title: A pilot study of differences in behavioral and psychological symptoms of dementia in nursing home residents in Sydney and Shanghai.
abstract: BACKGROUND
  There are limited cross-cultural studies of behavioral and psychological symptoms of dementia (BPSD). The aim of the present study was to increase understanding of the effects of culture on BPSD by comparing the rates of BPSD in nursing home residents across three residential facility types: (1) mainstream nursing homes in Sydney, (2) ethno-specific Chinese nursing homes in Sydney, and (3) a long-term high care facility in Shanghai known as a dementia hospital.
  
  
  METHODS
  149 residents and their caregivers voluntarily participated in this study. The rates and levels of BPSD were assessed by interviewing staff with the Neuropsychiatric Inventory-Nursing Home Version (NPI-NH). Clinical interviews using the Mini-mental State Examination (MMSE) and Global Deterioration Scale (GDS) were conducted with residents to assess dementia severity.
  
  
  RESULTS
  The mean NPI-NH total score for the sample was 28.5 (SD = 17.2) with no significant differences across the three facility types. Comparison of NPI-NH subscales showed residents from the ethno-specific Chinese facilities had lower rates of hallucinations than Shanghai residents (p = 0.003), but no differences from those in mainstream facilities. Shanghai residents had lower frequencies of disinhibition and irritability than ethno-specific Chinese residents (p = 0.003, p = 0.004 respectively), but no differences with mainstream residents.
  
  
  CONCLUSIONS
  The prevalence of BPSD does not differ among nursing home populations of different cultural backgrounds. Longitudinal community studies among different cultural groups would better elucidate the effects of culture on BPSD at different stages of dementia.
authors.affiliation: Primary Dementia Collaborative Research Centre, University of New South Wales, Coogee, Australia. helenwzy@hotmail.com
authors.forename: Helen Zong Ying
authors.initials: HZ
authors.lastname: Wu
authors.forename: Lee-Fay
authors.initials: LF
authors.lastname: Low
authors.forename: Shifu
authors.initials: S
authors.lastname: Xiao
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
mesh_terms: D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data; D001315:Australia / Q000453:epidemiology; D001526:Behavioral Symptoms / Q000175:diagnosis / Q000453:epidemiology*; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data; D002681:China / Q000453:epidemiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D003431:Cross-Cultural Comparison; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D009735:Nursing Homes / Q000145:classification / Q000706:statistics & numerical data*; D010865:Pilot Projects; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index