International Psychogeriatrics

Research Article

Behavioral and psychological symptoms of dementia in relation to level of cognitive impairment

Hugo Lövheima1 c1, Per-Olof Sandmana2, Stig Karlssona1 and Yngve Gustafsona1

a1 Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden

a2 Department of Nursing, Umeå University, Umeå, Sweden

ABSTRACT

Background: Many people with dementia exhibit some behavioral or psychological symptoms, e.g. aggressive or aberrant motor behavior, depression or hallucinations, at some time during the course of the disorder. The aim of the present study was to describe the probability of the occurrence of these symptoms of dementia in relation to the level of cognitive impairment.

Methods: 3404 people with cognitive impairment were selected from two large cross-sectional surveys of those in geriatric care settings, conducted in 1982 and 2000 in the county of Västerbotten, Sweden. Symptoms were assessed using the Multi-Dimensional Dementia Assessment Scale (MDDAS), subsumed with a rotated factor analysis, and investigated in relation to level of cognitive impairment, measured using the Gottfries cognitive scale.

Results: The passiveness factor had an almost linear correlation to the level of cognitive impairment (r2 = 0.237). Non-linear correlations, with highest prevalences in middle-stage cognitive impairment, were found for aggressive behavior (r2 = 0.057), wandering behavior (r2 = 0.065), restless behavior (r2 = 0.143), verbally disruptive/attention-seeking behavior (r2 = 0.099), regressive/inappropriate behavior (r2 = 0.058), hallucinatory symptoms (r2 = 0.021) and depressive symptoms (r2 = 0.029).

Conclusion: The relations between the behavioral and psychological symptoms of dementia and level of cognitive impairment were non-linear, with higher prevalence rates in the middle stages of dementia, apart from the symptom of passiveness, which increased almost linearly with the severity of cognitive impairment.

(Received September 06 2007)

(Online publication November 28 2007)

(Revised December 03 2007)

(Accepted December 06 2007)

(Online publication April 17 2008)

Correspondence:

c1 Correspondence should be addressed to: H. Lövheim, Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-901 85 Umeå, Sweden. Phone: +46 90 785 88 59; Fax: +46 90 13 06 23. Email: hugo.lovheim@germed.umu.se.