title: Investigating the stability of neuropsychiatric sub-syndromes with progression of dementia: a 2-year prospective study.
abstract: OBJECTIVE
  Previous studies have identified sub-syndromes of behavioral and psychological symptoms of dementia. But because of their cross-sectional design, the stability of these sub-syndromes over time remains unknown.
  
  
  METHODS
  Behavioral and psychological symptoms of dementia of 84 participants (out of an original sample of 144 patients) with Alzheimer's disease and vascular dementia were assessed by using the Neuropsychiatric Inventory every six months for two years. Principal component factor analysis with Varimax rotation was used to detect neuropsychiatric sub-syndromes at each time point.
  
  
  RESULTS
  The 12 symptoms were reduced to four factors at baseline, 12, 18, and 24 months and three factors at six months. None of the factor structures matched the four sub-syndromes previously identified by studies. The most stable group of symptoms were a combination of "psychosis" and "hyperactivity" symptoms (delusions, hallucinations, irritability, agitation), which became stable at 18 months.
  
  
  CONCLUSIONS
  The pattern of behavioral and psychological symptoms of dementia sub-syndromes over time has not been studied before, and this research suggests that some stability is evident particularly during the later stages of the disease process. These findings have implications for patients and their caregiver.
authors.affiliation: Manchester Mental Health and Social Care Trust, Park House, North Manchester General Hospital, Manchester, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Bettney
authors.forename: Shameem
authors.initials: S
authors.lastname: Butt
authors.forename: Julie
authors.initials: J
authors.lastname: Morris
authors.forename: Amanda
authors.initials: A
authors.lastname: Connolly
authors.forename: Charles
authors.initials: C
authors.lastname: McCollum
authors.forename: Alistair
authors.initials: A
authors.lastname: Burns
authors.forename: Nitin
authors.initials: N
authors.lastname: Purandare
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000523:psychology*; D018450:Disease Progression; D004739:England; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000209:etiology; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011596:Psychomotor Disorders / Q000209:etiology*; D011618:Psychotic Disorders / Q000175:diagnosis / Q000209:etiology*