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This version was published on June 1, 2008
American Journal of Alzheimer's Disease and Other Dementias®, Vol. 23, No. 3, 242-249 (2008)
DOI: 10.1177/1533317507313676

The Progression of Behavior in Dementia: An In-Office Guide for Clinicians

Lindy A. Kilik, PhD

Providence Care Mental Health Services Kingston, Department of Psychiatry and Psychology, Queen's University, Kingston

Robert W. Hopkins, PhD

Providence Care Mental Health Services Kingston, hopkinsr{at}queensu.ca, Department of Psychiatry and Psychology, Queen's University, Kingston

Duncan Day, PhD

Providence Care Mental Health Services Kingston, Department of Psychiatry and Psychology, Queen's University, Kingston

Christopher R. Prince, PhD

The Royal Ottawa Hospital Care Group, Ottawa Ontario, Canada

Pamela N. Prince, PhD

The Royal Ottawa Hospital Care Group, Ottawa Ontario, Canada

Catharine Rows, RPN

Providence Care Mental Health Services Kingston

This article examines the progression of behavioral changes in 200 community living and long term care patients using the Kingston Standardized Behavioral Assessment, a measure of traditional neuropsychiatric behaviors (behavioral and psychological symptoms of dementia) and neuropsychological behaviors. A group of patients diagnosed with probable Alzheimer's disease or mixed dementia (Alzheimer's disease and vascular dementia), was assessed using the Kingston Standardized Behavioral Assessment, ranked by total Kingston Standardized Behavioral Assessment score and were divided into quartile-based groups. The scores revealed changes in behavior patterns across quartiles. Significant behavior change appeared even in quartile one. Lower scores were predominantly associated with neuropsychological behaviors; as scores increased, neuropsychiatric behaviors became equally common. An at-a-glance guide characterizing the patterns of increasing behavioral change is provided for clinicians. Behavioral changes appear both early and throughout dementia; the type and pattern of these emerging behaviors change as the disease progresses. Clinicians can use the typical patterns of behavioral change to identify behavioral impairment in individual patients and anticipate future changes and related care needs.

Key Words: BPSD • behavior scales • behavior disturbances • Kingston Scales • dementia • Alzheimer's disease • behavior disorders • behavioral assessment • assessment of dementia • psychopathology rating scale


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