Association of caregiver demographic variables with neuropsychiatric symptoms in Alzheimer’s disease patients for distress on the Neuropsychiatric Inventory (NPI)

Behavioral symptoms are frequently observed in Alzheimer's disease patients and are associated to higher distress for patients and caregivers, early institutionalization, worst prognosis and increased care. Objectives The objective of the present study was to evaluate the frequency of neuropsychiatric symptoms in a sample of Alzheimer's disease patients and to analyze association between caregiver demographic characteristics and patient symptoms. Methods Sixty Alzheimer's disease patients (NINCDS-ADRDA) and their caregivers were consecutively included in the investigation by the Dementia Outpatient clinic of Hospital de Clínicas de Porto Alegre. The Neuropsychiatric Inventory (NPI) was applied to evaluate behavioral symptoms and their impact upon caregivers. Age, sex, educational attainment, relationship to the patient, and time as caregiver were obtained from all caregivers. Results Apathy was the symptom responsible for the highest distress level, followed by agitation and aggression. A significant correlation between total severity NPI and distress NPI was observed. None of the caregiver demographic data showed association to distress. The most frequent symptoms were apathy and aberrant motor behavior. Patients' relatives also considered apathy as the most severe symptom, followed by depression and agitation. Conclusions Apathy was the most frequent and severe neuropsychiatric symptom. No relationship between caregiver demographic characteristics and distress was observed.