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Neuropsychiatric symptoms and syndromes in institutionalized elderly people without dementia

Published online by Cambridge University Press:  03 August 2010

Luca Cravello ,
Katie Palmer ,
Giovanni de Girolamo ,
Carlo Caltagirone  and
Gianfranco Spalletta
Luca Cravello*
Affiliation:
IRCCS Fondazione Santa Lucia, Rome, Italy
Katie Palmer
Affiliation:
IRCCS Fondazione Santa Lucia, Rome, Italy
Giovanni de Girolamo
Affiliation:
IRCCS Centro S. Giovanni di Dio-Fatebenefratelli, Brescia, Italy
Carlo Caltagirone
Affiliation:
IRCCS Fondazione Santa Lucia, Rome, Italy Department of Neuroscience – University of Tor Vergata, Rome, Italy
Gianfranco Spalletta
Affiliation:
IRCCS Fondazione Santa Lucia, Rome, Italy
*
Correspondence should be addressed to: Luca Cravello, MD, PhD, Laboratory of Clinical and Behavioural Neurology, I.R.C.C.S. Santa Lucia Foundation, Via Ardeatina, 306 – 00179 Rome, Italy. Phone: +39-0651501519; Fax. +39-0651501584. Email: l.cravello@hsantalucia.it.
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Abstract

Background: Neuropsychiatric disorders are mainly studied in people with dementia but estimates are still not available for institutionalized elderly people without dementia. The aim of this work was to investigate neuropsychiatric syndromes in non-demented elderly people living in residential facilities (RFs).

Methods: Data from the PROGRES-Older people project, including 95 RFs in Italy, were analyzed. From a total of 1215 people, 252 without dementia were recruited. Behavioral syndromes were identified using both factor and cluster analysis of results from the 12-item Neuropsychiatric Inventory. Logistic regression was used to assess factors associated with behavioral syndromes. Global cognitive functioning was assessed with the Mini-mental State Examination (MMSE). Current pharmacological treatments were taken from the residents’ records.

Results: Five neuropsychiatric syndromes were identified: (1) Affective (depression, anxiety, night-time behaviors); (2) Hyperactive (agitation, irritability, appetite abnormalities); (3) Psychotic (delusions and hallucinations); (4) Manic (euphoria and disinhibition); (5) Apathetic (apathy and aberrant motor behavior). The risk of having a neuropsychiatric syndrome was higher in people with younger age (OR: 5.1, 1.3–20.0), higher education (OR: 7.3, 2.4–22.1), and low MMSE score (OR: 6.5, 1.9–22.2). Almost half of people with behavioral syndromes were not undergoing psychotropic treatment. Hypnotic and anxiolytic agents were the most frequently used drugs for most of the syndromes.

Conclusions: Older people without dementia living in RFs exhibit a syndrome pattern of neuropsychiatric behaviors different from those observed in patients with dementia, which are associated with cognitive and sociodemographic characteristics. A large proportion of non-demented older people with neuropsychiatric syndromes are not having adequate treatment for their psychiatric disturbances.

Keywords

residential facilitiesfactor analysiscluster analysisNPIpredictors
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 3 , April 2011 , pp. 425 - 434
Copyright
Copyright © International Psychogeriatric Association 2010

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