Behavioral and psychological symptoms of dementia and its relationship with caregiver burden: A cross-sectional study of inpatients with dementia in a tertiary center

Background: Behavioral and psychological symptoms of dementia (BPSD) is commonly associated with caregiver distress, and often a reason for short-term or long-term care. Very few studies have examined the pattern of the BPSD and caregiver burden in an Indian tertiary care inpatient setting. Aims: Our study aimed to understand the pattern of BPSD, particularly its individual domains, in different types of dementia, and its relationship with caregiver distress and burden in a geriatric inpatient setting. Methods: One hundred inpatients with dementia and their informal primary caregivers participated in a cross-sectional, semi-structured interview using validated tools to assess the types and severity of BPSD and the relationship with caregiver burden. Results: All inpatients had one or more BPSD, as expected, with a median of 7 (1QR 5-8). Night-time behavioral disturbances (79%), irritability (78%), and apathy (74%) were the most common ones. In Alzheimer’s dementia (AD), night-time behavioral disturbances (80%), irritability/lability (74.3%), and agitation/aggression (68.6%) were the most observed. Apathy (84.4%) was the most common BPSD in frontotemporal dementia (FTD), followed by irritability (80%), aberrant motor behavior (71.2%), and night-time behavioral disturbances (71.2%). Caregiver distress varied across different BPSD, with irritability (10%), agitation (8%), and aberrant motor behavior (7%) associated with the highest levels of distress in our study. Worsening cognitive impairment was not associated with increased burden. Conclusion: An individually tailored management approach targeting specific BPSD symptoms, with equal focus on both the patient and the caregiver, is key.