# Identifying central behavioral and psychological symptoms associated with care time in older adults with dementia: a network analysis

## TL;DR

This study uses network analysis to identify which dementia-related behaviors most strongly affect care time for older adults, highlighting agitation, irritability, and abnormal motor behaviors.

## Contribution

The study introduces a network analysis approach to reveal central and bridging BPSD symptoms linked to care time in dementia patients.

## Key findings

- Irritability and agitation/aggression were identified as central nodes in the network.
- Aberrant motor behaviors and agitation/aggression acted as key bridge nodes connecting BPSD symptoms to care time.
- Caregiver distress from these symptoms also emerged as central and bridging factors.

## Abstract

While behavioral and psychological symptoms of dementia (BPSD) are generally associated with care time, the strength and nature of these associations may vary across individual symptoms.

To examine these nuanced associations using a network perspective among older adults with dementia, thereby yielding more comprehensive insights.

A cross-sectional study design was employed.

Between December 2022 and May 2023, 205 Chinese older adults with dementia were recruited from two nursing homes in Guangzhou. BPSD severity and caregiver distress were assessed using the Neuropsychiatric Inventory (NPI). The Per-Minute Care Intensity method was used to quantify the amount of formal care time received within a 24-h period. Network analysis was conducted to illustrate the complex nuanced relationships between specific BPSD symptoms and corresponding care time.

Network analysis identified “irritability” and “agitation/aggression” severity, along with the caregiver distress caused by these two symptoms, as central nodes in two separate networks. In addition, the severity of “aberrant motor behaviors” and “agitation/aggression,” as well as the related caregiver distress, emerged as key bridge nodes connecting BPSD symptoms with care time.

These findings provide preliminary evidence of potential pathways through which specific BPSD symptoms are linked to care time in older adults with dementia. This underscores the importance of prioritizing targeted interventions for central and bridge symptoms such as agitation, irritability, and abnormal motor behavior. Future intervention studies are warranted to validate these findings and further refine strategies for optimizing care practice.

No patient or public contribution.

A deeper understanding of the intricate connections between specific BPSD symptoms and corresponding care time will help administrators prioritize symptoms such as agitation and irritability when designing interventions aimed at reducing caregiver burden.