The course of neuropsychiatric symptoms in patients with dementia in Norwegian nursing homes

Background: Neuropsychiatric symptoms (NPS) are common in patients with dementia, and cause distress for patients. Studies on the prevalence, incidence, persistence and resolution of NPS in patients living in nursing homes are sparse. The aim of this study was to evaluate the course of NPS in patients with dementia living in Norwegian nursing homes. Methods: 169 patients from seven Norwegian nursing homes were assessed five times over a period of 16 months with the Neuropsychiatric Inventory (NPI). The severity and the frequency of the NPI were analyzed. Results: 91.7% of the patients had at least one clinically significant NPS at one or more assessments over the 16 months. Irritability (63.5%), agitation (51.0%) and disinhibition (50.0%) had the highest cumulative prevalence, while irritability (42.6%), disinhibition (37.8%) and depression (31.5%) showed the highest cumulative incidence. Delusion, agitation and irritability were enduring symptoms while the other symptoms had high resolution rates. The severity of the NPS did not vary significantly over time. Conclusion: Almost every patient in Norwegian nursing homes had at least one clinically significant NPS over 16 months, but individual NPS show a fluctuating course. This should influence how we monitor and treat NPS in patients with dementia.