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Relation between caffeine and behavioral symptoms in elderly patients with dementia: An observational study

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The journal of nutrition, health & aging



Caffeine is known to improve concentration and reduce fatigue in healthy adults, but high doses may induce anxiety and agitation. Because the effects of caffeine in elderly people with dementia are unknown, this study explores the relation between caffeine and behavioral symptoms in a group of elderly patients with dementia.


An observational pilot study.


A dementia special care unit of a Dutch nursing home.


A total of 29 elderly patients with dementia.


Behavioral symptoms were measured with the NPI-NH, and sleep and caffeine consumption were measured using questionnaires.


A significant relation was found between the total amount of caffeine consumed during the day and apathy [Kendall’s tau (KT) −0.287 p=0.03], and the number of times that participants got up at night (KT 0.462; p <0.01). The amount of caffeine consumed after 6 p.m. was also significantly related to the number of times participants got up at night (KT 0.436; p <0.01). Multilevel analysis showed caffeine to be negatively correlated with aberrant motor behavior [b=−0.47 (0.22), Wald (461)=−2.12, p=0.03] and apathy [b=−0.88 (0.45), Wald (461)= −1.96, p=0.05], and showed a significant relation between caffeine consumption after 6 p.m. and the number of times participants got up at night [b=0.48 (0.22), Wald (461)= 2.20, p=0.03].


This study established an association between caffeine consumption and behavioral symptoms in elderly patients with moderately severe dementia. Therefore, adjusting caffeine consumption could be part of an interdisciplinary approach to behavioral symptoms, particularly when aberrant motor behavior, apathy or sleeping difficulties are involved. These results indicate that further research on the effects of caffeine on behavioral symptoms in dementia is warranted.

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  1. Pohanka M, Dobes P (2013) Caffeine inhibits acetylcholinesterase, but not butyrylcholinesterase. Int J Mol Sci May 8;14(5):9873–9882.

    Article  Google Scholar 

  2. Canas PM, Porciuncula LO, Cunha GM, et al (2009) Adenosine A2A receptor blockade prevents synaptotoxicity and memory dysfunction caused by beta-amyloid peptides via p38 mitogenactivated protein kinase pathway. J Neurosci 29:14741–14751.

    Article  CAS  PubMed  Google Scholar 

  3. Espinosa J, Rocha A, Nunes F, et al (2013) Caffeine consumption prevents memory impairment, neuronal damage, and adenosine A2A receptors upregulation in the hippocampus of a rat model of sporadic dementia. J Alzheimers Dis Jan 1;34(2):509–518.

    CAS  Google Scholar 

  4. Smith A (2002) Effects of caffeine on human behavior. Food Chem Toxicol Sep;40(9):1243–1255.

    Article  CAS  PubMed  Google Scholar 

  5. Zuidema SU, Derksen E, Verhey FR, Koopmans RT (2007) Prevalence of neuropsychiatric symptoms in a large sample of Dutch nursing home patients with dementia. Int J Geriatr Psychiatry Jul;22(7):632–638.

    Article  PubMed  Google Scholar 

  6. Tariot PN (2003) Medical management of advanced dementia. J Am Geriatr Soc May;51(5 Suppl Dementia):S305–S313.

    Article  PubMed  Google Scholar 

  7. Vernooij-Dassen M, Vasse E, Zuidema S, Cohen-Mansfield J, Moyle W (2010) Psychosocial interventions for dementia patients in long-term care. Int Psychogeriatr Nov;22(7):1121–1128.

    Article  PubMed  Google Scholar 

  8. Reisberg B, Ferris SH, Franssen E (1985) An ordinal functional assessment tool for Alzheimer’s-type dementia. Hosp Commun Psychiatry 36: 593–595.

    CAS  Google Scholar 

  9. Stephenson PE (1977) Physiologic and psychotropic effects of caffeine on man. A review. J Am Diet Assoc Sep;71(3):240–247.

    CAS  Google Scholar 

  10. Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J (1994) The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology Dec;44(12):2308–2314.

    Article  CAS  PubMed  Google Scholar 

  11. Cummings JL (1997) The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology 48(suppl 6):S10–S16.

    Article  CAS  PubMed  Google Scholar 

  12. Zuidema SU, Buursema AL, Gerritsen MG, et al (2011) Assessing neuropsychiatric symptoms in nursing home patients with dementia: reliability and Reliable Change Index of the Neuropsychiatric Inventory and the Cohen-Mansfield Agitation Inventory. Int J Geriatr Psychiatry Feb;26(2):127–134.

    Article  PubMed  Google Scholar 

  13. Cerejeira J, Lagarto L, Mukaetova-Ladinska EB (2012) Behavioral and psychological symptoms of dementia. Front Neurol. 3:73.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Cummings JL, Koumaras B, Chen M, Mirski D; Rivastigmine Nursing Home Study Team (2005) Effects of rivastigmine treatment on the neuropsychiatric and behavioral disturbances of nursing home residents with moderate to severe probable Alzheimer’s disease: a 26-week, multicenter, open-label study. Am J Geriatr Pharmacother Sep;3(3):137–148.

    Article  CAS  PubMed  Google Scholar 

  15. Morley JE (2013) Behavioral management in the person with dementia. J Nutr Health Aging Jan;17(1):35–38.

    Article  CAS  PubMed  Google Scholar 

  16. Bombois S, Derambure P, Pasquier F, Monaca C (2010) Sleep disorders in aging and dementia. J Nutr Health Aging Mar;14(3):212–217.

    Article  CAS  PubMed  Google Scholar 

  17. Vecchierini MF (2010) Sleep disturbances in Alzheimer’s disease and other dementias. Psychol Neuropsychiatr Vieil Mar;8(1):15–23.

    PubMed  Google Scholar 

  18. Ginsburg R, Weintraub M (1976) Caffeine in the “sundown syndrome”. Report of negative results. J Gerontol Jul;31(4):419–420.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Michelle A. Kromhout.

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Kromhout, M.A., Jongerling, J. & Achterberg, W.P. Relation between caffeine and behavioral symptoms in elderly patients with dementia: An observational study. J Nutr Health Aging 18, 407–410 (2014).

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