Behavioral and Psychological Symptoms of Dementia in Nigerian Hospital Patients: Prevalence, Correlates and Caregiver Burden

Abstract

Aims: This study was aimed at measuring the prevalence and impact of Behavioral and Psychological Symptoms of Dementia (BPSD) of elderly hospital attendees in Lagos Nigeria; and determining socio-cultural factors associated with the health of these elderly people with dementia. Study Design: This was a cross-sectional descriptive study. Fifty patients with dementia attending out-patient facilities of three tertiary hospitals in Lagos were interviewed along with their caregivers. Place and Duration of Study: The study was conducted over a 6 month period at the out-patient clinics of the Federal Neuro-Psychiatric Hospital, Yaba and the Neurology and Psychiatric Clinics of Lagos University Teaching Hospital, Idi-Araba Lagos. Methodology: Consecutively presenting patients who met the inclusion criteria for the study were recruited after obtaining consent from the participant and caregivers. The Mini Mental State Examination, Stick design and Indiana University Token test were administered to the patient, while Blessed Dementia Scale and Neuropsychiatry Inventory were administered to the caregivers. Results: Mean age was 72.5(±6.4) years, 52% were females and 54% had primary school education or less. Ninety-two percent lived with family and 96% had at least one BPSD, the commonest being hallucinations (68%), agitation (68%) and night-time behaviour (62%). The most severe BPSD using the mean NPI score (Frequency X Severity) were night-time behaviour 3.84, (SD3.71), aberrant motor behaviour 3.74, (SD4.06) and agitation 3.53, (SD3.52). The more distressing symptoms experienced by caregivers were agitation 1.78, (SD1.56), night-time behaviour 1.78, (SD1.43), and aberrant motor behaviour 1.66, (SD1.59), On regression analysis, BPSD independently predicted caregiver distress. Conclusion: These findings are similar to previous studies with high prevalence of BPSD in patients with dementia and distress in caregivers. Improving access to treatment of BPSD is vital in alleviating caregiver distress especially in low income countries where family care is about the only option for dementia care.