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BMC Geriatrics
Published in: BMC Geriatrics 1/2014

Open Access 01-12-2014 | Study protocol

Neuropsychiatric symptoms in patients with dementia in primary care: a study protocol

Authors: Petra Borsje, Roland B Wetzels, Peter LBJ Lucassen, Anne-Margriet Pot, Raymond TCM Koopmans

Published in: BMC Geriatrics | Issue 1/2014

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Abstract

Background

Neuropsychiatric symptoms (NPS) frequently occur in patients with dementia. To date, prospective studies on the course of NPS have been conducted in patients with dementia in clinical centers or psychiatric services. The primary goal of this study is to investigate the course of NPS in patients with dementia and caregiver distress in primary care. We also aim to detect determinants of both the course of NPS in patients with dementia and informal caregiver distress in primary care.

Methods/design

This is a prospective observational study on the course of NPS in patients with dementia in primary care. Thirty-seven general practitioners (GPs) in 18 general practices were selected based on their interest in participating in this study. We will retrieve electronic medical files of patients with dementia from these general practices. Patients and caregivers will be followed for 18 months during the period January 2012 to December 2013. Patient characteristics will be collected at baseline. Time to death or institutionalization will be measured. Co-morbidity will be assessed using the Charlson index. Psychotropic drug use and primary and secondary outcome measures will be measured at 3 assessments, baseline, 9 and 18 months. The primary outcome measures are the Neuropsychiatric Inventory score for patients with dementia and the Sense of Competence score for informal caregivers. In addition to descriptive analyses frequency parameters will be computed. Univariate analysis will be performed to identify determinants of the course of NPS and informal caregiver distress. All determinants will then be tested in a multivariate regression analysis to determine their unique contribution to the course of NPS and caregiver distress.

