Behavioural and psychological symptoms in neurocognitive disorders: Specific patterns in dementia subtypes

Background: Behavioural and psychological symptoms in dementia (BPSD) form an important sub-syndrome of dementia. We assessed the frequency and severity of BPSD in a random sample of Hungarian treatment-naive dementia patients. Furthermore, we examined the relationship between cognitive symptoms and BPSD and the pattern of BPSD in specific types of dementias. Methods: Patients (n=131) were classified into 3 groups: Alzheimer's (AD), vascular (VD), and mixed (MD) dementia. The Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) and Neuropsychiatric Inventory (NPI) neuropsychological tests were employed. Results: Mean age and MMSE score did not differ significantly among groups. BPSD was frequent (100% prevalence, NPI mean total Frequency score: 14.58, SD=7.55); abnormal motor behaviour showed the highest frequency. Hallucinations and delusions were related to the aetiology of dementia and were independent of the level of cognitive deterioration, whereas irritability, sleep-wake cycle dysfunctions, and eating-appetite change were associated with cognitive deterioration and were independent from aetiology. Both aberrant motor behaviour and disinhibition were significantly associated with aetiology and cognitive deterioration. Conclusions: BPSD symptoms are significant constituents of dementia syndromes, affecting quality of life and substantially contributing to the caregiver's burden. Specific symptom patterns can be identified in different types of dementia.