Characteristics of Behavioral and Psychological Symptoms of Dementia in Patients with Major Neurocognitive Disorder due to Vascular Disease

Main Article Content

ศิรินภา อภิสิทธิ์ภิญโญ
พูนศรี รังษีขจี
พงศธร พหลภาคย์
ภัทรี พหลภาคย์
วรินทร พุทธรักษ์


Objective : To study the prevalence and the trend of change during 24 weeks of follow-ups in pattern of behavioral and psychological symptoms of dementia (BPSD), the associated factors among patients with major neurocognitive disorder due to vascular disease.

Method : A retrospective chart review of 54 patients with major neurocognitive disorder due to vascular disease who attended psychiatric outpatient department at Srinagarind Hospital during 2014 to 2018 was performed. Demographic data, history of major neurocognitive disorder due to vascular disease and factor associated with BPSD were collected. Neuropsychiatric inventory questionnaire-Thai version (NPI-Q Thai) was used to measure BPSD in these patients. Data analysis used descriptive statistics for baseline characteristic and percentage of BPSD and analysis statistic for factors associated with BPSD using correlation analysis.

Results : Among 54 patients with major neurocognitive disorder due to vascular disease, predominately males (29 case, 53.7%), with a mean age of 71.9±8 years, mostly mildly ill (27.8-38.9%) according to clinical global impression scale (CGI-S). The prevalence of BPSD were 87% and 83.3% in the 1st and 24th week, respectively. Most common BPSD was apathy (50-55.6%), the second frequent was irritability (31.5%-38.9%). The least frequent BPSD was elation (3.7-9.3%). There is no statistically significant correlation between various factors and prevalence of BPSD.

Conclusion : The prevalence of BPSD in patients with major neurocognitive disorder due to vascular disease was high and a little change during 24 weeks of follow-ups. Patterns of BPSD were the same at both points. None of clinical factors were found to be correlated with BPSD. Early detection and multidisciplinary approach for patients, caregivers and their families should be considered.


Download data is not yet available.

Article Details

How to Cite
อภิสิทธิ์ภิญโญ ศ., รังษีขจี พ., พหลภาคย์ พ., พหลภาคย์ ภ., & พุทธรักษ์ ว. (2019). Characteristics of Behavioral and Psychological Symptoms of Dementia in Patients with Major Neurocognitive Disorder due to Vascular Disease. Journal of the Psychiatric Association of Thailand, 64(4), 371–384. Retrieved from
Original Articles


Association AP. Diagnostic and Statistical Manual of Mental Disorders US: American Psychiatric Association; 2013.

Ford AH. Neuropsychiatric aspects of dementia. Maturitas. 2014; 79(2): 209-215.

Cerejeira J, Lagarto L, Mukaetova-Ladinska EB. Behavioral and psychological symptoms of dementia. Front Neurol. 2012; 3: 73.

Chiu MJ, Chen TF, Yip PK, Hua MS, Tang LY. Behavioral and psychologic symptoms in different types of dementia. J Formos Med Assoc. 2006; 105(7): 556-562.

Mukherjee A, Biswas A, Roy A, Biswas S, Gangopadhyay G, Das SK. Behavioural and Psychological Symptoms of Dementia: Correlates and Impact on Caregiver Distress. Dement Geriatr Cogn Dis Extra. 2017; 7(3): 354-365.

Selbaek G, Engedal K, Benth JS, Bergh S. The course of neuropsychiatric symptoms in nursing-home patients with dementia over a 53-month follow-up period. Int Psychogeriatr. 2014; 26(1): 81-91.

Tschanz JT, Corcoran CD, Schwartz S, et al. Progression of cognitive, functional, and neuropsychiatric symptom domains in a population cohort with Alzheimer dementia: the Cache County Dementia Progression study. Am J Geriatr Psychiatry. 2011; 19(6): 532-542.

D’Onofrio G, Sancarlo D, Panza F, et al. Neuropsychiatric symptoms and functional status in Alzheimer’s disease and vascular dementia patients. Curr Alzheimer Res. 2012; 9(6): 759-771.

Fernandez Martinez M, Castro Flores J, Perez de las Heras S, Mandaluniz Lekumberri A, Gordejuela Menocal M, Zarranz Imirizaldu JJ. Prevalence of neuropsychiatric symptoms in elderly patients with dementia in Mungialde County (Basque Country, Spain). Dement Geriatr Cogn Disord. 2008; 25(2): 103-108.

Fernandez-Martinez M, Castro J, Molano A, Zarranz JJ, Rodrigo RM, Ortega R. Prevalence of neuropsychiatric symptoms in Alzheimer’s disease and vascular dementia. Curr Alzheimer Res. 2008; 5(1): 61-69.

Staekenborg SS, Su T, van Straaten EC, et al. Behavioural and psychological symptoms in vascular dementia; differences between small-and large-vessel disease. J Neurol Neurosurg Psychiatry. 2010; 81(5): 547-551.

Taemeeyapradit U UD, Tepparak N. Characteristics of behavioral and psychologi¬cal symptoms of dementia, severity and levels of distress on caregivers. J Med Assoc Thai. 2014; 97(4): 423-430.

Pinidbunjerdkool A SS, Sithinamsuwan P. Behavioral and Psychological Symptoms of Dementia. J Med Assoc Thai. 2014; 97(2): 168-174.