Discussion

The results of this study will provide data on the course of NPS, which is clinically important for prognosis. The data will help GPs and other professionals in planning follow-up visits and in the timing for offering psycho-education, psychosocial interventions and the provision of care. In addition, these data will enlarge health professionals’ awareness of NPS in their patients with dementia.
Appendix
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Literature
1.
World Health Organization: Dementia: a public health priority. 2012, United Kingdom: WHO
2.
Shin I-S, Carter M, Masterman D, Fairbanks L, Cummings JL: Neuropsychiatric symptoms and quality of life in Alzheimer disease. Am J Geriatr Psychiatry. 2005, 13 (6): 469-474. 10.1097/00019442-200506000-00005.CrossRefPubMed
3.
de Vugt E, Stevens F, Aalten P, Lousberg R, Jaspers N, Winkens I, Jolles J, Verhey FRJ: Behavioural disturbances in dementia patients and quality of the marital relationship. Am J Geriatr Psychiatry. 2003, 18: 149-154. 10.1002/gps.807.CrossRef
4.
Gaugler JE, Yu F, Krichbaum K, Wyman JF: Predictors of nursing home admission for persons with dementia. Med Care. 2009, 47: 191-198. 10.1097/MLR.0b013e31818457ce.CrossRefPubMed
5.
Dorenlot P, Harboun M, Bige V, Henrard J-L, Ankri J: Major depression as a risk factor for early institutionalization of dementia patients living in the community. Int J Geriatr Psychiatr. 2005, 20 (5): 471-478. 10.1002/gps.1238.CrossRef
6.
Asada T, Motonaga T, Kinoshita T: Predictors of severity of behavioral disturbance among community-dwelling elderly individuals with alzheimer’s disease: a 6-year follow-up study. Psychiatry Clin Neurosci. 2000, 54: 673-677. 10.1046/j.1440-1819.2000.00768.x.CrossRefPubMed
7.
Chow TW, Liu CK, Fuh JL, Leung VPY, Tai CT, Chen L-W, Wang SJ, Chiu HFK, Lam LCW, Chen QL, Cummings JL: Neuropsychiatric symptoms of alzheimer’s disease differ in Chinese and American patients. Int J Geriatr Psychiatry. 2002, 17: 22-28. 10.1002/gps.509.CrossRefPubMed
8.
Lyketsos CG, Lopez O, Jones B, Fitzpatrick AL, Breitner J, DeKosky S: Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment. J Am Med Assoc. 2002, 288 (12): 1475-1483. 10.1001/jama.288.12.1475.CrossRef
9.
Ikeda M, Fukuhara R, Shigenobu K, Hokoishi K, Maki N, Nebu A, Komori K, Tanabe H: Dementia associated mental and behavioural disturbances in elderly people in the community: findings from the first Nakayama study. J Neurol Neurosurg Psychiatry. 2004, 75: 146-148.PubMedPubMedCentral
10.
Suh G-H, Kim SK: Behavioral and psychological signs and symptoms of dementia (BPSD) in antipsychotic-naïve alzheimer’s disease patients. Int Psychogeriatr. 2004, 16 (3): 337-350. 10.1017/S1041610204000432.CrossRefPubMed
11.
Craig D, Mirakhur A, Hart DJ, McIlroy SP, Passmore AP: A cross-sectional study of neuropsychiatric symptoms in 435 patients with alzheimer’s disease. Am J Geriatr Psychiatry. 2005, 13 (6): 460-468. 10.1097/00019442-200506000-00004.CrossRefPubMed
12.
Ryu S-H, Katona C, Rive B, Livingston G: Persistence of and changes in neuropsychiatric symptoms in alzheimer disease over 6 months. Am J Geriatr Psychiatry. 2005, 13: 976-983.PubMed
13.
Gonfrier S, Andrieu S, Renaud D, Vellas B, Robert PH: Course of neuropsychiatric symptoms during a 4-year follow up in the REAL-FR cohort. J Nutr Health Aging. 2012, 16 (2): 134-137. 10.1007/s12603-011-0147-9.CrossRefPubMed
14.
Steinberg M, Sheppard J-M, Tschanz JT, Norton MC, Steffens DC, Breitner JCS, Lyketsos CG: The incidence of mental and behavioral disturbances in dementia: the cache county study. J Neuropsychiatry Clin Neurosci. 2003, 15 (3): 340-345. 10.1176/appi.neuropsych.15.3.340.CrossRefPubMed
15.
