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van der Linde, Rianne M. and Dening, Tom and Stephan, Blossom C.M. and Prina, A. Matthew and Evans, Elizabeth and Brayne, Carol (2016) Longitudinal course of behavioural and psychological symptoms of dementia: a systematic review. British Journal of Psychiatry, 209 (5). pp. 366-377. ISSN 1472-1465

Abstract

Background

More information about the pattern of Behavioural and Psychological Symptoms of Dementia (BPSD) in the course of dementia is needed to inform patients and clinicians and to design future interventions.

Aims

To determine the persistence and incidence of BPSD and their relation to cognitive function, in individuals with dementia or in cohorts investigating dementia onset.

Methods

Systematic literature review of baseline prevalence, persistence and incidence of 11 BPSD. The review was conducted according to established (PRISMA) guidelines with the exception that we could not exclude the possibilities of bias in the studies examined.

Results

59 studies were included. There was considerable heterogeneity in study objectives and methods. Hyperactivity and apathy showed high persistence and incidence; depression and anxiety low or moderate persistence and moderate incidence; and psychotic symptoms low persistence with moderate or low incidence.

Conclusions

Despite heterogeneity across studies in terms of setting, focus and length of follow-up, there are clinically relevant differences in the longitudinal courses of different BPSD. Apathy was the only single BPSD with high baseline prevalence, persistence and incidence during the course of dementia.

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