Reports by caregivers of behavioral and psychological symptoms of dementia

Behavioral and Psychological Symptoms of Dementia (BPSD) are relevant since they are frequent and cause distress to caregivers. However, they may not be reported by physicians due to the priority usually attributed to cognitive symptoms. Objectives To verify whether BPSD is being systematically investigated by physicians even in specialized settings and whether their records on medical files are accurate. Methods Assessment of records on medical files of BPSD reported by caregivers to 182 patients (57.1% men, mean age 67.6±13.5 years) assisted in a tertiary-care behavioral neurology outpatient clinic (BNOC) who also had appointments in other clinics of the same hospital. Alzheimer's disease (37.9%) and vascular disease (19.2%) were the most frequent causes of dementia. Results Report/appointment ratios were 0.58 in BNOC, 0.43 in other neurological, 0.93 in psychiatric and 0.20 in non-neurological, non-psychiatric clinics. BPSD most frequently recorded in BNOC were insomnia, aggressiveness, agitation/hyperactivity, visual hallucinations, apathy, inadequate behavior and ease of crying. Sorted by psychiatrists, categories associated to more BPSD were affect/mood, thought and personality/behavior. affect/mood and sensoperception symptoms were the most frequently reported. Sorted according to Neuropsychiatric Inventory (NPI), categories associated to more BPSD were depression/dysphoria, delusion and apathy/indifference. depression/dysphoria and agitation/ aggression symptoms were the most frequently reported. Conclusions BPSD reported by caregivers were very diverse and were not systematically investigated by physicians. Notes in medical files often contained non-technical terms.