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The impact of neuropsychiatric symptoms on caregiver distress and quality of life in persons with dementia in an Asian tertiary hospital memory clinic

Published online by Cambridge University Press:  09 September 2013

S. A. Khoo ,
T. Y. Chen ,
Y. H. Ang  and
P. Yap
S. A. Khoo*
Affiliation:
Department of Psychological Medicine, Khoo Teck Puat Hospital, Singapore
T. Y. Chen
Affiliation:
Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Y. H. Ang
Affiliation:
Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
P. Yap
Affiliation:
Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
*
Correspondence should be addressed to: Sue Anne Khoo, Principal Clinical Psychologist, Department of Psychological Medicine, Khoo Teck Puat Hospital, Alexandra Health, Singapore 90 Yishun CentralSingapore, 768826. Phone: +65-65558000; Fax: +65-66023646. Email: [email protected].
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Abstract

Background:

This study aims to determine the prevalence, profile, and severity of neuropsychiatric symptoms (NPS) across the dementia continuum and their relative impact on caregiver distress and quality of life (QoL) in persons with dementia (PWD).

Method:

Six hundred and sixty-seven PWD and their family caregivers presented to a memory clinic in a tertiary hospital across a 60-month period. Clinicians determined the dementia diagnosis and severity using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition and the Clinical Dementia Rating scale, respectively. The Neuropsychiatric Inventory Questionnaire was administered to assess NPS in PWD and the corresponding distress experienced by the caregiver. QoL for PWD (PWD-QoL) was assessed by the Quality of Life–Alzheimer's Disease scale.

Results:

Ninety-six percent of PWD presented with at least one NPS, 18% experiencing mild, 31% moderate, and 47% severe symptoms, respectively. While agitation (63.1%), apathy (61.8%), depression (55.5%), and irritability (55.5%) were the most common NPS; disinhibition (35.2%), hallucination (25.5%), and elation (14.2%) were the least common. NPS increased generally but differentially as dementia progressed and significantly predicted caregiver distress (ηp2 = 0.732, p < 0.0001) and PWD-QoL (ηp2 = 0.066, p < 0.0001). Factor analysis revealed two NPS clusters, disruptive and affective; the former exerting greater impact on caregiver distress and the latter on PWD-QoL.

Conclusion:

The results show a high prevalence of NPS which increase caregiver distress and negatively impact PWD-QoL. The differential profile of NPS across the dementia stages warrants stage-specific interventions and due consideration in resource planning and service design for PWD and their caregivers.

Keywords

dementianeuropsychiatric symptoms; quality of lifecarers
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 12 , December 2013 , pp. 1991 - 1999
Copyright
Copyright © International Psychogeriatric Association 2013 

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