title: Neuropsychiatric symptoms and syndromes in institutionalized elderly people without dementia.
abstract: BACKGROUND
  Neuropsychiatric disorders are mainly studied in people with dementia but estimates are still not available for institutionalized elderly people without dementia. The aim of this work was to investigate neuropsychiatric syndromes in non-demented elderly people living in residential facilities (RFs).
  
  
  METHODS
  Data from the PROGRES-Older people project, including 95 RFs in Italy, were analyzed. From a total of 1215 people, 252 without dementia were recruited. Behavioral syndromes were identified using both factor and cluster analysis of results from the 12-item Neuropsychiatric Inventory. Logistic regression was used to assess factors associated with behavioral syndromes. Global cognitive functioning was assessed with the Mini-mental State Examination (MMSE). Current pharmacological treatments were taken from the residents' records.
  
  
  RESULTS
  Five neuropsychiatric syndromes were identified: (1) Affective (depression, anxiety, night-time behaviors); (2) Hyperactive (agitation, irritability, appetite abnormalities); (3) Psychotic (delusions and hallucinations); (4) Manic (euphoria and disinhibition); (5) Apathetic (apathy and aberrant motor behavior). The risk of having a neuropsychiatric syndrome was higher in people with younger age (OR: 5.1, 1.3-20.0), higher education (OR: 7.3, 2.4-22.1), and low MMSE score (OR: 6.5, 1.9-22.2). Almost half of people with behavioral syndromes were not undergoing psychotropic treatment. Hypnotic and anxiolytic agents were the most frequently used drugs for most of the syndromes.
  
  
  CONCLUSIONS
  Older people without dementia living in RFs exhibit a syndrome pattern of neuropsychiatric behaviors different from those observed in patients with dementia, which are associated with cognitive and sociodemographic characteristics. A large proportion of non-demented older people with neuropsychiatric syndromes are not having adequate treatment for their psychiatric disturbances.
authors.affiliation: IRCCS Fondazione Santa Lucia, Rome, Italy. l.cravello@hsantalucia.it
authors.forename: Luca
authors.initials: L
authors.lastname: Cravello
authors.forename: Katie
authors.initials: K
authors.lastname: Palmer
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.forename: Carlo
authors.initials: C
authors.lastname: Caltagirone
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Spalletta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D016000:Cluster Analysis; D005163:Factor Analysis, Statistical; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D009483:Neuropsychological Tests; D011619:Psychotropic Drugs / Q000627:therapeutic use; D013577:Syndrome
chemical_list: D011619:Psychotropic Drugs