Aalten P, de Vugt ME, Jaspers N, Jolles J, Verhey FRJ: The course of neuropsychiatric symptoms in dementia: part I: findings from the two-year longitudinal Maasbed study. Int J Geriatr Psychiatry. 2005, 20: 523-530. 10.1002/gps.1316.CrossRefPubMed
16.
Steinberg M, Tschanz JT, Corcoran C, Steffens DC, Norton MC, Lyketsos CG, Breitner JCS: The persistence of neuropsychiatric symptoms in dementia: the Cache county study. Int J Geriatr Psychiatry. 2004, 19: 19-26. 10.1002/gps.1025.CrossRefPubMed
17.
Savva GM, Zaccai J, Matthews FE, Davidson JE, McKeith I, Brayne C: Prevalence, correlates and course of behavioural and psychological symptoms of dementia in the population. Br J Psychiatry. 2009, 194: 212-219. 10.1192/bjp.bp.108.049619.CrossRefPubMed
18.
Charlson ME, Pompei P, Ales KL, MacKenzie CR: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987, 40 (5): 373-383. 10.1016/0021-9681(87)90171-8.CrossRefPubMed
19.
Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J: The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994, 44 (12): 2308-2314. 10.1212/WNL.44.12.2308.CrossRefPubMed
20.
Cummings JL: The neuropsychiatric inventory: assessing psychopathology in dementia patients. Neurology. 1997, 48 (Suppl 6): S10-S16.CrossRefPubMed
21.
Leung VP, Lam LC, Chiu HF, Cummings JL, Chen QL: Validation study of the Chinese version of the neuropsychiatric inventory (CNPI). Int J Geriatr Psychiatry. 2001, 16 (8): 789-793. 10.1002/gps.427.CrossRefPubMed
22.
Kat MG, de Jonghe JF, Aalten P, Kalisvaart CJ, Dröes RM, Verhey FR: Neuropsychiatric symptoms of dementia: psychometric aspects of the Dutch neuropsychiatric inventory (NPI). Tijdschr Gerontol Geriatr. 2002, 33 (4): 150-155.PubMed
23.
Zuidema SU, de Jonghe JF, Verhey FR, Koopmans RTCM: Neuropsychiatric symptoms in nursing home patients; factor structure invariance of the Dutch nursing home version of the neuropsychiatric inventory in different stages of dementia. Dement Geriatr Cogn Disord. 2007, 24: 169-176. 10.1159/000105603.CrossRefPubMed
24.
Aalten P, Verhey FR, Boziki M, Brugnolo A, Bullock R, Byrne EJ, Camus V, Caputo M, Collins D, De Deyn PP, Elina K, Frisoni G, Holmes C, Hurt C, Marriott A, Mecocci P, Nobili F, Ousset PJ, Reynish E, Salmon E, Tsolaki M, Vellas B, Robert PH: Consistency of neuropsychiatric syndromes across dementias: results from the European alzheimer disease consortium: part II. Dement Geriatr Cogn Disord. 2008, 25: 1-8. 10.1159/000111082.CrossRefPubMed
25.
Cohen-Mansfield J: Agitated behaviors in the elderly II: preliminary results in the cognitively deteriorated. J Am Geriatr Soc. 1986, 34: 722-727.CrossRefPubMed
26.
de Jonghe J, Kat M: Factor structure and validity of the Dutch version of the cohen-mansfield agitation inventory (CMAI-D). J Am Geriatr Soc. 1996, 44: 888-889.CrossRefPubMed
27.
Zuidema SU, Buursema AL, Gerritsen MGJM, Oosterwal KC, Smits MMM, Koopmans RTCM, de Jonghe JFM: Assessing neuropsychiatric symptoms in nursing home patients with dementia: reliability and reliable change index of the neuropsychiatric inventory and the cohen-mansfield agitation inventory. Int J Geriatr Psychiatry. 2011, 26: 127-134. 10.1002/gps.2499.CrossRefPubMed
28.
Zuidema SU, de Jonghe JFM, Verhey FRJ, Koopmans RTCM: Agitation in Dutch institutionalized patients with dementia: factor analysis of the Dutch version of the cohen-mansfield agitation inventory. Dement Geriatr Cogn Disord. 2007, 23: 35-41. 10.1159/000096681.CrossRefPubMed
29.
Weiner MF, Tractenberg RE, Jin S, Gamst A, Thomas RG, Koss E, Thal LJ: Assessing alzheimer’s disease patients with the cohen-mansfield agitation inventory: scoring and clinical implications. J Psychiatr Res. 2002, 36 (1): 19-25. 10.1016/S0022-3956(01)00047-4.CrossRefPubMed
30.
