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BACKGROUND: Behavioural and psychological symptoms of dementia (BPSD) can complicate acute hospital care, but evidence on BPSD in this setting is heterogeneous. OBJECTIVE: To determine the prevalence of BPSD in acute hospitals and explore related risk factors, treatments, and outcomes (PROSPERO: CRD42023406294). METHODS: We conducted a systematic review and meta-analysis by searching Cochrane Library, MEDLINE, and PsycINFO for studies on BPSD prevalence among older people with dementia during their acute hospital admissions (up to 5 March 2024). Independent double-review processes were used for study screening, selection, and data extraction. Data on 12 BPSD symptoms were extracted based on the Neuropsychiatric Inventory Questionnaire (NPI) and Behavioural Pathology in Alzheimer's Disease (BEHAVE-ad). Risk factors, treatments, and outcomes were summarised. Meta-analysis was used to synthesise results. RESULTS: Out of 15 101 records, 30 articles from 23 studies were included. Most studies were rated as moderate (n = 12) to poor (n = 17) quality. Meta-analysis revealed a pooled prevalence of overall BPSD (one or more BPSD symptoms) at 60% (95% CI = 43-78%) among older inpatients with dementia in acute hospitals (N = 11 studies). Subgroup analysis showed variations in the overall BPSD prevalence based on assessment tools (BEHAVE-ad = 85%, NPI = 74%, Others = 40%). Common BPSD symptoms included aggression/agitation (39%), sleep problems (38%), eating problems (36%), and irritability (32%). BPSD were linked to delirium, pain, increased use of uncomfortable interventions, psychotropic medication uses and higher caregiver distress. Poor patient-staff interactions and fragmented discharge plans often led to frequent emergency admissions and hospital readmissions. CONCLUSION: Healthcare systems should implement tailored approaches for managing BPSD in acute hospitals, enhance staff training, improve caregiver communication, and develop integrated discharge plans.
Anantapong et al. (Wed,) studied this question.