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Assessment and management of behavioral and psychological symptoms of dementia

BMJ (Online), 2015-03, Vol.350 (mar02 7), p.h369-h369 [Peer Reviewed Journal]

BMJ Publishing Group Ltd 2015 ;BMJ Publishing Group Ltd 2015. ;Copyright BMJ Publishing Group LTD Mar 2, 2015 ;Copyright: 2015 (c) BMJ Publishing Group Ltd 2015 ;BMJ Publishing Group Ltd 2015 2015 BMJ Publishing Group Ltd ;ISSN: 0959-8138 ;ISSN: 1756-1833 ;EISSN: 1756-1833 ;DOI: 10.1136/bmj.h369 ;PMID: 25731881

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Title:
Assessment and management of behavioral and psychological symptoms of dementia
Author: Kales, Helen C ; Gitlin, Laura N ; Lyketsos, Constantine G
Subjects: Aggression - psychology ; Alzheimers disease ; Anxieties ; Apathy ; Behavior ; Clinical Review ; Clinical trials ; Cost control ; Dementia ; Dementia - psychology ; Depression - diagnosis ; Depression - psychology ; Depression - therapy ; Geriatric psychology ; Hallucinations ; Health facilities ; Hospitals ; Humans ; Long term health care ; Mortality ; Neurobiology ; Neurosciences ; Psychomotor Agitation - diagnosis ; Psychomotor Agitation - psychology ; Psychomotor Agitation - therapy ; Psychosis ; Psychotic Disorders - diagnosis ; Psychotic Disorders - psychology ; Psychotic Disorders - therapy ; Psychotropic drugs ; Sleep Wake Disorders - diagnosis ; Sleep Wake Disorders - psychology ; Sleep Wake Disorders - therapy ; STATE OF THE ART REVIEW ; Studies ; Wandering Behavior - psychology
Is Part Of: BMJ (Online), 2015-03, Vol.350 (mar02 7), p.h369-h369
Description: Behavioral and psychological symptoms of dementia include agitation, depression, apathy, repetitive questioning, psychosis, aggression, sleep problems, wandering, and a variety of inappropriate behaviors. One or more of these symptoms will affect nearly all people with dementia over the course of their illness. These symptoms are among the most complex, stressful, and costly aspects of care, and they lead to a myriad of poor patient health outcomes, healthcare problems, and income loss for family care givers. The causes include neurobiologically related disease factors; unmet needs; care giver factors; environmental triggers; and interactions of individual, care giver, and environmental factors. The complexity of these symptoms means that there is no “one size fits all solution,” and approaches tailored to the patient and the care giver are needed. Non-pharmacologic approaches should be used first line, although several exceptions are discussed. Non-pharmacologic approaches with the strongest evidence base involve family care giver interventions. Regarding pharmacologic treatments, antipsychotics have the strongest evidence base, although the risk to benefit ratio is a concern. An approach to integrating non-pharmacologic and pharmacologic treatments is described. Finally, the paradigm shift needed to fully institute tailored treatments for people and families dealing with these symptoms in the community is discussed.
Publisher: England: British Medical Journal Publishing Group
Language: English
Identifier: ISSN: 0959-8138
ISSN: 1756-1833
EISSN: 1756-1833
DOI: 10.1136/bmj.h369
PMID: 25731881
Source: AUTh Library subscriptions: ProQuest Central
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Assessment and management of behavioral and psychological symptoms of dementia

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