Highlights
- •Interventions for dementia symptoms rely on identification of their determinants.
- •Patient, caregiver, and environmental determinants of symptoms are identified.
- •Little evidence for caregiver and environmental determinants was found.
- •Research gaps include lack of consistent measures and longitudinal data for symptoms.
- •Policy implications reflect goals of the National Alzheimer's Project Act.
Abstract
Background
Behavioral and psychological symptoms of dementia (BPSD) are prevalent in people with
neurodegenerative diseases.
Purpose
In this scoping review the Kales, Gitlin and Lykestos framework is used to answer
the question: What high quality evidence exists for the patient, caregiver and environmental
determinants of five specific BPSD: aggression, agitation, apathy, depression and
psychosis?
Method
An a priori review protocol was developed; 692 of 6013 articles retrieved in the search
were deemed eligible for review. Gough’s Weight of Evidence Framework and the Cochrane
Collaboration’s tool for assessing risk of bias were used. The findings from 56 high
quality/low bias articles are summarized.
Discussion
Each symptom had its own set of determinants, but many were common across several
symptoms: neurodegeneration, type of dementia, severity of cognitive impairments,
and declining functional abilities, and to a lesser extent, caregiver burden and communication.
Conclusion
Research and policy implications are relevant to the National Plan to Address Alzheimer’s
Disease.
Keywords
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Article info
Publication history
Published online: June 15, 2017
Accepted:
June 6,
2017
Received in revised form:
May 20,
2017
Received:
February 27,
2017
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
