The British Journal of Psychiatry (2009) 194: 212-219. doi: 10.1192/bjp.bp.108.049619
© 2009 The Royal College of Psychiatrists
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Prevalence, correlates and course of behavioural and psychological symptoms of dementia in the population{dagger}

George M. Savva, PhD* and Julia Zaccai, PhD*

Department of Public Health and Primary Care, University of Cambridge

Fiona E. Matthews, PhD

MRC Biostatistics Unit, Institute of Public Health, Cambridge

Julie E. Davidson, MPH

Worldwide Epidemiology, GlaxoSmithKline R&D, Harlow

Ian McKeith, MD, FRCPsych, FMedSci

Wolfson Research Centre, Newcastle General Hospital, Newcastle Upon Tyne

Carol Brayne, MD, MSc, FRCP, FFPH

Department of Public Health and Primary Care, University of Cambridge, UK.

the Medical Research Council Cognitive Function and Ageing Study

Correspondence: George M. Savva, Department of Public Health and Primary Care, University of Cambridge, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 0SR, UK. Email: george.savva{at}phpc.cam.ac.uk

Declaration of interest

This study was funded by a grant from GlaxoSmithKline. The Cognitive Function and Ageing Study is supported by the Medical Research Council.

{dagger} See editorial, pp. 199–200, this issue.

* These authors contributed equally to the work.

Background

Behavioural and psychological symptoms of dementia (BPSD) are major contributors to the burden of dementia.

Aims

To describe the prevalence, correlates and course of BPSD in the population of England and Wales.

Method

The prevalence of 12 symptoms was estimated in 587 participants with dementia and 2050 participants without dementia as part of a population-based longitudinal study of ageing. The effect of risk factors and the factor structure were estimated using 1782 interviews provided by participants with dementia throughout the study.

Results

Each symptom apart from sleeping problems was more common in the population with dementia. The co-occurrence of the symptoms was explained by a four-factor solution, corresponding to psychosis/apathy, depression/anxiety, irritability/persecution and wandering/sleep problems. Psychosis occurred more frequently with declining cognition. Anxiety and depression were more common in younger individuals and in those with poor self-reported health. Persistence varied between symptoms.

Conclusions

Behavioural and psychological symptoms of dementia affect nearly all people with dementia. Symptoms co-occur, and the symptoms that affected individuals experience are related to their socio-demographic and clinical characteristics.


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