Open Access Open Badges Study protocol

Neuropsychiatric symptoms in patients with dementia in primary care: a study protocol

Petra Borsje12*, Roland B Wetzels1, Peter LBJ Lucassen1, Anne-Margriet Pot34 and Raymond TCM Koopmans1

Author Affiliations

1 Department of Primary and Community Care, Radboud university medical centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands

2 Thebe, Region South-East, Bergstraat 6, Goirle 5051 HC, The Netherlands

3 Department of Clinical Psychology, Faculty of Psychology and Education, VU University Amsterdam, Van der Boechorststraat 1, Amsterdam 1081 BT, The Netherlands

4 Trimbos Institute, Netherlands Institute of mental Health and Addiction, Da Costakade 45, Utrecht 3521 VS, The Netherlands

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BMC Geriatrics 2014, 14:32  doi:10.1186/1471-2318-14-32

Published: 17 March 2014



Neuropsychiatric symptoms (NPS) frequently occur in patients with dementia. To date, prospective studies on the course of NPS have been conducted in patients with dementia in clinical centers or psychiatric services. The primary goal of this study is to investigate the course of NPS in patients with dementia and caregiver distress in primary care. We also aim to detect determinants of both the course of NPS in patients with dementia and informal caregiver distress in primary care.


This is a prospective observational study on the course of NPS in patients with dementia in primary care. Thirty-seven general practitioners (GPs) in 18 general practices were selected based on their interest in participating in this study. We will retrieve electronic medical files of patients with dementia from these general practices. Patients and caregivers will be followed for 18 months during the period January 2012 to December 2013. Patient characteristics will be collected at baseline. Time to death or institutionalization will be measured. Co-morbidity will be assessed using the Charlson index. Psychotropic drug use and primary and secondary outcome measures will be measured at 3 assessments, baseline, 9 and 18 months. The primary outcome measures are the Neuropsychiatric Inventory score for patients with dementia and the Sense of Competence score for informal caregivers. In addition to descriptive analyses frequency parameters will be computed. Univariate analysis will be performed to identify determinants of the course of NPS and informal caregiver distress. All determinants will then be tested in a multivariate regression analysis to determine their unique contribution to the course of NPS and caregiver distress.


The results of this study will provide data on the course of NPS, which is clinically important for prognosis. The data will help GPs and other professionals in planning follow-up visits and in the timing for offering psycho-education, psychosocial interventions and the provision of care. In addition, these data will enlarge health professionals’ awareness of NPS in their patients with dementia.

Dementia; Neuropsychiatric symptoms; Primary care; Longitudinal; Observational; Quality of life; Caregiver distress