Abstract
Objectives
Caring for people with Korsakoff syndrome (KS) residing in specialized long-term care
facilities (LTCFs) can be distressing because of challenging neuropsychiatric symptoms
(NPS). However, good-quality studies on NPS in this under-researched population are
lacking. This study examined the prevalence and severity of NPS in people with KS
living in specialized LTCFs and the associated caregiver distress.
Design
Cross-sectional, observational study. Data were obtained using structured interviews
with care staff, elderly care physicians, and residents.
Setting
Nine specialized LTCFs in the Netherlands.
Participants
KS residents admitted for at least 3 months.
Measurements
The prevalence and severity of NPS were measured with the Neuropsychiatric Inventory–Questionnaire
(NPI-Q). The associated caregiver distress was assessed with the NPI Distress Scale
(NPI-D) according to the nurse or nurse assistant.
Results
Almost all of the 281 residents (96.4%) showed at least 1 NPS and 45.8% showed 5 or
more symptoms. Irritability/lability (68.3%), agitation/aggression (58.7%), and disinhibition
(52.7%) were most prevalent. Although the mean level of severity for all NPS was relatively
low, half of the residents (49.1%) had at least 1 severe NPS. Care staff experienced
low levels of distress associated with NPS.
Conclusion
NPS are highly prevalent in KS residents. Unexpectedly, these did not have any severe
impact on residents and care staff. Acquiring more insight into the persistence and
course of NPS, and its associations, among KS residents is important to better understand
and reduce these symptoms and, ultimately, improve the quality of care for these residents.
Keywords
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References
- An international perspective on the prevalence of the Wernicke-Korsakoff syndrome.Metab Brain Dis. 1995; 10: 17-24
- Brain lesions in alcoholics. A neuropathological study with clinical correlations.J Neurol Sci. 1982; 56: 233-248
- Alcohol-related brain damage: Not a silent epidemic.Br J Psychiatry. 2009; 194: 287-288
- Organic Psychiatry: The Psychological Consequences of Cerebral Disorder.3rd ed. Blackwell Science, Oxford1998
- Alcohol-related cognitive impairment and the DSM-5.Tijdschr Psychiatr. 2016; 58: 397-401
- The Korsakoff syndrome: Clinical aspects, psychology and treatment.Alcohol Alcohol. 2009; 44: 148-154
- Revisiting the continuum hypothesis: Toward an in-depth exploration of executive functions in Korsakoff syndrome.Front Hum Neurosci. 2014; 8: 498
- Korsakoff's syndrome on the MMPI-2.Acta Neuropsychiatr. 2002; 14: 231-236
- The evolution and treatment of Korsakoff's syndrome: Out of sight, out of mind?.Neuropsychol Rev. 2012; 22: 81-92
- Self-awareness of cognitive dysfunction: Self-reported complaints and cognitive performance in patients with alcohol-induced mild or major neurocognitive disorder.Psychiatry Res. 2016; 245: 291-296
- The Wernicke–Korsakoff Syndrome and Related Neurological Disorders Due to Alcoholism and Malnutrition.2nd ed. F.A. Davis, Philadelphia, PA1989
- Cognitive and behavioral aspects of Korsakoff’s syndrome: The effect of special Korsakoff wards in a general psychiatric hospital.Tijdschr Alcohol Drugs Andere Psychotrope Stoffen. 1994; 20: 20-31
- The course of alcohol amnestic disorder: A three-year follow-up study of clinical signs and social disabilities.Acta Psychiatr Scand. 1992; 86: 240-246
- Patients with Korsakoff syndrome in nursing homes: Characteristics, comorbidity, and use of psychotropic drugs.Int Psychogeriatr. 2014; 26: 115-121
- Patients with Korsakoff's syndrome in a nursing home: Characteristics and comorbidity.Tijdschr Gerontol Geriatr. 2000; 31: 113-118
- Dealing With Aggression and Korsakoff.Korsakov Kenniscentrum & Hogeschool Inholland, Rotterdam2012
