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Clinical Manifestations.

Olufisayo Oluyinka Elugbadebo1,2, Olusegun Baiyewu3, Hephzibah Oyedapo-Ishola4

  • 1College of Medicine, University of Ibadan, Ibadan, Nigeria.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
PubMed
Summary
This summary is machine-generated.

Behavioral and Psychological Symptoms of Dementia (BPSD) are common in older adults with cognitive impairment. Depression and appetite changes were frequent, causing significant caregiver distress, especially in the dementia group.

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Area of Science:

  • Gerontology
  • Neuroscience
  • Psychiatry

Background:

  • Behavioral and Psychological Symptoms of Dementia (BPSD) are integral to dementia, causing caregiver distress and impacting mortality.
  • Limited research exists on BPSD in the oldest-old with cognitive impairment in developing nations.
  • This study investigates BPSD in survivors of the Indianapolis-Ibadan Dementia Project.

Purpose of the Study:

  • To appraise the prevalence and severity of BPSD in the oldest-old population in Ibadan, Nigeria.
  • To assess the level of caregiver distress associated with BPSD in different cognitive diagnostic groups.
  • To identify specific BPSD and their impact on caregivers within this demographic.

Main Methods:

  • Re-examination of survivors from the Ibadan arm of the Indianapolis-Ibadan Dementia Project (enrolled 1992/2001, re-examined 2021/2022).
  • Neuropsychological assessment using the CERAD Neuropsychological battery.
  • Diagnosis based on DSM IV TR and NIA criteria (normal cognition, MCI, dementia); BPSD assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q).

Main Results:

  • 135 survivors (mean age 92.5 years) were assessed: 46.1% normal cognition, 32.4% MCI, 21.5% dementia.
  • Depression was the most frequent BPSD in MCI (27.3%) and dementia (34.5%) groups.
  • Dementia group had highest BPSD severity (4.20 ± 4.49); appetite change was most severe. Caregiver distress highest in dementia group (2.21 ± 4.14), with appetite change and depression causing most distress.

Conclusions:

  • Depression and associated caregiver distress are prevalent across all cognitive diagnostic groups in the oldest-old.
  • Findings underscore the need for targeted interventions for depression and other BPSD in cognitively impaired older adults in developing countries.
  • Addressing caregiver distress is crucial for managing BPSD in this vulnerable population.