Background: BPSD increases morbidity, worsen quality of life and are a major source of care giver burden. There is paucity of data on the spectrum of BPSD and their impact on caregiver. The present study was planned to estimate the frequency, type and severity of BPSD in patients with dementia and impact of BPSD severity and type on caregiver burden.

Material and Methods: Cross sectional descriptive study among hundred patients with primary dementias and vascular dementia (VaD) excluding all other secondary dementia. NPI-Q was used to rate BPS. Caregiver burden was assessed by both NPI-Q and Novak and Guest Inventory. Statistical analysis was performed by the SPSS program for Windows, version 17.0. Continuous variables were compared using ANOVA and Categorical variables were analysed using the chi square test. Pearson Correlation was also used among various variables.

Result: Alzheimer disease was the most common dementia. Apathy was the commonest BPSD among patients with AD and VaD. Patients with FTD, DLB and PDD had motor disturbance change in appetite, hallucination and aggression.  Most severe BPSD in AD, VaD, FTD, PDD and DLB was apathy, night time behaviour, disinhibition, hallucination and hallucination and irritability respectively. Most troublesome BPSD to care giver were change in night time behaviour and irritability and least was elation or euphoria. Care giver burden was highest in DLB and least in PDD.

Conclusion: Spectrum and severity of Behavioural and psychological symptoms in each type of dementia are different and increases morbidity, worsen quality of life and are a major source of care giver burden. They should be managed accordingly to relive care giver stress.

Keywords: Dementia, BPSD, Alzheimer disease, DLB, FTD, VaD, PDD, Care giver burden, NPI

