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Dementia associated mental and behavioural disturbances in elderly people in the community: findings from the first Nakayama study
  1. M Ikeda,
  2. R Fukuhara,
  3. K Shigenobu,
  4. K Hokoishi,
  5. N Maki,
  6. A Nebu,
  7. K Komori,
  8. H Tanabe
  1. Department of Neuropsychiatry, Ehime University School of Medicine, Ehime, Japan
  1. Correspondence to:
 Dr M Ikeda
 Department of Neuropsychiatry, Ehime University School of Medicine, Shigenobu, Onsen-gun, Ehime 791-0295, Japan; mikedam.ehime-u.ac.jp

Abstract

Objective: To determine the prevalence of mental and behavioural disturbances associated with dementia in elderly people living in the Japanese community of Nakayama.

Methods: A door to door three phase population survey was carried out on all persons aged 65 years and older living at home. The study included a psychiatric interview, neurological and neuropsychological examination, and cranial computed tomography. Participants with dementia were rated on the neuropsychiatric inventory.

Results: Of 1438 inhabitants, 1162 (81.0%) completed the protocol. The prevalence of dementia was 4.8%. Of the 60 participants with dementia (Alzheimer’s disease 35%, vascular dementia 47%, and dementia from other causes 17%), 53 (88.3%) had shown one or more mental and behavioural disturbances. Apathy/indifference (56.7%), followed by agitation/aggression (35%), aberrant motor behaviour (31.7%), and irritability (31.7%) were the common symptoms. More productive (positive) symptoms such as delusions and aberrant motor behaviour were found in the Alzheimer group than in the vascular dementia group.

Conclusions: A wide range of dementia associated mental and behavioural disturbances developed in the majority of community dwelling individuals with dementia. The findings suggest that a screening programme focusing on identifying these symptoms should be included in the physician’s diagnostic tools for dementia.

  • Alzheimer’s disease
  • dementia
  • behavioural disturbance
  • elderly
  • BPSD, behavioural and psychological symptoms of dementia
  • CDR, clinical dementia rating scale
  • DSM, Diagnostic and Statistical Manual of Mental Disorders
  • MMSE, mini-mental state examination
  • NPI, neuropsychiatric inventory
  • SMQ, short memory questionnaire

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Footnotes

  • Competing interests: none declared