[Neuropsychiatric symptoms in older adults with dementia and their relationship to disease severity]

Abstract

Neuropsychiatric symptoms are the psychopathological dimension of dementia and they integrate a set of symptoms among those are: personality, behavioral and basic functions changes.

Objective: To analyze the prevalence of neuropsychiatric symptoms in elder people diagnosed with dementia, the association of symptoms with each other, their relationship with the severity of the disease and the stress generated by them in caregivers.

Material and methods: Secondary data analysis of 180 cases diagnosed with dementia from a population-based cross-sectional study of 2,003 older adults living in rural and urban areas of low to medium income in Mexico.

Results: Twelve symptoms were assessed using the Neuropsychiatric Inventory, with depression (47.8%), sleep disorders (37.2%) and irritability (34.4%) being the most prevalent ones. Statistically significant associations were found between severity of dementia and frequency of delusions, hallucinations, agitation, depression, euphoria, apathy, disinhibition, irritability and aberrant motor behavior. Anxiety, depression and sleep disorders were associated with mild/moderate caregivers stress levels. Three factors were identified by clustering technique Principal Components Analysis: the first conforming by delusions, disinhibition and euphoria; the second factor was integrated for disorders of appetite and apathy and the third factor included anxiety and aberrant motor behavior.

Conclusions: As in samples from other countries neuropsychiatric symptoms are common in Mexican elderly with dementia in non-institutionalized population, they may be auxiliary as indicators of severity of dementia and their grouping is related to 1) behavioral disorders, 2) vegetative symptoms and apathy, and 3) symptoms of anxiety.