Interactions of fluoxetine with metabolism of dopamine and serotonin in rat brain regions. Brain Res. Neurropatholic and neurochemical correlates of psychosis in primary dementia. J Neuropsychiatry Clin Neurosci. Brain Stimul. J Neurol Neurosurg Psychiatry. The Comprehensive Process Model of Engagement. A systematic review of stress in staff caring for people with dementia living in hour care settings.
The needs of people with dementia in care homes: the perspectives of users, staff and family caregivers. Subjective needs in people with dementia: a review of the literature. Physical restraint use and falls in nursing homes: A comparison between residents with and without dementia.
The more physical inactivity, the more agitation in dementia. Wang WW, Moyle W. Physical restraint use on people with dementia. A review of literature. Aust J Adv Nurs. Quality of care in people with dementia in private sector and NHS facilities for people with dementia: cross sectional survey. Morley J. Dementia-related agitation. Desai AK. Psychotropic side effects of commonly prescribed drugs in the elderly.
Primary Psychiatry. Delirium superimposed on dementia: A systematic review. Cognitive impairment and pain management: Review of issues and challenges. J Rehabil Res Dev. Bourbonnais A, Ducharme F. The meanings of screams in older people living with dementia in a nursing home. Caregiver burden in Alzheimer disease: cross-sectional and longitudinal patient correlates. The contribution of neuropsychiatric symptoms to the cost of dementia care. Caregiver burden associated with behavioral and psychological symptoms of dementia in elderly people in the local community.
Predicting time to nursing home care and death in individuals with Alzheimer disease. The impact of young onset dementia on the family: a literature review. Sleep in dementia and caregiving — assessment and treatment implications: a review.
Incontinence and troublesome behaviors predict institutionalization in dementia. J Geriatr Psychiatry Neurol. Elopement among community-dwelling older adults with dementia. J Gerontol Med Sci. J Alzheimer Dis. Alzheimer Dement. Comprehensive assessment of depression and behavioral problems in long-term care.
The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. J Clin Psychiatry. Recommended measures for the assessment of behavioral disturbances associated with dementia. Cornell scale for depression in dementia. Biol Psychiatry. Accessed 8 February Latest and most comprehensive approach to management of behavioral disturbances in patients with dementia. Second edition. Nonpharmacological treatment of agitation: a controlled trial of systematic individualized intervention.
A systematic evidence review of non-pharmacological interventions for behavioral symptoms of dementia. Tune LE. Nonpharmacological treatment of inappropriate sexual behaviors in dementia: the case of the Pink Panther. Dement Geritr Cogn Disord. Psychosocial interventions for dementia patients in long-term care. Research on treating neuropsychiatric symptoms of advanced dementia with non-pharmacological strategies, — a systematic literature review.
Excellent review of the literature on the efficacy of non-pharmacological strategies for the treatment of behavioral disturbances in patients with advanced dementia. Light therapy for managing cognitive, sleep, functional behavioural, or psychiatric disturbances in dementia. Cochane Database Syst Rev. Effect of bright light and melatonin on cognitive function in elderly residents of group care facilities: a randomized controlled trial.
Beyond bingo: meaningful activities for persons with dementia in nursing homes. Ann Long Term Care. Outcomes of antipsychotic drug use in community-dwelling elders with dementia. Arch Psychiatr Nurs.
Effect of the BACE intervention on agitation of people with dementia. Effects of community occupational therapy on quality of life, mood, and health status in dementia patients and their caregivers: a randomized controlled trial. Effects of continuous activity programming on the behavioral symptoms of dementia. J Am Med Direct Assoc.
Cohen-Mansfield J. Nonpharmacologic interventions for inappropriate behaviors in dementia: a review, summary and critique. Behavioral treatment of depression in dementia patients: a controlled clinical trial. Caring for aged dementia care resident study CADRES of person-centered care, dementia-care mapping, and usual care in dementia: a cluster-randomized trial.
Landau R, Werner S. Ethical aspects of using GPS for tracking people with dementia: recommendations for practice. Effect of person-centered showering and the towel bath on bathing-associated aggression, agitation, and discomfort in nursing home residents with dementia: A randomized controlled trial.
Lavretsky H. Consequences of antipsychotic medications for the dementia patient. Eur J Neurol. Expert Rev Neurother.
