Behavioral and psychological symptoms of dementia: prevalence, symptom groups and their correlates in community-based older adults with dementia in Singapore.

BACKGROUND: This study assessed the prevalence and factor structure of behavioral and psychological symptoms of dementia (BPSD) in a community-based sample of older adults with dementia and identified their correlates.

METHODS: Data collected from 399 Singapore residents with dementia aged 60 years and above, interviewed along with a family/friend during a national survey, were used for this analysis. Neuropsychiatric Inventory Questionnaire assessed older adults' BPSD. Other data included socio-demographics, dementia severity, cognition, chronic physical conditions, disability, and caregivers' burden. Exploratory factor analysis assessed BPSD sub-groups, factor scores of which were used to identify socio-demographic, and clinical correlates.

RESULTS: Prevalence of BPSD was 67.9% and 30% of the population had experienced three or more BPSD in the past month. Two distinct and moderately correlated symptom groups representing "psychosis and behavior dysregulation" and "mood disturbance and restlessness" were identified. As factor scores for both the groups increased with older age, poor cognition and caregiver burden, the former was also related to being never married and having no formal education.

CONCLUSIONS: Study provides evidence of two distinct groups of BPSD and their important correlates. Clinicians treating BPSD should consider their age and cognitive impairment and be cognizant of their caregivers' burden.