Behavioural and psychological symptoms of early‐onset and late‐onset Alzheimer's disease among Chinese adults: analysis of modifiable factors

Abstract

Background To conduct a comprehensive comparison of behavioural and psychological symptoms of dementia (BPSD) in Chinese people with early‐onset Alzheimer's disease (EOAD) and late‐onset Alzheimer's disease (LOAD) and analyse the factors of differences. Methods A cross‐sectional survey of 93 EOAD and100 LOAD and their caregivers in China from November 2018 to May 2019. Results The total Neuropsychiatric Inventory score was significantly higher in LOAD. A higher level of agitation in EOAD was related to a lower quality of life of caregivers and the emotional expression of ignoring people with dementia. Higher euphoria scores in LOAD were associated with reduced negative coping by caregivers and reduced stability and predictability at home. Conclusion The early identification and management of specific BPSD of EOAD and LOAD by family members and health professionals may improve the quality of care and life for people with dementia and that of caregivers.

Initial symptoms of early‐onset dementia in Japan: nationwide survey

“…However, previous literature reported there were no gender differences concerning irritability or agitation among people with AD, 16 and people with EO‐AD were less agitated than people with late‐onset AD 17 . These contrasting results may be explained by the fact that the emotional relationship between people with dementia and caregivers is influenced by caregivers' attitudes and quality of life 18 . As shown in Table 1, spouses were more likely to notice anomalies, and as many respondents in this study were spouses, spouses' subjectivity might have influenced our results.…”

Behavioural and psychological symptoms of early‐onset and late‐onset Alzheimer's disease among Chinese adults

“…1 Additionally, the authors showed that an improvement in BPSD was associated with positive attitudes and fewer expressions of criticism. 1 We agree that positive aspects of caregiving are important. However, previous longitudinal studies have reported that BPSD impacts caregiver burden.…”

“…The authors reported significant differences in BPSD between the EOAD and LOAD groups at baseline. 1 We would like to discuss their result in detail below.Fang et al reported that worse caregiver attitudes were associated with more severe overall psychobehavioural symptoms in the EOAD group. 1 Additionally, the authors showed that an improvement in BPSD was associated with positive attitudes and fewer expressions of criticism.…”

“…The authors reported significant differences in BPSD between the EOAD and LOAD groups at baseline. 1 We would like to discuss their result in detail below.…”

Recent research advances in young-onset dementia

“…High levels of carer burden, psychological distress and quality of life have been described for the care-partners who are often the spouses of individuals with dementia [58–60]. The behaviour changes associated with dementia are a significant cause of adverse mental health for caregivers, though it remains unclear whether these behaviours seen in YOD compared to OOD are more frequent or more severe or cause more distress for their respective caregivers [61–63,64 ▪▪ ]. In FTD, apathy, disinhibition and psychosis were strongly associated with caregiver burden [65 ▪ ] with more frequently problem-focused and positive emotion coping strategies employed by their caregivers [66].…”