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CLUSTERING OF BEHAVIOURAL AND PSYCHOLOGICAL SYMPTOMS IN DEMENTIA WITHIN AND BEYOND THE NEUROPSYCHIATRIC INVENTORY: A EUROPEAN ALZHEIMER?S DISEASE CONSORTIUM STUDY
Petrovic M, Hurt C, Collins D, Burns A, Camus V, Liperoti R, Marriott A, Nobili F, Robert P, Tsolaki M, Vellas B, Verhey F, Byrne EJ for the EADC BPSD group
Objectives: This cross-sectional study investigated relationships between behavioural and psychological symptoms of dementia (BPSD).
Methods: We recruited 194 patients with different types of dementia from six European Alzheimer?s Disease Consortium centres. BPSD were assessed using a pre-designed questionnaire comprising both the Neuropsychiatric Inventory (NPI) and the following additional symptoms: shouting, misidentification, cursing, sexual disinhibition, hoarding, mirror sign and change in personality. Shouting, cursing and sexual disinhibition were sub-items within the NPI and the others were ?non-NPI?. BPSD scores were analysed by Spearman?s correlation analysis and principal components factor analysis.
Results: Four NPI-based factors were identified (58% of the common variance): F1 (irritability, agitation, hallucinations and anxiety), F2 (aberrant motor behaviour and delusions), F3 (disinhibition, elation and depression) and F4 (appetite disturbance, sleep disturbance and apathy). Six factors were identified when the NPI symptoms were assessed together with the additional symptoms (62% of the variance): F1 (misidentification, aberrant motor behaviour, delusions, apathy, sleep disturbance and change in personality), F2 (cursing, shouting, mirror sign and hallucinations), F3 (irritability, agitation and anxiety), F4 (disinhibition, elation and depression), F5 (hoarding) and F6 (appetite disturbance). Three factors based on additional symptoms were identified (71% of the variance): F1 (shouting and cursing), F2 (misidentification, change in personality and sexual disinhibition) and F3 (hoarding and mirror sign).
Conclusion: The additional (i.e. sub-items of the NPI and ?non-NPI?) symptoms explained most of the common variance. Assessment of the ?non-NPI? symptoms alone and together with the NPI contributes to the variety of BPSD patterns in dementia.
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