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Co‐occurrence of neuropsychiatric syndromes in demented and psychotic institutionalized elderly
Author(s) -
Dechamps Arnaud,
Jutand Marthe Aline,
Onifade Chérifa,
RichardHarston Sandrine,
BourdelMarchasson Isabelle
Publication year - 2008
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2052
Subject(s) - varimax rotation , psychosis , dementia , psychomotor agitation , psychiatry , distress , psychology , observational study , medicine , psychometrics , clinical psychology , disease , cronbach's alpha
Abstract Objectives To explore and determine the clinical figures of behavioral syndromes from the factor structure of the Neuropsychiatric Inventory‐Nursing Home version (NPI‐NH) in demented and psychotic patients. Setting Two nursing homes and two long‐term care homes. Design Observational, cross‐sectional. Participants One hundred and sixty‐three institutionalized elderly with dementia or psychosis (66.9% female), mean age 80.9 ± 9.1 years. Measurements The NPI‐NH includes 12 neuropsychiatric symptoms and a distress scale. The product score of frequency (F) and severity (S) ratings provides an overall score for each of the 12 items. An exploratory principal component analysis with Varimax rotation was performed on the F × S scores according to patients' diagnosis. Results High internal consistency of the NPI‐NH was found ( α = 0.8). In demented patients a 4‐factor solution was found that explained 63.9% of the variance, with the syndromes: (a) ‘hyperactivity’; (b) ‘affective’; (c) ‘psychosis’; and (d) ‘Hallucinations’. A four‐factor solution was also found in psychotic patients, explaining 61.3% of variance, with syndromes: (a) ‘affective’; (b) ‘frontal lobe symptoms’; (c) ‘sundowning’; and (d) ‘psychomotor agitation’. A syndrome was unlikely to appear alone but was most likely to occur with other syndromes. A specific pattern of syndrome co‐occurrence were found in demented (a + b + c in 30.5% of cases) and psychotic patients (a + b + c + d in 35.2% of cases). Conclusion The syndrome taxonomies are consistent with the diagnostic criteria. The clinical use of syndrome co‐occurrence could help to further understand and evaluate behavioral changes in pharmacological and non‐pharmacological treatments. Copyright © 2008 John Wiley & Sons, Ltd.