al, 2014b), aggressiveness (Cipriani et al, 2011), repetitive behavior (Cipriani et al, 2013c), wandering (Cipriani et al, 2014e), and apathy (Cipriani et al, 2014c). Declines in memory are considered a hallmark symptom, but an alternative approach to improve early detection is to study noncognitive symptoms such as behavioral and personality changes that may precede diagnosis or occur early in the course of the dementia.…”

Grouped factors of the ‘SSADE: signs and symptoms accompanying dementia while eating’ and nutritional status—An analysis of older people receiving nutritional care in long‐term care facilities in Japan

“…This methodological process followed that of some previous studies. The classification of BPSD scales such as the NPI and BEHAVE‐AD has provided information on the overall structure of BPSD, as well as comorbidity patterns, as noted in previous studies (Chen et al., ; Colombo et al., ; Crellin, Charlesworth, & Orrell, ; Garre‐Olmo, López‐Pousa, Vilalta‐Franch, de Gracia, & Vilarrasa, ; Mirakhur, Craig, Hart, McLlroy, & Passmore, ; Moran et al., ; Petrovic et al., ; Poletti, Nuti, Cipriani, & Bonuccelli, ; Proitsi et al., ; Van der Linde, Stephan, Matthews, Brayne, & Savva, ). Moreover, Van der Linde et al.…”

“…() reported the NPI profile among older people with mild cognitive impairment (MCI), while Poletti et al. () included patients with AD and frontotemporal dementia (FTD) in an analysis. In these previous studies, the authors classified BPSD into three or four groups with similar trends identified through factor analysis.…”

“…‘Hyperactivity’ (Factor 2: ‘agitation’, ‘delusion’, ‘wandering’ and ‘eating too rapidly’) correlated negatively with BMI. In previous studies of the NPI, ‘agitation or aggression’, ‘irritability or lability’ and ‘delusions’ were divided into an ‘agitation’ factor (Poletti et al., ). Likewise, ‘motor behaviour’ and ‘appetite and eating’ were grouped into a ‘physical behaviour’ factor (Mirakhur et al., ).…”

Appraising the need for care in alzheimer’s disease

“…‘Cognitive symptoms’ include aspects such as attention span deficit, memory impairment, visual-perceptive and orientation deficits, apraxia, and agnosia. ‘Non-cognitive’ symptoms or ‘behavioural and psychological symptoms of dementia (BPSD)’, comprise a broad spectrum of symptoms such as depression, agitation, delusions, irritability, and stereotypic motor behaviour [3]. The chronological appearance of cognitive symptoms is somewhat predictable in the progression of AD, whereas non-cognitive symptoms present in a heterogeneous fashion and appear inconsistent.…”