McKeith I, Cummings J. Behavioural changes and psychological symptoms in dementia disorders. Lancet Neurol. 2005; 4(11): 735- 742.

Ballard C, Day S, Sharp S, Wing G, Sorensen S. Neuropsychiatric symptoms in dementia: importance and treatment considerations. Int Rev Psychiatry. 2008; 20(4): 396-404.

Russ TC, Batty GD, Starr JM. Cognitive and behavioural predictors of survival in Alzheimer disease: results from a sample of treated patients in a tertiary-referral memory clinic. Int J Geriatr Psychiatry. 2012; 27(8): 844-853.

Tun SM, Murman DL, Long HL, Colenda CC, von Eye A. Predictive validity of neuropsychiatric subgroups on nursing home placement and survival in patients with Alzheimer disease. Am J Geriatr Psychiatry. 2007; 15(4): 314-327.

O’Donnell BF, Drachman DA, Barnes HJ, Peterson KE, Swearer JM, Lew RA. Incontinence and troublesome behaviors predict institutionalization in dementia. J Geriatr Psychiatry Neurol. 1992; 5(1): 45-52.

Herrmann N, Lanctot KL, Sambrook R, et al. The contribution of neuropsychiatric symptoms to the cost of dementia care. Int J Geriatr Psychiatry. 2006; 21(10): 972-976.

Yamane. Statistics: An Introductory Analysis. New York: Harper and Row; 1967.

Cummings JL. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology. 1997; 48(5 Suppl 6): S10-16.

Roman GC, Tatemichi TK, Erkinjuntti T, et al. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology. 1993; 43(2): 250-260.

Caputo M, Monastero R, Mariani E, et al. Neuropsychiatric symptoms in 921 elderly subjects with dementia: a comparison between vascular and neurodegenerative types. Acta Psychiatr Scand. 2008; 117(6): 455-464.

F u h J L , W a n g S J , C u m m i n g s J L . Neuropsychiatric profiles in patients with Alzheimer’s disease and vascular dementia. J Neurol Neurosurg Psychiatry. 2005; 76(10): 1337-1341.

Shelley BP, Al Khabouri J. The spectrum of dementia: frequency, causes and clinical profile. A national referral hospital-based study in Oman. Dement Geriatr Cogn Disord. 2007; 24(4): 280-287.

Srikanth S, Nagaraja AV, Ratnavalli E. Neuropsychiatric symptoms in dementia-frequency, relationship to dementia severity and comparison in Alzheimer’s disease, vascular dementia and frontotemporal dementia. J Neurol Sci. 2005; 236(1-2): 43-48.

Kushwaha S, Talwar P, Anthony A, et al. Clinical Spectrum, Risk Factors, and Behavioral Abnormalities among Dementia Subtypes in a North Indian Population: A Hospital-Based Study. Dement Geriatr Cogn Dis Extra. 2017; 7(2): 257-273.

Hsieh CJ, Chang CC, Lin CC. Neuropsychiatric profiles of patients with Alzheimer’s disease and vascular dementia in Taiwan. Int J Geriatr Psychiatry. 2009; 24(6): 570-577.

Lyketsos CG, Steinberg M, Tschanz JT, Norton MC, Steffens DC, Breitner JC. Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. Am J Psychiatry. 2000; 157(5): 708-714.

Groves WC, Brandt J, Steinberg M, et al. Vascular dementia and Alzheimer’s disease: is there a difference? A comparison of symptoms by disease duration. J Neuropsy¬chiatry Clin Neurosci. 2000; 12(3): 305-315.

Aalten P, de Vugt ME, Jaspers N, Jolles J, Verhey FR. The course of neuropsychiatric symptoms in dementia. Part II: relationships among behavioural sub-syndromes and the influence of clinical variables. Int J Geriatr Psychiatry. 2005; 20(6): 531-536.

Kim JM, Lyons D, Shin IS, Yoon JS. Differences in the behavioral and psychological symptoms between Alzheimer’s disease and vascular dementia: are the different pharmacologic treatment strategies justifiable? Hum Psychopharmacol. 2003; 18(3): 215-220.

Kiely KM, Mortby ME, Anstey KJ. Differential associations between sensory loss and neuropsychiatric symptoms in adults with and without a neurocognitive disorder. Int Psychogeriatr. 2018; 30(2): 2 61-272.

Sathida Rakkhamnuan PL. Behavioral and Psychological Symptoms of Dementia (BPSD) and Caregiver Burden among Caregivers of Alzheimer’s Dementia Patients at Department of Psychiatry, King Chulalongkorn Memorial Hospital. Journal of The Psychiatric Association of Thailand. 2012; 57: 335-346.

Fernandez M, Gobartt AL, Balana M. Behavioural symptoms in patients with Alzheimer’s disease and their association with cognitive impairment. BMC Neurol. 2010; 10: 87.

Tible OP, Riese F, Savaskan E, von Gunten A. Best practice in the management of behavioural and psychological symptoms of dementia. Ther Adv Neurol Disord. 2017; 10(8): 297-309.

Torrisi M, De Cola MC, Marra A, De Luca R, Bramanti P, Calabro RS. Neuropsychiatric symptoms in dementia may predict caregiver burden: a Sicilian exploratory study. Psychogeriatrics. 2017; 17(2): 103-107.

Most read articles by the same author(s)