Alexopoulos GS, Abrams RC, Young RC, Shamoian CA: Cornell scale for depression in dementia. Biol Psychiatry. 1988, 23: 271-284. 10.1016/0006-3223(88)90038-8.CrossRefPubMed
31.
Kørner A, Lauritzen L, Abelskov K, Gulmann N, Brodersen AM, Wedervang-Jensen T, Kjeldgaard KM: The geriatric depression scale and the cornell scale for depression in dementia. Nord J Psychiatry. 2006, 60 (5): 360-364. 10.1080/08039480600937066.CrossRefPubMed
32.
Folstein MF, Folstein SE, McHugh PR: “Mini-mental state” a practical method for grading the cognitive state of patients for the clinician. J psychiat Res. 1975, 12: 189-198. 10.1016/0022-3956(75)90026-6.CrossRefPubMed
33.
Tombaugh TN, McIntyre NJ: The mini-mental state examination: a comprehensive review. J Am Geriatr Soc. 1992, 40 (9): 922-935.CrossRefPubMed
34.
Logsden RG, Gibbons LE, McCurry SM, Teri L: Quality of life in alzheimer’s disease: patients’ and caregivers’. J Ment Health Aging. 1999, 5: 21-32.
35.
Merchant C, Hope KW: The quality of life in alzheimer’s disease scale: direct assessment of people with cognitive impairment. J Clin Nurs. 2004, 13 (6b): 105-110.CrossRefPubMed
36.
Logsdon RG, Gibbons LE, McCurry SM, Teri L: Assessing quality of life in older adults with cognitive impairment. Psychosomatic Med. 2002, 64: 510-519.CrossRef
37.
Brod M, Stewart AL, Sands L, Walton P: Conceptualization and measurement of quality of life in dementia: the dementia quality of life instrument (DQOL). Gerontologist. 1999, 39: 25-35. 10.1093/geront/39.1.25.CrossRefPubMed
38.
Selai CE, Trimble MR, Rossor MN, Harvey RJ: The quality of life assessment schedule (QOLAS) – a new method for assessing quality of life (QOL) in dementia. Assessing quality of life in alzheimer’s disease. Edited by: Albert SM, Logsdon RG. 2000, New York: Springer Publishing Company, 31-48.
39.
Thorgrimsen L, Selwood A, Spector A, Royan L, De Madariaga-Lopez M, Woods RT: Whose quality of life is it anyway? the validity and reliability of the quality of life – alzheimer’s disease (QOL-AD) scale. Alzheimer Dis Assoc Disord. 2003, 17: 201-208. 10.1097/00002093-200310000-00002.CrossRefPubMed
40.
Hoe J, Katona C, Roch B, Livingston L: Use of the QOL-AD for measuring quality of life in people with severe dementia-the LASER-AD study. Age Aging. 2005, 34: 130-135. 10.1093/ageing/afi030.CrossRef
41.
Bengston VL, Kuypers J: The family support cycle: psychosocial issues in the aging family. Lifespan and change in a gerontological perspective. 1985, New York: Academic Press, 257-273.
42.
Zarit SH, Reever KE, Bach-Peterson J: Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist. 1980, 20: 649-655. 10.1093/geront/20.6.649.CrossRefPubMed
43.
Vernooij-Dassen MJFJ: In Dutch: dementia and home-care. 1993, University of Nijmegen: PhD thesis
44.
Jansen APD, van Hout HPJ, van Marwijk HWJ, Nijpel G, Gundy C, Vernooij-Dassen MJFJ, deVet HCW, Schellevis FG, Stalman WAB: Sense of competence questionnaire among informal caregivers of older adults with dementia symptoms: a psychometric evaluation. Clinical Practice and Epidemiology in Mental Health. 2007, 3: 11-10.1186/1745-0179-3-11.CrossRefPubMedPubMedCentral
45.
Vernooij-Dassen MJFJ, Persoon JMG, Felling AJA: Predictors of sense of competence in caregivers of demented persons. Soc Sci Med. 1996, 43: 41-49. 10.1016/0277-9536(95)00332-0.CrossRefPubMed
46.
Kurz X, Scuvee-Moreau J, Vernooij-Dassen M, Dresse A: Cognitive impairment, dementia and quality of life in patients and caregivers. Acta Neurol Belg. 2003, 103: 24-34.PubMed
47.
Radloff LS: The CES-D scale: a self-report depression scale for research in the general population. Appl Psych Meas. 1977, 1: 138-401.CrossRef
48.
