The Burden of Behavioural and Psychological Symptoms in Dementia (BPSD) in Post-Diagnostic Memory Services

Introduction:

BPSD significantly impact patient wellbeing and caregiver burden [1]. The Cardiff and Vale Memory Service provides integrated assessment, diagnosis and post-diagnostic care to around 5000 community-dwelling people with dementia (PwD) across South Wales. BPSD frequently prompt escalation to the multidisciplinary team (MDT). This project aimed to evaluate the burden of BPSD within the service.

Method:

Over 5 weeks, surveys were completed for patients discussed at the MDT with BPSD concerns. The survey captured number and type of BPSD features, demographics and routine clinical information.

Data was analysed to identify common symptoms and explore associations between symptom burden and service involvement.

Results:

Over 5 weeks, 111 patients were discussed at MDT, 59 with BPSD (53.15%). The mean number of BPSD features per patient was 3 (60.38% of patients exhibited ≥3 symptoms).

Agitation or aggression predominated (81.13%), followed by night-time behavioural disturbance (49.06%) and delusions or hallucinations (49.06%).

Across total recorded symptoms (n= 159), behavioural symptoms accounted for 52%; mood for 28%, and psychotic symptoms for 19%.

Patients with ≥3 symptoms were more likely to have a package of care (62.5% vs 33.33%) and mental health involvement (34.36% vs 19.04%).

Conclusions:

Patients escalated to MDT exhibited substantial BPSD burden. Higher symptom loads were associated with increased reliance on both social care packages and mental health services. This indicates significant resource pressures and reinforces the need for proactive identification, patient‑centred multidisciplinary working, and structured post‑diagnostic support. Such targeted approaches may help to reduce demand on healthcare services and improve overall care for PwD.

Bibliography

1. National Institute for Health and Care Excellence. Dementia: assessment, management and support for people living with dementia and their carers (NG97). London: NICE; 2018 [accessed 5 Feb 2026]. Available from: https://www.nice.org.uk/guidance/ng97