1. Elizabeth C Hersch Sharon Falzgraf. REVIEW, Management of the behavioral and psychological symptoms of dementia Clinical Interventions in Aging 2007:2(4) 611–621.
2. Yahya A, Chandra M,  Anand K S, Garg J.Review Behavioral and psychological symptoms in dementia and caregiver burden: Clinical Medicine Research 2015; 4(2-1): 8-14
3. S Shaji,Roy K, George et al. Behavioral symptoms and care giver burden in dementia;Indian J Psychiatry.2009; jan-mar;51(1):45-49.
4. Meena Gupta, Abhijit Dasgupta, Geeta Anjum Khwaja, Debashish Chowdhury, Yogesh Patidar, and Amit Batra. The profile of behavioral and psychological symptoms in vascular cognitive impairment with and without dementia: Ann Indian Acad Neurol. 2013 Oct-Dec; 16(4): 599–602.
5. Tripathi M, Vibha D. Review An approach to and the rationale for the pharmacological management of of behavioral and psychological symptoms of dementia: Ann Indian Acad Neurol 2010;13:S94-8
6. Spalletta G, Baldinetti F, Buccione I, Fadda L, Perri R, Scalmana S, Serra L, Caltagirone C. Cognition and behaviour are independent and heterogeneous dimensions in Alzhei-mer’s disease. J Neurol 2004;251: 688-95.
7. Hersch EC, Falzgraf S. Management of the behavioral and psychological symptoms of dementia. ClinInterv Aging 2007;2:611-21.
8. Lyketsos, C. G., Steinberg, M., Tschanz, J. T., et alet al Mental and behavioral disturbances in dementia findings from Cache County Study on Memory and Aging.. American Journal of Psychiatry American Journal of Psychiatry, 2000:157, 708-714.
9. Saldanha D, Mani R, Srivastav K, Goyal S, Bhattacharya D. An epidemiological study of dementia under the aegis of mental health program, Maharstra, Pune Chapter. Indian J Psychiatry 2010;52:131-9.
10. Tatsuoyamada, Hiroyuki Hattori, Ayako Miyura, Mitunori Tanabe, Yukio Yamuri. Prevalence of Alzheimer’s disease, Vascular dementia and dementia with lewy bodies in Japanese populations: Psychiatry and clinical neurosciences, 2001; 55,21-25.
11. G Amoo, RO Akinyemi, LU Onofa, JO Akinyemi; Profile of clinically-diagnosed dementias in a neuropsychiatric practice in Abeokuta, South-Western Nigeria;African Journal of Psychiatry• November 2011;14:377-8.
12. Benoit M, Staccini P, Brocker P, Benhamidat T, Bertogliati C, Lechowski L, et al. Behavioral and psychologic symptoms in Alzheimer’s disease: results of the REAL.FR study. Rev Med Interne 2003;24:319s-24s.
13. Lyketsos C, Lopez O, Jones B, et al. 2002. Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: Results from the Cardiovascular Health Study. JAMA, 288:1475–83.
14. Vega UM, Marinho V, Engelhardt E, Laks J. Neuropsychiatric symptoms in dementias: preliminary report of a prospective outpatient evaluation in Brazil. Arq Neuropsiquiatr 2007;65:498-502.
15. Fuh JL. Study of behavioral and psychological symptoms of dementia in Taiwan. ActaNeurol Taiwan 2006;15:154-60.
16. Engelborghs S, Maertens K, Nagels G, Vloeberghs E, Mariën P, Symons A, et al. Neuropsychiatric symptoms of dementia: cross-sectional analysis from a prospective, longitudinal Belgian study. Int J Geriatr Psychiatry 2005;20:1028-37.
17. Boyle PA,Malloy PF. Treating apathy in Alzheimer’s disease. Dement Geriatr Cogn Disord 2004;17:91-9.
18. Salka S Staekenborg, Tanja Su, Elisabeth C W van Straaten, Roger Lane, Philip Scheltens, FrederikBarkhof, Wiesje M van der Flier. Behavioural and psychological symptoms in vascular dementia; differences between small- and large-vessel disease: J Neurol Neurosurg Psychiatry 2010;81:547-551.
19. Fernandez M, Castro J, Molano A, Zarrana jj et al. Prevalence of neuropsychiatric symptoms in Alzheimer’s disease and vascular dementia: Curr Alzheimer Res. 2008 Feb;5(1):61-9
20. Kenji Kosaka; Behavioral and psychological symptoms of dementia (BPSD) in dementia with Lewybodies L: Psychogeriatrics September 2008;8(3): 134–136.
21. Arsland D, Bronnick K, Ehrt U. et alNouropsychiatric Symptoms in patients with PD and denertia: Frequency, Profile and associated casegiver stress. J NeurolNeurosurg Psychiatry 2006. 7836–42.
22. Huang SS, Lee MC, Liao YC, Wang WF, Lai TJ. Caregiver burden associated with behavioral and psychological symptoms of dementia (BPSD) in Taiwanese elderly: Arch Gerontol Geriatr.2012 Jul-Aug;55(1):55-9.
23. Matsumoto N1, Ikeda M, Fukuhara R, Shinagawa S, Ishikawa T, Mori T, Toyota Y, Matsumoto T, Adachi H, Hirono N, Tanabe H. Caregiver burden associated with behavioral and psychological symptoms of dementia in elderly people in the local community: Dement Geriatr Cogn Disord.2007;23(4):219-24.
24. LoGiudice D, Waltrowicz W, McKenzie S, Ames D, Flicker L. Prevalence of dementia among patients referred to an aged care assessment team and associated stress in their  Aust J Public Health 1995 Jun;19(3):275-279.
25. Allegri RF, Sarasola D, Serrano CM, et al. Neuropsychiatric symptoms as a predictor of caregiver burden in Alzheimer's disease. & europsychiatr Dis Treat 2006 Mar;2(1):105-110.
26. Grafstrom M, Winblad B. Family burden in the care of the demented and nondemented elderly--a longitudinal study. Alzheimer Dis Assoc Disord 1995;9(2):78-86.
27. Lily Dongxia Xiao1, Jing Wang, Guo-Ping He, Anita De Bellis, Jenny Verbeeck and Helena Kyriazopoulos.Family caregiver challenges in dementia care in Australia and China: A critical perspective: Xiao et al. BMC Geriatrics 2014, 14:6.
28. Vetter PH, Krauss S, Steiner O, et al. Vascular dementia versus dementia of Alzheimer’s type: do they have differential effects on caregivers’ burden? J Gerontol B Psychol Sci SocSci 1999; 54(Suppl):S93–8.
29. Cummings JL et al. The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia. Neurology. 1994 Dec;44(12):2308-14
30. Novak, M. & Guest, C. I. (1989). Application of a multidimensional Care-giver Burden Inventory. Gerontologist, 29, 798-803
31. Blessed, G., Tomlinson, B.E., & Roth, M.. (1968). The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. British Journal of Psychiatry, 1114, 797-811.

Dr Arshad Yahya

Yahya Neurology Clinic, Raja Bazar, Patna, Bihar, 800014, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.