Associations between unmet needs for daytime activities and company and scores on the Neuropsychiatric Inventory-Questionnaire in people with dementia: a longitudinal study

Abstract

Objectives

To examine prospectively the association between unmet needs for daytime activities and company and behavioural and psychological symptoms of dementia.

Methods

We included 451 people with mild or moderate dementia, from eight European countries, who were assessed three times over 12 months. Unmet needs were measured with the Camberwell Assessment of Need for the Elderly. Three sub-syndromes of the Neuropsychiatric Inventory-Questionnaire were regressed, one-by-one, against unmet needs for daytime activities and company, adjusting for demographic and clinical-functional covariates.

Results

Unmet needs for daytime activities were associated with more affective symptoms at baseline, six and twelve months, mean 0.74 (p < 0.001), 0.76 (p < 0.001) and 0.78 (p = 0.001) points higher score respectively, and with more psychotic symptoms at baseline (mean 0.39 points, p = 0.007) and at six months follow-up (mean 0.31 points, p = 0.006). Unmet needs for company were associated with more affective symptoms at baseline, six and twelve months, mean 0.44 (p = 0.033), 0.67 (p < 0.001) and 0.91 (p < 0.001) points higher score respectively, and with more psychotic symptoms at baseline (mean 0.40 points, p = 0.005) and at six months (mean 0.35 points, p = 0.002) follow-up.

Conclusion

Interventions to reduce unmet needs for daytime activities and company could reduce affective and psychotic symptoms in people with dementia.

Keywords:

• Dementia
• needs assessment
• daytime activities
• company
• BPSD

Acknowledgements

Data was from the Actifcare EU Joint Programme – Neurodegenerative Disease Research (JPND) project. The Actifcare Consortium partners are:

Coordinator: Maastricht University (NL): Frans Verhey, Marjolein de Vugt (scientific coordinators, WP1 leader).

Consortium members: Maastricht University (NL): Marjolein de Vugt, Claire Wolfs, Ron Handels, Liselot Kerpershoek. Martin-Luther University Halle-Wittenberg (DE): Gabriele Meyer (WP2 leader), Astrid Stephan, Anja Bieber, Anja Broda, Gabriele Bartoszek. Bangor University (UK): Bob Woods (WP3 leader), Hannah Jelley. Nottingham University (UK): Martin Orrell. Karolinska Institutet (SE): Anders Wimo (WP4 leader), Anders Sköldunger, Britt-Marie Sjölund. Oslo University Hospital (NO): Knut Engedal, Geir Selbaek (WP5 leader), Mona Michelet, Janne Rosvik, Siren Eriksen. Dublin City University (IE): Kate Irving (WP6 leader), Louise Hopper, Rachael Joyce. CEDOC, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa (PT): Manuel Gonçalves-Pereira, Maria J. Marques, Conceiçäo Balsinha, on behalf of the Portuguese Actifcare team (FCT-JPNDHC/0001/2012). Alzheimer’s Research Unit-Memory Clinic, IRCCS Instituto Centro San Giovanni di Dio Fatebenefratelli (IT): Orazio Zanetti, Daniel M. Portolani.

Disclosure statement

Geir Selbaek is a member of the advisory board of Biogen in Norway. The authors report no other conflict of interest.

Additional information

Funding

The Actifcare project was supported through the following funding organisations under the aegis of JPND – www.jpnd.eu. Germany, Ministry of Education and Research, Ireland, Health research board, Italy, Ministry of Health, the Netherlands, The Netherlands Organization for Health Research and Development, Sweden, The Swedish Research Council for Health, Working Life and Welfare, Norway, The Research Council of Norway, Portugal, Foundation for Science and Technology, FCT, United Kingdom, Economic and Social Research Council. The funding body had no influence in the design of the study, nor collection, analysis, and interpretation of data, or in writing the manuscript. JPND has read and approved the protocol of the Actifcare study.

Funding

The Actifcare project was supported through the following funding organisations under the aegis of JPND – www.jpnd.eu. Germany, Ministry of Education and Research, Ireland, Health research board, Italy, Ministry of Health, the Netherlands, The Netherlands Organization for Health Research and Development, Sweden, The Swedish Research Council for Health, Working Life and Welfare, Norway, The Research Council of Norway, Portugal, Foundation for Science and Technology, FCT, United Kingdom, Economic and Social Research Council. The funding body had no influence in the design of the study, nor collection, analysis, and interpretation of data, or in writing the manuscript. JPND has read and approved the protocol of the Actifcare study.