Background: Behavioral and psychological symptoms of dementia (BPSD) are a major contributor to high levels of carer burden and poor quality of life in patients with dementia. Optimal management is yet to be determined. It is imperative to understand the occurrence of BPSD with the severity of cognitive impairment, since this would allow caregivers and healthcare workers to predict likely behavioral and psychological issues.

Aims: To describe the patterns of BPSD among patients admitted to the National Institute of Mental Health (NIMH), Sri Lanka and its association with the degree of cognitive impairment.

Methods: A cross-sectional descriptive study was carried out among patients diagnosed with dementia admitted to NIMH over a two-year period from 2013. An interviewer administered questionnaire, the mini mental state examination and the Neuropsychiatric Inventory (NPI) were used.

Results: Of the total 122 patients, 51.6% were females. The mean age was 71.2 years. According to the MMSE scores, the severity of dementia was mild, moderate and severe in 32.8%, 42.6% and 24.6% participants respectively. All were on pharmacological treatment in the form of antipsychotics and/or acetylcholinesterase inhibitors. A majority (96.72%) had BPSD. Frequent symptoms included delusions (42.6%), irritability (41%), appetite changes (34.4%) and depression (32%). Aberrant motor behavior, sleep and night-time behavior disorders were significantly associated with increased severity of dementia, while irritability, disinhibition, agitation, hallucinations and delusions were significantly higher in moderate dementia. Anxiety and depression were mostly seen in mild dementia.

Conclusion: A majority of participants had BPSD, despite being on pharmacological treatment. There was a statistically significant prevalence in groups of symptoms, according to the degree of cognitive impairment can be seen.