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A systematic review of the relationship between behavioral and psychological symptoms (BPSD) and caregiver well-being

Published online by Cambridge University Press:  27 June 2016

Alexandra Feast ,
Esme Moniz-Cook ,
Charlotte Stoner ,
Georgina Charlesworth  and
Martin Orrell
Alexandra Feast*
Affiliation:
Division of Psychiatry, University College London, London, UK
Esme Moniz-Cook
Affiliation:
Faculty of Health and Social Care, University of Hull, Hull, UK
Charlotte Stoner
Affiliation:
Research Department of Clinical, Educational, and Health Psychology, University College London, London, UK
Georgina Charlesworth
Affiliation:
Research Department of Clinical, Educational, and Health Psychology, University College London, London, UK
Martin Orrell
Affiliation:
Institute of Mental Health, University of Nottingham, Nottingham, UK
*
Correspondence should be addressed to: Alexandra Feast, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK. Phone: 0300 555 1200; ext 64491. Email: [email protected].
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Abstract

Background:

Behavioral and psychological symptoms in dementia (BPSD) are important predictors of institutionalization as well as caregiver burden and depression. Previous reviews have tended to group BPSD as one category with little focus on the role of the individual symptoms. This review investigates the role of the individual symptoms of BPSD in relation to the impact on different measures of family caregiver well-being.

Methods:

Systematic review and meta-analysis of papers published in English between 1980 and December 2015 reporting which BPSD affect caregiver well-being. Paper quality was appraised using the Downs and Black Checklist (1998).

Results:

Forty medium and high quality quantitative papers met the inclusion criteria, 16 were suitable to be included in a meta-analysis of mean distress scores. Depressive behaviors were the most distressing for caregivers followed by agitation/aggression and apathy. Euphoria was the least distressing. Correlation coefficients between mean total behavior scores and mean distress scores were pooled for four studies. Irritability, aberrant motor behavior and delusions were the most strongly correlated to distress, disinhibition was the least correlated.

Conclusions:

The evidence is not conclusive as to whether some BPSD impact caregiver well-being more than others. Studies which validly examined BPSD individually were limited, and the included studies used numerous measures of BPSD and numerous measures of caregiver well-being. Future research may benefit from a consistent measure of BPSD, examining BPSD individually, and by examining the causal mechanisms by which BPSD impact well-being by including caregiver variables so that interventions can be designed to target BPSD more effectively.

Keywords

behavioral and psychological symptoms of dementiacarerdementianeuropsychiatric symptomsquality of life
Type
Review Article
Information
International Psychogeriatrics , Volume 28 , Issue 11 , November 2016 , pp. 1761 - 1774
Copyright
Copyright © International Psychogeriatric Association 2016 

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