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Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging
Lyketsos CG, Steinberg M, Tschanz JT, Norton MC, Steffens DC, Breitner JC.. The American journal of psychiatry, 2000-05-01
Topic: Risk, prevention and care in population studies
Plain-language summary
Objective The authors report findings from a study of 5,092 community residents who constituted 90% of the elderly resident population of Cache County, Utah. Method The 5,092 participants, who were 65 years old or older, were screened for dementia. Based on the results of this screen, 1,002 participants (329 with dementia and 673 without dementia) underwent comprehensive neuropsychiatric examinations and were rated on the Neuropsychiatric Inventory, a widely used method for ascertainment and classification of dementia-associated mental and behavioral disturbances. Results Of the 329 participants with dementia, 214 (65%) had Alzheimer's disease, 62 (19%) had vascular dementia, and 53 (16%) had another DSM-IV dementia diagnosis; 201 (61%) had exhibited one or more mental or behavioral disturbances in the past month. Apathy (27%), depression (24%), and agitation/aggression (24%) were the most common in participants with dementia. These disturbances were almost four times more common in participants with dementia than in those without. Only modest differences were observed in the prevalence of mental or behavioral disturbances in different types of dementia or at different stages of illness: participants with Alzheimer's disease were more likely to have delusions and less likely to have depression. Agitation/aggression and aberrant motor behavior were more common in participants with advanced dementia. Conclusions On the basis of their findings in this large community population of elderly people, the authors conclude that a wide range of dementia-associated mental and behavioral disturbances afflict the majority of individuals with dementia. Because of their frequency and their adverse effects on patients and their caregivers, these disturbances should be ascertained and treated in all cases of dementia.
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APA 7th
Lyketsos, C. G., Steinberg, M., Tschanz, J. T., Norton, M. C., Steffens, D. C., & Breitner, J. C. (2000). Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. The American journal of psychiatry. https://doi.org/10.1176/appi.ajp.157.5.708
Vancouver
Lyketsos CG, Steinberg M, Tschanz JT, Norton MC, Steffens DC, Breitner JC. Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. The American journal of psychiatry. 2000. doi:10.1176/appi.ajp.157.5.708. PMID: 10784462.
BibTeX
@article{lyketsos2000-10784462,
author = {Lyketsos, C. G. and Steinberg, M. and Tschanz, J. T. and Norton, M. C. and Steffens, D. C. and Breitner, J. C.},
title = {{Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging}},
journal = {The American journal of psychiatry},
year = {2000},
doi = {10.1176/appi.ajp.157.5.708},
pmid = {10784462},
url = {https://doi.org/10.1176/appi.ajp.157.5.708}
}
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Key findings
- Based on the results of this screen, 1,002 participants (329 with dementia and 673 without dementia) underwent comprehensive neuropsychiatric examinations and were rated on the Neuropsychiatric Inventory, a widely used method for ascertainment and classification of dementia-associated mental and behavioral disturbances.
- Results Of the 329 participants with dementia, 214 (65%) had Alzheimer's disease, 62 (19%) had vascular dementia, and 53 (16%) had another DSM-IV dementia diagnosis; 201 (61%) had exhibited one or more mental or behavioral disturbances in the past month.
- Conclusions On the basis of their findings in this large community population of elderly people, the authors conclude that a wide range of dementia-associated mental and behavioral disturbances afflict the majority of individuals with dementia.
Why it matters
In a community study of people aged 65 and over in Cache County, Utah, 61% of the 329 participants with dementia had at least one mental or behavioral disturbance in the past month, most often apathy (27%), depression (24%) and agitation/aggression (24%), and such disturbances were almost four times more common than in participants without dementia. Because of how often these symptoms occur and their effects on patients and caregivers, the authors conclude they "should be ascertained and treated in all cases of dementia." The study counted symptoms at one point in time; it did not test any treatment.
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Study details
- Participants5,092
- Evidence strengthLow
How this study scored 60/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The American journal of psychiatry) |
| Journal's citation record | 4 / 4 | American Journal of Psychiatry: journal h-index 549 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2000 — older than 20 years, still counted |
| Sample size | 3 / 4 | 5,092 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 7 / 7 | Cited 1,130 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 40.4 citations a year over 28 year(s) since 2000 |
| Impact for its field and year | 5 / 6 | Cited 22.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 35 other studies in this library |
| Still being cited | 3 / 4 | Cited 56 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author John C.S. Breitner: h-index 93 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Johns Hopkins University: institution h-index 2,306 (OpenAlex) |
| Multicenter collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 10784462) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 60 / 100 | — |
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