PMID- 28065176
OWN - NLM
STAT- MEDLINE
DCOM- 20181211
LR  - 20200506
IS  - 2045-7960 (Print)
IS  - 2045-7979 (Electronic)
IS  - 2045-7960 (Linking)
VI  - 27
IP  - 3
DP  - 2018 Jun
TI  - Behavioural and psychological symptoms in general hospital patients with 
      dementia, distress for nursing staff and complications in care: results of the 
      General Hospital Study.
PG  - 278-287
LID - 10.1017/S2045796016001098 [doi]
AB  - AIMS: Little is known about how behavioural and psychological symptoms of 
      dementia (BPSD) manifest in the general hospital. The aim was to examine the 
      frequency of BPSD in general hospitals and their associations with nursing staff 
      distress and complications in care. METHODS: Cross-sectional representative study 
      with 1469 patients aged >/=65, including 270 patients with dementia, of 33 randomly 
      selected general hospitals in Germany. BPSD and complications were reported by 
      nurses. RESULTS: Overall frequency of BPSD was higher in patients with dementia 
      (76%) than without (38%). The most frequent symptoms in patients with dementia 
      were nighttime disturbances (38%), depression (29%) and aberrant motor behaviour 
      (28%) and the most distressing symptoms for nursing staff were delusions, 
      aggression and nighttime disturbances. The overall frequency of BPSD increased 
      from 67% in mild dementia, to 76% in moderate dementia and to 88% in severe 
      dementia. The most frequent symptoms in patients without dementia were depression 
      (19%), nighttime disturbances (13%) and irritability (13%). The most distressing 
      symptoms were aggression and delusions, while the same symptoms were consistently 
      rated as less distressing than in patients with dementia. Factor analysis 
      revealed three independent groups of BPSD that explained 45% of the total 
      variance. First, expansive symptoms (aggression, irritability, nighttime 
      disturbances, aberrant motor behaviour and disinhibition) were frequent, 
      distressing for nursing staff and associated with many complications. Second, 
      psychotic symptoms (delusions and hallucinations) were infrequent, distressing 
      and associated with some complications. Third, affective symptoms (apathy, 
      anxiety and depression) were frequent, non-distressing and associated with few 
      complications. The results did not change when cases with delirium were excluded 
      from both groups. CONCLUSIONS: BPSD are common in older hospital patients with 
      dementia and associated with considerable distress in nursing staff, as well as a 
      wide range of special treatments needs and additional behavioural and medical 
      complications. Management strategies are needed to improve the situation for both 
      patients and hospital staff.
FAU - Hessler, J B
AU  - Hessler JB
AUID- ORCID: 0000-0002-6994-7951
AD  - Department of Psychiatry and Psychotherapy,Klinikum rechts der Isar,Technical 
      University of Munich,Germany.
FAU - Schaufele, M
AU  - Schaufele M
AD  - Faculty of Social Work,Mannheim University of Applied Sciences,Mannheim,Germany.
FAU - Hendlmeier, I
AU  - Hendlmeier I
AD  - Faculty of Social Work,Mannheim University of Applied Sciences,Mannheim,Germany.
FAU - Junge, M N
AU  - Junge MN
AD  - Department of Psychiatry and Psychotherapy,Klinikum rechts der Isar,Technical 
      University of Munich,Germany.
FAU - Leonhardt, S
AU  - Leonhardt S
AD  - Faculty of Social Work,Mannheim University of Applied Sciences,Mannheim,Germany.
FAU - Weber, J
AU  - Weber J
AD  - Faculty of Social Work,Mannheim University of Applied Sciences,Mannheim,Germany.
FAU - Bickel, H
AU  - Bickel H
AD  - Department of Psychiatry and Psychotherapy,Klinikum rechts der Isar,Technical 
      University of Munich,Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20170109
PL  - England
TA  - Epidemiol Psychiatr Sci
JT  - Epidemiology and psychiatric sciences
JID - 101561091
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Anxiety/diagnosis/*epidemiology/psychology
MH  - Behavior
MH  - Behavioral Symptoms/*epidemiology/psychology
MH  - Cross-Sectional Studies
MH  - Delusions/*epidemiology/psychology
MH  - Dementia/*epidemiology/*psychology
MH  - Depression/complications/diagnosis/psychology
MH  - Female
MH  - Germany/epidemiology
MH  - Hospitals, General
MH  - Humans
MH  - Inpatients/psychology/*statistics & numerical data
MH  - Irritable Mood
MH  - Male
MH  - Nursing Staff/*psychology
MH  - Psychomotor Agitation/*epidemiology/psychology
MH  - *Quality of Health Care
MH  - Severity of Illness Index
PMC - PMC6998873
OTO - NOTNLM
OT  - Acute hospital
OT  - BPSD
OT  - behavioural and psychological symptoms of dementia
EDAT- 2017/01/10 06:00
MHDA- 2018/12/12 06:00
PMCR- 2017/01/09
CRDT- 2017/01/10 06:00
PHST- 2017/01/10 06:00 [pubmed]
PHST- 2018/12/12 06:00 [medline]
PHST- 2017/01/10 06:00 [entrez]
PHST- 2017/01/09 00:00 [pmc-release]
AID - S2045796016001098 [pii]
AID - 00109 [pii]
AID - 10.1017/S2045796016001098 [doi]
PST - ppublish
SO  - Epidemiol Psychiatr Sci. 2018 Jun;27(3):278-287. doi: 10.1017/S2045796016001098. 
      Epub 2017 Jan 9.