- Healthcare professionals' dilemmas: Judging patient's decision making competence in day-to-day care of patients suffering from Korsakoff's syndrome.Med Health Care Philos. 2014; 17: 633-640
- S.S. Korsakoff’s psychic disorder in conjunction with peripheral neuritis: A translation of Korsakoff’s original article with brief comments on the author and his contribution to clinical medicine.Neurology. 1955; 5: 394-406
- Prevalence and severity of behavioural symptoms in patients with Korsakoff syndrome and other alcohol-related cognitive disorders: A systematic review.Int J Geriatr Psychiatry. 2017; 32: 256-273
- The neuropsychology of cognitive functions in alcohol abstinence.Tijdschr Psychiatr. 2013; 55: 101-111
- Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory.J Neuropsychiatry Clin Neurosci. 2000; 12: 233-239
- The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia.Neurology. 1994; 44: 2308-2314
- Neuropsychiatric Inventory Questionnaire (NPI-Q): A validity study of the Dutch form.Tijdschr Gerontol Geriatr. 2003; 34: 74-77
- Assessing the impact of neuropsychiatric symptoms in Alzheimer's disease: The Neuropsychiatric Inventory Caregiver Distress Scale.J Am Geriatr Soc. 1998; 46: 210-215
- Scaling ADLs within the MDS.J Gerontol A Biol Sci Med Sci. 1999; 54: M546-M553
- MDS Cognitive Performance Scale.J Gerontol. 1994; 49: M174-M182
- A revised index for social engagement for long-term care.J Gerontol Nurs. 2008; 34: 40-48
- The effect of depression on social engagement in newly admitted Dutch nursing home residents.Gerontologist. 2003; 43: 213-218
- Behavioral limitations that brain injured patients tend to underestimate.Clin Neuropsychol. 1990; 4: 163-176
- Measurement of impaired self-awareness after traumatic brain injury: A comparison of the patient competency rating scale and the awareness questionnaire.Brain Inj. 2003; 17: 25-37
- The prevalence and course of neuropsychiatric symptoms in nursing home patients with dementia: A systematic review.J Am Med Dir Assoc. 2013; 14: 161-169
- Nurses in distress? An explorative study into the relation between distress and individual neuropsychiatric symptoms of people with dementia in nursing homes.Int J Geriatr Psychiatry. 2014; 29: 384-391
- Prevalence and correlates of neuropsychiatric symptoms in nursing home patients with young-onset dementia: The BEYOnD study.J Am Med Dir Assoc. 2016; 17: 495-500
- Frontotemporal dementia: Behavioral symptoms and caregiver distress.Dement Geriatr Cogn Disord. 2004; 18: 299-306
- Neuropsychological correlates of apathy in mild cognitive impairment and Alzheimer's disease: The role of executive functioning.Int Psychogeriatr. 2011; 23: 1327-1333
- Function and dysfunction of prefrontal brain circuitry in alcoholic Korsakoff's syndrome.Neuropsychol Rev. 2012; 22: 154-169
- Executive functioning in chronic alcoholism and Korsakoff syndrome.J Clin Exp Neuropsychol. 2013; 35: 501-508
- Comorbidity of alcoholism and psychiatric disorders. An overview.Alcohol Res Health. 2002; 26: 81-89
- Confabulation behavior and false memories in Korsakoff's syndrome: Role of source memory and executive functioning.Psychiatry Clin Neurosci. 2008; 62: 220-225
- Course of neuropsychiatric symptoms in residents with dementia in nursing homes over 2-year period.Am J Geriatr Psychiatry. 2010; 18: 1054-1065
- Severity of neuropsychiatric symptoms in nursing home residents.Dement Geriatr Cogn Dis Extra. 2016; 6: 28-42
- Neuroleptic drugs in dementia: Benefits and harm.Nat Rev Neurosci. 2006; 7: 492-500
- An Empathic Directive Approach: Caring for People With Korsakoff Syndrome.Stichting Saffier, The Hague2008
Article info
Publication history
Published online: October 24, 2017
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
