The impact of neuropsychiatric symptoms of dementia on distress in family and professional caregivers in Singapore.
BACKGROUND
Behavioral and psychological symptoms of dementia (BPSD) are a source of distress and burden for caregivers. This study attempts to determine the neuropsychiatric symptoms, demographic characteristics, and referral patterns of outpatients with dementia compared with patients admitted to the acute psychogeriatric wards of Woodbridge Hospital. We also assessed the impact of neuropsychiatric symptoms on distress in family and professional caregivers.


METHODS
Eighty-five consecutive patients with a first-time diagnosis of dementia were recruited. They were assessed using the Neuropsychiatric Inventory Caregiver Distress Scale (NPI-D). The professional caregiver distress questions were rephrased to assess the "occupational disruptiveness" of behaviors in the nursing home version (NPI-NH).


RESULTS
Neuropsychiatric symptoms were common and were positively correlated with caregiver distress. Family caregivers were significantly more distressed than professional caregivers over the delusion, agitation, depression and aberrant motor domains, although the severity of the behavioral disturbances reported was not higher in the sample. The median NPI scores for the agitation and disinhibition domains were significantly higher in the inpatient group, contrasting with a higher score for the depression domain among the outpatient group.


CONCLUSIONS
This study highlights the prevalence of neuropsychiatric symptoms in dementia and illustrates the strong correlation between the severity of behavioral disturbances and caregiver distress.
Tan
Lay Ling
LL
Department of Geriatric Psychiatry, Institute of Mental Health/Woodbridge Hospital, 10 Buangkok View, Singapore 539747. Lay_ling_Tan@imh.com.sg
Wong
Hwee Bee
HB
Allen
Harry
H
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D017028:Caregivers / Q000523:psychology*; D016009:Chi-Square Distribution; D003704:Dementia / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D003863:Depression / Q000209:etiology / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011368:Professional-Family Relations; D012846:Singapore / Q000453:epidemiology