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A systematic review of the relationship between behavioral and psychological symptoms (BPSD) and caregiver well-being
Feast A, Moniz-Cook E, Stoner C, Charlesworth G, Orrell M.. International psychogeriatrics, 2016-06-27
Topic: Risk, prevention and care in population studies
Background Behavioral and psychological symptoms in dementia (BPSD) are important predictors of institutionalization as well as caregiver burden and depression. Previous reviews have tended to group BPSD as one category with little focus on the role of the individual symptoms. This review investigates the role of the individual symptoms of BPSD in relation to the impact on different measures of family caregiver well-being. Methods Systematic review and meta-analysis of papers published in English between 1980 and December 2015 reporting which BPSD affect caregiver well-being. Paper quality was appraised using the Downs and Black Checklist (1998). Results Forty medium and high quality quantitative papers met the inclusion criteria, 16 were suitable to be included in a meta-analysis of mean distress scores. Depressive behaviors were the most distressing for caregivers followed by agitation/aggression and apathy. Euphoria was the least distressing. Correlation coefficients between mean total behavior scores and mean distress scores were pooled for four studies. Irritability, aberrant motor behavior and delusions were the most strongly correlated to distress, disinhibition was the least correlated. Conclusions The evidence is not conclusive as to whether some BPSD impact caregiver well-being more than others. Studies which validly examined BPSD individually were limited, and the included studies used numerous measures of BPSD and numerous measures of caregiver well-being. Future research may benefit from a consistent measure of BPSD, examining BPSD individually, and by examining the causal mechanisms by which BPSD impact well-being by including caregiver variables so that interventions can be designed to target BPSD more effectively.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Feast, A., Moniz-Cook, E., Stoner, C., Charlesworth, G., & Orrell, M. (2016). A systematic review of the relationship between behavioral and psychological symptoms (BPSD) and caregiver well-being. International psychogeriatrics. https://doi.org/10.1017/s1041610216000922
Vancouver
Feast A, Moniz-Cook E, Stoner C, Charlesworth G, Orrell M. A systematic review of the relationship between behavioral and psychological symptoms (BPSD) and caregiver well-being. International psychogeriatrics. 2016. doi:10.1017/s1041610216000922. PMID: 27345942.
BibTeX
@article{feast2016-27345942,
author = {Feast, A. and Moniz-Cook, E. and Stoner, C. and Charlesworth, G. and Orrell, M.},
title = {{A systematic review of the relationship between behavioral and psychological symptoms (BPSD) and caregiver well-being}},
journal = {International psychogeriatrics},
year = {2016},
doi = {10.1017/s1041610216000922},
pmid = {27345942},
url = {https://doi.org/10.1017/s1041610216000922}
}
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Key findings
- Results Forty medium and high quality quantitative papers met the inclusion criteria, 16 were suitable to be included in a meta-analysis of mean distress scores.
Why it matters
This review of 40 papers found depressive behaviors, agitation/aggression and apathy were most distressing to caregivers, but concluded the evidence is not conclusive about whether some symptoms affect caregiver well-being more than others. It offers no treatment or cure for Alzheimer's disease itself.
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Study details
- Study designsystematic review
- Evidence strengthHigh
How this study scored 64/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for sample size, effect reported and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (International psychogeriatrics) |
| Journal's citation record | 2 / 4 | International Psychogeriatrics: journal h-index 161 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2016 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 5 / 7 | Cited 286 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 23.8 citations a year over 12 year(s) since 2016 |
| Impact for its field and year | 3 / 6 | Cited 3.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 18 other studies in this library |
| Still being cited | 3 / 4 | Cited 81 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Martin William Orrell: h-index 88 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University College London: institution h-index 2,029 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 27345942) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 64 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1017/s1041610216000922
- PubMed: 27345942
- Original source →
- Free full text: International Psychogeriatrics →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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