Behavioural and psychological symptoms in poststroke vascular cognitive impairment.
BACKGROUND
Behavioural and psychological symptoms of dementia (BPSD) cause significant patient and caregiver morbidity in vascular cognitive impairment (VCI). Objectives. To study and compare the occurrence and severity of BPSD between multi-infarct dementia (MID), subcortical ischaemic vascular disease (SIVD), and strategic infarct subtypes of poststroke VCI and to evaluate the relationship of these symptoms with the severity of cognitive impairment.


METHODS
Sixty patients with poststroke VCI were classified into MID, SIVD, and strategic infarct subtypes. BPSD were studied by the neuropsychiatric inventory (NPI). The severity of cognitive impairment was evaluated by the clinical dementia rating scale (CDR).


RESULTS
95% of cases had at least one neuropsychiatric symptom, with depression being the commonest, irrespective of subtype or severity of VCI. Strategic infarct patients had the lowest frequency of all symptoms. SIVD showed a higher frequency and severity of apathy and higher total NPI scores, compared to MID. Apathy and appetite disturbances occurred more commonly with increasing CDR scores. The total NPI score correlated positively with the CDR score.


CONCLUSIONS
Depression was the commonest neuropsychiatric symptom in VCI. The neuropsychiatric profiles of MID and SIVD were similar. The frequency and severity of apathy and the net burden of BPSD increased with increasing cognitive impairment.
Department of Neurology, GB Pant Hospital, Jawaharlal Nehru Road, New Delhi 110002, India.
Meena
M
Gupta
Department of Neurology, GB Pant Hospital, Jawaharlal Nehru Road, New Delhi 110002, India.
Abhijit
A
Dasgupta
Department of Neurology, GB Pant Hospital, Jawaharlal Nehru Road, New Delhi 110002, India.
Geeta Anjum
GA
Khwaja
Department of Neurology, GB Pant Hospital, Jawaharlal Nehru Road, New Delhi 110002, India.
Debashish
D
Chowdhury
Department of Neurology, GB Pant Hospital, Jawaharlal Nehru Road, New Delhi 110002, India.
Yogesh
Y
Patidar
Department of Neurology, GB Pant Hospital, Jawaharlal Nehru Road, New Delhi 110002, India.
Amit
A
Batra
D000328:Adult; D000368:Aged; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000523:psychology; D063189:Symptom Assessment