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The prevalence of neuropsychiatric symptoms in people with acquired brain injury in nursing homes

Roy Kohnen tweette: "Hiermee zijn de eerste resultaten bekend over neuropsychiatrische symptomen, zoals angst en depressie, bij jonge mensen met niet-aangeboren hersenletsel in de Nederlandse verpleeghuizen". Het artikel, van dit onderzoek, heeft de volgende auteurs: Roy F. Kohnen, MD, Jan C.M. Lavrijsen, MD, PhD, Reinier P. Akkermans, MSc, Debby L. Gerritsen, PhD en Raymond T.C.M. Koopmans, MD, PhD. Klik hier voor de link naar het onderzoek.

Dit is de samenvatting. Objectives. Establishing the prevalence and determinants of neuropsychiatric symptoms (NPS) in patients with acquired brain injury (ABI) in nursing homes. Methods. Nursing homes were recruited through the national expertise network for patients with severe ABI, regional brain injury teams, and by searching the Internet. Patient characteristics were collected through digital questionnaires. NPS were assessed with the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) and the Cohen-Mansfield Agitation Inventory (CMAI), cognition with the Mini-Mental State Examination, and activities of daily living with the Disability Rating Scale. Psychotropic drug use (PDU) was retrieved from the electronic prescription system. Individual NPS were clustered. Associations between determinants and NPS were examined using multilevel multivariate linear regression models.

Results. In a population of 118 patients from 12 nursing homes, 73.7% had 1 or more clinically relevant NPS and 81.3% 1 or more agitated behaviors. The most common NPS were agitation, in particular aberrant motor behavior (24.6%), repetitious sentences/questions (35.5%), and constant requests for attention (34.6%), verbal (33.6%) and physical (50.5%) aggression, and irritability (28.0%). Male patients were more likely to display hyperactivity. Being married was associated with less verbally agitated behavior and pain was associated with a higher CMAI total score. PDU increased the likelihood of a higher NPI-NH total score.

Conclusions and Implications. NPS are common in patients with ABI ≤65 years of age residing in nursing homes. This is a first step to fill in the knowledge gap concerning NPS in this population. An increasing number of patients with severe ABI may survive the acute phase and will reside many years in nursing homes. It is important to shed more light on these NPS, with regard to course, magnitude, and severity, to ultimately develop appropriate care for this vulnerable group of patients.

The prevalence of neuropsychiatric symptoms in people with acquired brain injury in nursing homes