Determinants of behavioral and psychological symptoms of dementia: A scoping review of the evidence

Ann Kolanowski, Marie Boltz, Elizabeth Galik, Laura N. Gitlin, Helen C. Kales, Barbara Resnick, Kimberly S. Van Haitsma, Amy Knehans, Jane E. Sutterlin, Justine S. Sefcik, Wen Liu, Darina V. Petrovsky, Lauren Massimo, Andrea Gilmore-Bykovskyi, Margaret MacAndrew, Glenna Brewster, Vycki Nalls, Ying Ling Jao, Naomi Duffort, Danny Scerpella

Research output: Contribution to journalArticlepeer-review

103 Scopus citations


Background Behavioral and psychological symptoms of dementia (BPSD) are prevalent in people with neurodegenerative diseases. Purpose In this scoping review the Kales, Gitlin and Lykestos framework is used to answer the question: What high quality evidence exists for the patient, caregiver and environmental determinants of five specific BPSD: aggression, agitation, apathy, depression and psychosis? Method An a priori review protocol was developed; 692 of 6013 articles retrieved in the search were deemed eligible for review. Gough's Weight of Evidence Framework and the Cochrane Collaboration's tool for assessing risk of bias were used. The findings from 56 high quality/low bias articles are summarized. Discussion Each symptom had its own set of determinants, but many were common across several symptoms: neurodegeneration, type of dementia, severity of cognitive impairments, and declining functional abilities, and to a lesser extent, caregiver burden and communication. Conclusion Research and policy implications are relevant to the National Plan to Address Alzheimer's Disease.

Original languageEnglish (US)
Pages (from-to)515-529
Number of pages15
JournalNursing outlook
Issue number5
StatePublished - Sep 2017

All Science Journal Classification (ASJC) codes

  • General Nursing


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