PMID- 33663416
OWN - NLM
STAT- MEDLINE
DCOM- 20210426
LR  - 20210426
IS  - 1471-2318 (Electronic)
IS  - 1471-2318 (Linking)
VI  - 21
IP  - 1
DP  - 2021 Mar 5
TI  - Behavioural and psychological symptoms of dementia in patients with Alzheimer's 
      disease and family caregiver burden: a path analysis.
PG  - 160
LID - 10.1186/s12877-021-02109-w [doi]
LID - 160
AB  - BACKGROUND: Studies reported the relationship between behavioural and 
      psychological symptoms of dementia (BPSD), cognitive function, caregiver burden, 
      and therapeutic effects. However, the causal relationship between BPSD in 
      community-dwelling patients with Alzheimer's disease (AD) and caregiver burden is 
      yet to be established. This study aimed to classify BPSD in patients with AD and 
      identify the relationship between BPSD and the factors affecting family caregiver 
      burden. METHODS: Path analysis was conducted at a neurology outpatient clinic of 
      a tertiary general hospital in South Korea. The medical records of 170 patients, 
      aged >/=50 years, diagnosed with or suspected for AD were retrospectively reviewed. 
      We investigated cognitive function (Korean version of the Mini-Mental-State 
      Exam), dementia stages (Korean version of the Expanded Clinical Dementia Rating 
      scale), depression (Short-form Geriatric Depression Scale-Korea), activities of 
      daily living (ADL; Korean version of the Barthel Activities of Daily Living 
      index), instrumental activities of daily living (IADL; Seoul-Instrumental 
      Activities of Daily Living), and BPSD and caregiver burden (Korean 
      Neuropsychiatric Inventory). Considering the characteristic features of BPSD with 
      various symptoms, BPSD was classified using factor analysis. Factor extraction 
      was performed using principal component analysis, followed by Varimax factor 
      rotation. RESULTS: Mean total BPSD score was 17.66 +/- 20.67, and the mean score 
      for family caregiver burden was 9.65 +/- 11.12. Symptom cluster-1 (hyperactivity 
      symptoms) included disinhibition, irritability, and agitation/aggression. Symptom 
      cluster-2 (psychosis symptoms) included hallucinations, anxiety, 
      elation/euphoria, delusions, and depression/dysphoria. Symptom cluster-3 
      (physical behaviour symptoms) included appetite and eating abnormalities, 
      apathy/indifference, aberrant motor behaviour, sleep, and night-time behaviour 
      disturbances. Dementia stages, ADL, and IADL had indirect effects on family 
      caregiver burden through hyperactivity, psychosis, and physical behaviour 
      symptoms, indicating that BPSD exerted a complete mediating effect. CONCLUSIONS: 
      Unlike previous studies, we classified BPSD symptoms into similar symptom 
      clusters to evaluate its effect on caregiver burden, rather than collectively 
      investigating the 12 symptoms of BPSD. As the dementia stage worsens, symptom 
      clusters in BPSD serve as a medium between ADL and IADL degradation and for the 
      increase in caregivers' burden. The development and implementation of 
      therapeutic, nursing interventions, and policies focusing on dementia stages, 
      ADL, and IADL, delaying and preventing BPSD can alleviate family caregivers' 
      burden.
FAU - Kim, Bokyoung
AU  - Kim B
AD  - Department of Nursing, Catholic Kwandong University, Gangneung, South Korea.
FAU - Noh, Gie Ok
AU  - Noh GO
AD  - Department of Nursing, Konyang University, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 
      35365, South Korea. nkorn91@gmail.com.
FAU - Kim, Kyunghee
AU  - Kim K
AD  - Department of Nursing, Chung-Ang University, Seoul, South Korea.
LA  - eng
PT  - Journal Article
DEP - 20210305
PL  - England
TA  - BMC Geriatr
JT  - BMC geriatrics
JID - 100968548
SB  - IM
MH  - Activities of Daily Living
MH  - Aged
MH  - *Alzheimer Disease/diagnosis/therapy
MH  - Caregiver Burden
MH  - Caregivers
MH  - *Dementia/diagnosis
MH  - Humans
MH  - Psychiatric Status Rating Scales
MH  - Republic of Korea
MH  - Retrospective Studies
PMC - PMC7934246
OTO - NOTNLM
OT  - Alzheimer's disease
OT  - Behavioural and psychological symptoms
OT  - Burden
OT  - Dementia
OT  - Family caregivers
OT  - Neurology
OT  - Path analysis
OT  - Symptom cluster
COIS- The authors declare that they have no competing interests.
EDAT- 2021/03/06 06:00
MHDA- 2021/04/27 06:00
PMCR- 2021/03/05
CRDT- 2021/03/05 05:39
PHST- 2020/10/29 00:00 [received]
PHST- 2021/02/18 00:00 [accepted]
PHST- 2021/03/05 05:39 [entrez]
PHST- 2021/03/06 06:00 [pubmed]
PHST- 2021/04/27 06:00 [medline]
PHST- 2021/03/05 00:00 [pmc-release]
AID - 10.1186/s12877-021-02109-w [pii]
AID - 2109 [pii]
AID - 10.1186/s12877-021-02109-w [doi]
PST - epublish
SO  - BMC Geriatr. 2021 Mar 5;21(1):160. doi: 10.1186/s12877-021-02109-w.