title: Burden of Behavioral and Psychiatric Symptoms in People Screened Positive for Dementia in Primary Care: Results of the DelpHi-Study.
abstract: BACKGROUND
  There is limited knowledge about the range and effects of neuropsychiatric symptoms shown by persons with dementia (PWD) living in the community and their related caregiver burden.
  
  
  OBJECTIVE
  To examine neuropsychiatric symptoms in PWD in primary care with regard to frequency, severity, and burden to caregiver; to compare PWD with and without symptoms with regard to sociodemographics, care-related, and disease-related variables; and to identify variables associated with symptoms.
  
  
  METHODS
  A general physician-based epidemiological cohort of 248 people screened positive for dementia over the age of 70 (living at home) and their caregivers, was assessed using the Neuropsychiatric Interview (NPI), sociodemographics, and disease-related variables.
  
  
  RESULTS
  In preliminary analyses, neuropsychiatric symptoms were frequent in PWD. Prevalence numbers ofdysphoria/depression, apathy, and agitation/aggression were each more than 30% . The severity of neuropsychiatric symptoms in people screened positive for dementia in primary care is moderate with a mean NPI score of m = 11.91 (SD = 16.0). Overall, caregiver distress is low, indicated by a total distress score of m = 5.94 (SD = 7.2, range 0-39). Common or frequent symptoms are not necessarily the most distressing symptoms.
  
  
  CONCLUSIONS
  Neuropsychiatric symptoms are common in people screened positive for dementia in primary care. While frequency, severity, and perceived distress might be low in the total sample, we identified the dimensions delusions, aggression, anxiety, disinhibition, and depression to be perceived "severely" to "extremely" distressing in more than 30% of the caregivers affected. The association between activities of daily living and symptoms needs further attention.
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
authors.forename: Jochen René
authors.initials: JR
authors.lastname: Thyrian
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
authors.forename: Tilly
authors.initials: T
authors.lastname: Eichler
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Hertel
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
authors.forename: Diana
authors.initials: D
authors.lastname: Wucherer
authors.affiliation: Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Adina
authors.initials: A
authors.lastname: Dreier
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Michalowsky
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Rostock, Germany.|Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Killimann
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Rostock, Germany.|Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Teipel
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.|Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hoffmann
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003704:Dementia / Q000175:diagnosis*; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008403:Mass Screening; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D011320:Primary Health Care; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000175:diagnosis*; D012720:Severity of Illness Index
keywords: Behavioral symptoms; Neuropsychiatric Interview; caregiver burden; population-based; primary care