The prevalence and course of neuropsychiatric symptoms in nursing home patients with dementia: a systematic review

J Am Med Dir Assoc. 2013 Mar;14(3):161-9. doi: 10.1016/j.jamda.2012.09.027. Epub 2012 Nov 16.


Background: Persons with dementia frequently exhibit neuropsychiatric symptoms (NPSs). Previous studies have indicated that the prevalence is particularly high in nursing home (NH) patients. However, differences in methodology in studies of the prevalence and course of NPSs have made it difficult to compare their results.

Methods: We searched the electronic databases MEDLINE, EMBASE, PsycINFO, Ovid Nursing, and AgeLine from their inception until July 2012 using medical subject headings to identify studies that reported figures on the prevalence and course of NPSs in NH patients with dementia.

Results: A total of 28 studies met the inclusion criteria. In total, 8468 and 1458 persons participated in the prevalence and longitudinal studies, respectively. The weighted mean prevalence of having at least one NPS was 82%. Although the prevalence of individual symptoms varied, the highest prevalence figures were found for agitation and apathy. The persistence of individual NPSs varied substantially, but in these studies, having at least one NPS was highly persistent across the studies.

Conclusion: This review confirms that clinically significant NPSs are common in NH patients with dementia. Even though great variability exists across studies, recent studies applying similar methodology have made comparisons between studies feasible, revealing relatively consistent prevalence patterns for individual symptoms. The natural course of symptoms deserves closer attention. This is vital in planning prevention and treatment of NPSs in NH patients with dementia.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Dementia / psychology*
  • Humans
  • Mental Disorders / epidemiology*
  • Mental Disorders / psychology
  • Neuropsychological Tests
  • Nursing Homes*
  • Prevalence