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Co-occurrence of neuropsychiatric syndromes in demented and psychotic institutionalized elderly

✍ Scribed by Arnaud Dechamps; Marthe Aline Jutand; Chérifa Onifade; Sandrine Richard-Harston; Isabelle Bourdel-Marchasson

Publisher
John Wiley and Sons
Year
2008
Tongue
English
Weight
92 KB
Volume
23
Category
Article
ISSN
0885-6230

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✦ Synopsis

Abstract

Objectives

To explore and determine the clinical figures of behavioral syndromes from the factor structure of the Neuropsychiatric Inventory‐Nursing Home version (NPI‐NH) in demented and psychotic patients.

Setting

Two nursing homes and two long‐term care homes.

Design

Observational, cross‐sectional.

Participants

One hundred and sixty‐three institutionalized elderly with dementia or psychosis (66.9% female), mean age 80.9 ± 9.1 years.

Measurements

The NPI‐NH includes 12 neuropsychiatric symptoms and a distress scale. The product score of frequency (F) and severity (S) ratings provides an overall score for each of the 12 items. An exploratory principal component analysis with Varimax rotation was performed on the F × S scores according to patients' diagnosis.

Results

High internal consistency of the NPI‐NH was found (α = 0.8). In demented patients a 4‐factor solution was found that explained 63.9% of the variance, with the syndromes: (a) ‘hyperactivity’; (b) ‘affective’; (c) ‘psychosis’; and (d) ‘Hallucinations’. A four‐factor solution was also found in psychotic patients, explaining 61.3% of variance, with syndromes: (a) ‘affective’; (b) ‘frontal lobe symptoms’; (c) ‘sundowning’; and (d) ‘psychomotor agitation’. A syndrome was unlikely to appear alone but was most likely to occur with other syndromes. A specific pattern of syndrome co‐occurrence were found in demented (a + b + c in 30.5% of cases) and psychotic patients (a + b + c + d in 35.2% of cases).

Conclusion

The syndrome taxonomies are consistent with the diagnostic criteria. The clinical use of syndrome co‐occurrence could help to further understand and evaluate behavioral changes in pharmacological and non‐pharmacological treatments. Copyright © 2008 John Wiley & Sons, Ltd.

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