Obsessive-compulsive symptoms in dementia: Systematic review with meta-analysis

Area of Science:

• Neuroscience
• Psychiatry
• Gerontology

Background:

• Dementia is a prevalent syndrome characterized by cognitive deficits and functional impairment.
• Neuropsychiatric symptoms, including obsessive-compulsive symptoms (OCS), frequently co-occur with dementia.

Purpose of the Study:

• To conduct a meta-analysis to determine the prevalence of OCS in patients with dementia.
• To describe the types of obsessions and compulsions observed in dementia.

Main Methods:

• A systematic search of MEDLINE, CENTRAL, and Psycnet databases was performed up to March 2023.
• The Joanna Briggs Institute Critical Appraisal Checklist was used for quality assessment.
• Prevalence data and types of OCS were extracted and analyzed.

Main Results:

• Thirty studies with 37 cohorts were included, analyzing 643 initially screened articles.
• The overall prevalence of OCS in dementia was 35.3% (95% CI: 23.1-47.6%).
• OCS were more prevalent in frontotemporal dementia (48.4%, 95% CI: 29.8-67.0%) compared to other dementia types (17.6%, 95% CI: 9.1-26.2%).
• Common obsessions included symmetry (28.6%) and somatic concerns (20.0%); common compulsions included checking (27.4%) and hoarding (27.8%).

Conclusions:

• OCS are notably prevalent in dementia, especially frontotemporal dementia.
• Heterogeneity in prevalence estimates may be linked to diagnostic criteria and assessment methods.
• Improved, standardized instruments are needed for reliable OCS assessment in dementia populations.