Behavioural and psychological symptoms of early‐onset and late‐onset Alzheimer's disease among Chinese adults

Dear Editor, We read with interest the report by Fang et al. on the comparison of behavioural and psychological symptoms of dementia (BPSD) in Chinese patients with early-onset Alzheimer’s disease (EOAD) and late-onset Alzheimer’s disease (LOAD) and the analysis of the modifiable factors. The authors reported significant differences in BPSD between the EOAD and LOAD groups at baseline. We would like to discuss their result in detail below. Fang et al. reported that worse caregiver attitudes were associated with more severe overall psychobehavioural symptoms in the EOAD group. Additionally, the authors showed that an improvement in BPSD was associated with positive attitudes and fewer expressions of criticism. We agree that positive aspects of caregiving are important. However, previous longitudinal studies have reported that BPSD impacts caregiver burden. We believe that both positive and negative aspects of caregiving are important. We wonder if caregiver burden of negative aspects among caregivers may be considered a confounding factor. Therefore, we are interested in an analysis of the negative aspects with regard to caregivers in this study. Undoubtedly, it is important to focus on BPSD in patients with EOAD and LOAD. Fang et al. provide useful data on the same. We believe that focusing on BPSD may support caregiving at home for Chinese patients with EOAD and LOAD in the future.