N Engl J Med. Vidal JS, et al. Evaluation of the impact of Memantine treatment initiation on psychotropics use: a study from the French national health care database. A systematic review and meta-analysis of placebo-controlled antidepressant studies in people with depression and dementia. This class of drugs has been used primarily for depression, with efficacy especially for the selective serotonin reuptake inhibitors SSRIs; Gauthier et al.
Some authors found that citalopram and sertraline could improve symptoms of agitation and psychosis in subjects with dementia with similar efficacy, but better tolerability and safety, than haloperidol and risperidone Gauthier et al. Citalopram was effective in treating disinhibition, irritability and depression and also behaviors specific to FTD Herrmann et al. However, the evidence so far does not support the use of these medications for BPSD other than depression Azermai et al.
Donepezil, galantamine, or rivastigmine have all shown a modest effect on the broad spectrum of neuropsychiatric symptoms in AD Rodda et al. They should be initiated prior to the use of other psychotropic agents since ChEIs reduce behavioral changes and improve or delay cognitive and functional decline Gauthier et al. The behavioral symptoms most likely to improve with ChEIs treatment appear to be apathy, depression, and aberrant motor behavior Cummings, ; Holmes et al.
Memantine, an NMDA receptor antagonist, can also have beneficial effects on behavior, as well as on cognition and function; however there is insufficient evidence to recommend its use Azermai et al.
The use of memantine appears to improve specific behaviors, such as agitation and irritability, which differ from those affected by ChEIs mood symptoms, apathy, and aberrant motor behavior. The latest report on combined memantine and ChEIs donepezil treatment did not show any major advantages on cognitive and behavioral changes in subjects with moderate-to-severe AD, compared to those treated with either memantine or donepezil, with only negligible improvement on the NPI scores in the subjects treated with the combination of the two antidementia drugs Howard et al.
Anticonvulsant mood stabilizers such as carbamazepine, valproic acid, gabapentin, lamotrigine, topiramate are widely used in clinical practice. Treatment regimens with anticonvulsant mood stabilizers have shown promising results and seem to be beneficial for some dementia patients Konovalov et al. Anticonvulsants may allow dose reduction of antipsychotics; however, investigation regarding benefits, safety, and tolerability of these drugs has produced mixed results, so they are not recommended for routine use.
In particular sodium valproate has been shown to be ineffective in the treatment of agitation in AD, and has been associated with increased adverse effects, including falls, infection, and gastrointestinal disorders Lonergan and Luxenberg, Benzodiazepines may be used at short-term for acute agitation or agitation associated with anxiety Azermai et al. Neuropsychiatric symptoms are frequent in dementia and contribute significantly for burden caregiver and illness costs. Correct identification and evaluation of these symptoms is a crucial part of the clinical approach to dementia.
The pathogenesis of these symptoms is not well understood, and the current knowledge supports multifactorial causes. Development and use of new specific investigation techniques may be helpful to better understand the underlying etiological mechanisms of various neuropsychiatric symptoms. At present, combination of non-pharmacological and appropriate pharmacological strategies represents the best treatment of BPSD.
However, there is no consistent evidence about specific strategies for individual symptoms. It is necessary to encourage application of novel non-pharmacological interventions, which are safer than pharmacological therapies.
Further investigation is similarly needed to find more effective, safe, and well-tolerated pharmacological therapies. This will help to devise novel, more symptom targeted, and specific interventions that will improve significantly the management of BPSD symptoms in subjects with dementia.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Aalten, P. The course of neuropsychiatric symptoms in dementia. Part I: findings from the two-year longitudinal Maasbed study.
Psychiatry 20, — CrossRef Full Text. Part II: relationships among behavioural sub-syndromes and the influence of clinical variables. Behavioral problems in dementia: a factor analysis of the neuropsychiatric inventory. Consistency of neuropsychiatric syndromes across dementias: results from the European Alzheimer Disease Consortium. Part II. Neuropsychiatric syndromes in dementia. Aharon-Peretz, J. Alexopoulos, G.
Depression in the elderly. Lancet , — American Psychiatric Association. Angelucci, F. Alzheimers Dis. Pubmed Abstract Pubmed Full Text. Apostolova, L. Azermai, M. Systematic appraisal of dementia guidelines for the management of behavioural and psychological symptoms. Ageing Res. Ballard, C.
