The Behavioral and Psychological Symptoms of Dementia in Down Syndrome scale (BPSD-DS II): Optimization and Further Validation

Alain D Dekker*, Aurora M Ulgiati, Henk Groen, Vincent A Boxelaar, Silvia Sacco, Ségolène Falquero, Angelo Carfi, Antonella di Paola, Bessy Benejam, Silvia Valldeneu, Roelie Fopma, Marjo Oosterik, Marloes Hermelink, Gonny Beugelsdijk, Mieke Schippers, Hepie Henstra, Martine Scholten-Kuiper, Judith Willink-Vos, Lisa de Ruiter, Liesbeth WillemsAnneke Loonstra-de Jong, Antonia M W Coppus, Marleen Tollenaere, Juan Fortea, Graziano Onder, Anne-Sophie Rebillat, Debby Van Dam, Peter P De Deyn

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

8 Citaten (Scopus)
114 Downloads (Pure)


BACKGROUND: People with Down syndrome (DS) are at high risk to develop Alzheimer's disease dementia (AD). Behavioral and psychological symptoms of dementia (BPSD) are common and may also serve as early signals for dementia. However, comprehensive evaluation scales for BPSD, adapted to DS, are lacking. Therefore, we previously developed the BPSD-DS scale to identify behavioral changes between the last six months and pre-existing life-long characteristic behavior.

OBJECTIVE: To optimize and further study the scale (discriminative ability and reliability) in a large representative DS study population.

METHODS: Optimization was based on item irrelevance and clinical experiences obtained in the initial study. Using the shortened and refined BPSD-DS II, informant interviews were conducted to evaluate 524 DS individuals, grouped according to dementia status: no dementia (DS, N = 292), questionable dementia (DS + Q, N = 119), and clinically diagnosed dementia (DS + AD, N = 113).

RESULTS: Comparing item change scores between groups revealed prominent changes in frequency and severity for anxious, sleep-related, irritable, restless/stereotypic, apathetic, depressive, and eating/drinking behavior. For most items, the proportion of individuals displaying an increased frequency was highest in DS + AD, intermediate in DS + Q, and lowest in DS. For various items within sections about anxious, sleep-related, irritable, apathetic, and depressive behaviors, the proportion of individuals showing an increased frequency was already substantial in DS + Q, suggesting that these changes may serve as early signals of AD in DS. Reliability data were promising.

CONCLUSION: The optimized scale yields largely similar results as obtained with the initial version. Systematically evaluating BPSD in DS may increase understanding of changes among caregivers and (timely) adaptation of care/treatment.

Originele taal-2English
Pagina's (van-tot)1505-1527
Aantal pagina's23
TijdschriftJournal of Alzheimer’s Disease
Nummer van het tijdschrift4
Vroegere onlinedatum2021
StatusPublished - 15-jun.-2021

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