Caffeine Consumption and Behavioral Symptoms in Nursing Home Residents: A Cross-Sectional Analysis.

OBJECTIVE: Although behavioral changes are common in nursing home residents with dementia and caffeine is known to influence behavior in healthy adults, the effects of caffeine on the behavior of persons with dementia has received little attention. In this study we assessed the relationship of caffeine and behavioral symptoms in older persons with dementia. DESIGN: A multicenter sub-cohort study embedded in the Elderly Care Physicians (ECP) training program. SETTING: Dutch nursing homes associated with the ECP training program. PARTICIPANTS: A total of 206 individuals with both diabetes and dementia resident in Dutch nursing homes. MEASUREMENTS: Trainee ECPs collected data on caffeine consumption, cognition and behavioral symptoms using the NPI-NH, MDS-DRS and AES-C. Data on factors known to influence behavior in persons with dementia (e.g. marital status, kidney function, urinary tract infection and medication) were also collected. RESULTS: Of the 206 participants, 70% showed behavioral symptoms. An increase in caffeine consumption was associated with a decrease in the presence of behavioral symptoms in the NPI-NH cluster affect and NPI-NH item agitation. Caffeine consumption groups also differed on the presence of disinhibition and depression. In addition, the severity of dementia influenced agitation, anxiety and the clusters affect and psychomotor. CONCLUSION: In a large group of older persons with dementia resident in nursing homes, a low daily consumption of caffeine was associated with greater behavioral symptoms.