Radloff LS, Teri L: Use of the center for epidemiological studies-depression scale with older adults. Clin Gerontol. 1985, 5: 119-136.CrossRef
49.
Haley WE, Roth DL, Coleton MI, Ford GR, West CA, Collins RP, Isobe TL: Appraisal, coping, and social support as mediators of well-being in black and white family caregivers of patients with alzheimer’s disease. J Consult Clin Psychol. 1996, 64 (1): 121-129.CrossRefPubMed
50.
Beeson R, Horton-Deutsch S, Farran C, Neundorfer M: Loneliness and depression in caregivers of persons with alzheimer’s disease or related disorders. Issues Ment Health Nurs. 2000, 21: 779-806. 10.1080/016128400750044279.CrossRefPubMed
51.
Roth DL, Haley WE, Owen JE, Clay O, Goode KT: Latent growth models of the longitudinal effects of dementia caregiving: a comparison of African American and white family caregivers. Psychol Aging. 2001, 16: 427-436.CrossRefPubMed
52.
Gallicchio L, Siddiqi N, Langenberg P, Baumgarten M: Gender differences in burden and depression among informal caregivers of demented elders in the community. Int J Geriatr Psychiatry. 2002, 17: 154-163. 10.1002/gps.538.CrossRefPubMed
53.
Jensen CJ, Ferrari M, Cavanaugh JC: Building on the benefits: assessing satisfaction and well-being in elder care. Ageing International. 2004, 29: 88-110. 10.1007/s12126-004-1011-6.CrossRef
54.
Schulz R, Belle SH, Czaja SJ, McGinnis KA, Stevens AB, Zhang S: Long-term care placement of dementia patients and caregiver health and well- being. JAMA. 2004, 292: 961-967. 10.1001/jama.292.8.961.CrossRefPubMed
55.
O’Rourke N: Factor structure of the center for epidemiologic studies–depression scale (CES-D) among older men and women who provide care to persons with dementia. Int J Test. 2005, 5: 265-277. 10.1207/s15327574ijt0503_5.CrossRef
56.
Roth DL, Ackerman ML, Okonkwo OC, Burgio LD: The four-factor model of depressive symptoms in dementia caregivers: a structural equation model of ethnic differences. Psychol Aging. 2008, 23 (3): 567-576.CrossRefPubMedPubMedCentral
57.
Goldberg DP, Williams P: A user guide to the general health questionnaire. 1988, Nger, Nelson: Windson
58.
McCabe CJ, Thomas KJ, Brazier JE, Coleman P: Measuring the mental health status of a population: a comparison of the GHQ-12 and the SF-36 (MHI-5). Br J Psychiatry. 1996, 169: 516-521. 10.1192/bjp.169.4.516.CrossRefPubMed
59.
Schmitz N, Kruse J, Tress W: Psychometric properties of the general health questionnaire (GHQ-12) in a German primary care sample. Acta Psychiatr Scand. 1999, 100: 462-468. 10.1111/j.1600-0447.1999.tb10898.x.CrossRefPubMed
60.
Kind P: The EuroQol instrument: an index of healthrelated quality of life. Quality of life and pharmacoeconomics in clinical trials. Edited by: Spilker B. 1996, Philadelphia: Lippincott-Raven, 2
61.
Ankri J, Beaufils B, Novella JL, Morrone I, Guillemin F, Jolly D, Ploton L, Blanchard F: Use of the EQ-5D among patients suffering from dementia. J Clin Epidemiol. 2003, 56: 1055-1063. 10.1016/S0895-4356(03)00175-6.CrossRefPubMed
62.
Coucill W, Bryan S, Bentham P, Buckley A, Laight A: EQ-5D in patients with dementia: an investigation of inter-rater agreement. Med Care. 2001, 39 (8): 760-771. 10.1097/00005650-200108000-00003.CrossRefPubMed
63.
Vittinghoff E, McCulloch CE: Relaxing the rule of ten events per variable in logistic and cox regression. Am J Epidemiol. 2007, 165: 710-718. 10.1093/aje/kwk052.CrossRefPubMed
Metadata
Title
Neuropsychiatric symptoms in patients with dementia in primary care: a study protocol
Authors
Petra Borsje
Roland B Wetzels
Peter LBJ Lucassen
Anne-Margriet Pot
Raymond TCM Koopmans
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2014
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/1471-2318-14-32

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