HOME HELP FEEDBACK SUBSCRIPTIONS ALL ISSUES SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Google Scholar Articles by Selbæk, G. Articles by Engedal, K. PubMed PubMed Citation Articles by Selbæk, G. Articles by Engedal, K.

The Course of Psychiatric and Behavioral Symptoms and the Use of Psychotropic Medication in Patients With Dementia in Norwegian Nursing Homes—A 12-Month Follow-Up Study

From the Research Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad (GS, KE); The Norwegian Centre for Dementia Research, Vestfold Mental Health Care Trust, Tønsberg (ØK); The Norwegian Centre for Dementia Research, Ullevaal University Hospital, Oslo (GS, KE); Department of Geriatrics, University of Oslo, N-0318 Oslo (KE); and Agder University College, Faculty of Health and Sports, 4604 Kristiansand S (ØK), Norway.

Objective: This study investigates the natural course of neuropsychiatric symptoms and the concomitant use of psychotropic medication among a large and representative sample of nursing-home patients with dementia.

Method: The authors performed two data collections with structured interviews in a 1-year follow-up cohort-study including 26 nursing homes in four counties in two Norwegian health regions. The main outcome measures were baseline and follow-up frequencies, persistence and incidence of neuropsychiatric symptoms, and the change in neuropsychiatric symptoms with regard to the use of psychotropic medication.

Results: At baseline a representative sample of 1,163 nursing-home patients participated, of whom 933 had dementia. At the follow-up interview after 1 year, 633 of the patients who had dementia at baseline were assessed. Clinically significant neuropsychiatric symptoms were exhibited by 84% of patients with dementia at the baseline or follow-up interviews. Overall persistence of symptoms was 79%. Individual symptoms, such as depression (58%), delusions (56%), and agitation/aggression (47%) had resolved at a high rate. Persistent use of antidepressants (79%), antipsychotics (75%), or any psychotropic drug (88%) was common. There were no differences between users and nonusers of antipsychotics or antidepressants regarding the course of psychosis, agitation, or depression over the 1-year observation period.

Conclusion: Neuropsychiatric symptoms are ubiquitous in nursing home patients with dementia. Overall the symptoms are chronically present, whereas individual symptoms often show an intermittent course. Long-term use of psychotropic medication is extensive. Uncertainty about treatment effects emphasizes the need for further treatment trials.

Key Words: Dementia • neuropsychiatric symptoms • psychotropic medication • nursing home

This article has been cited by other articles:

				H. Lavretsky Neuropsychiatric Symptoms in Alzheimer Disease and Related Disorders: Why Do Treatments Work in Clinical Practice but Not in the Randomized Trials? Am J Geriatr Psychiatry, July 1, 2008; 16(7): 523 - 527. [Full Text] [PDF]