Psychiatry 17, — Neuropsychiatric symptoms in dementia: importance and treatment considerations. Anxiety, depression and psychosis in vascular dementia: prevalence and associations.
Delusions associated with elevated muscarinic binding in dementia with Lewy bodies. Attention and fluctuating attention in patients with dementia with Lewy bodies and Alzheimer disease. Neuropathological substrates of psychiatric symptoms in prospectively studied patients with autopsy-confirmed dementia with Lewy bodies.
Psychiatry , — Bathgate, D. Acta Neurol. Beeri, M. Benoit, M. Bergh, S. The course of neuropsychiatric symptoms in patients with dementia in Norwegian nursing homes. Berlow, Y. Psychiatry 25, — Borroni, B. Aging 27, — Bozeat, S. Briesacher, B. The quality of antipsychotic drug prescribing in nursing homes. Bruen, P. Brain Pt 9 , — Campbell, P. Determinants of burden in those who care for someone with dementia. Psychiatry 23, — Caraci, F. Casanova, M. Clinicopathological correlates of behavioral and psychological symptoms of dementia.
Acta Neuropathol. Chan, D. Presence of behavioral and psychological symptoms predicts nursing home placement in community-dwelling elders with cognitive impairment in univariate but not multivariate analysis. A Biol. Chan, W.
Neuropsychiatric symptoms are associated with increased risks of progression to dementia: a 2-year prospective study of Chinese older persons with mild cognitive impairment. Age Ageing 40, 30— Chen, J. Psychiatry 8, — Cheng, T. Chiu, M.
Behavioral and psychologic symptoms in different types of dementia. Choi, A. Effects of group music intervention on behavioral and psychological symptoms in patients with dementia: a pilot-controlled trial. Chow, T. Psychiatry 17, 22— Cohen-Mansfield, J. Measurement of inappropriate behavior associated with dementia. Can agitated behavior of nursing home residents with dementia be prevented with the use of standardized stimuli?
Craig, A. Cerebral blood flow correlates of apathy in Alzheimer disease. Craig, D. Psychiatry 13, — Cummings, J. The neuropsychiatric inventory: assessing psychopathology in dementia patients.
Neurology 48 5 Suppl. Behavioural disturbances in dementia patients and quality of the marital relationship. Psychiatry 18, — Do caregiver management strategies influence patient behaviour in dementia? Psychiatry 19, 85— Dechamps, A. Co-occurrence of neuropsychiatric syndromes in demented and psychotic institutionalized elderly.
Devanand, D. Di Iulio, F. Di Maria, E. Egger, K. Pattern of brain atrophy in elderly patients with depression revealed by voxel-based morphometry. Psychiatry Res. Emanuel, J. Trajectory of cognitive decline as a predictor of psychosis in early Alzheimer disease in the cardiovascular health study.
Psychiatry 19, — Farber, N. Increased neocortical neurofibrillary tangle density in subjects with Alzheimer disease and psychosis. Psychiatry 57, — Feldman, H. Alzheimer Res. Prevalence of neuropsychiatric symptoms in elderly patients with dementia in Mungialde County Basque Country, Spain.
Fernandez-Martinez, M. Finkel, S. Behavioral and psychological signs and symptoms of dementia: a consensus statement on current knowledge and implications for research and treatment. Psychiatry , 53— Frisoni, G. Fuh, J. Gabryelewicz, T. The rate of conversion of mild cognitive impairment to dementia: predictive role of depression. Psychiatry 22, — Neuropsychiatric and behavioral symptomatology in Alzheimer disease.
Actas Esp. Garre-Olmo, J. Incidence and subtypes of early-onset dementia in a geographically defined general population. Neurology 75, — Part II: two-year patient trajectories.
Gauthier, S. Geda, Y. De novo genesis of neuropsychiatric symptoms in mild cognitive impairment MCI. Harding, A. Visual hallucinations in Lewy body disease. Relate to Lewy bodies in the temporal lobe. Brain Pt 2 , — Harwood, D. Henry, G.
Efficacy and tolerability of antidepressants in the treatment of behavioral and psychological symptoms of dementia, a literature review of evidence. Other Demen. Herrmann, N. Serotonergic function and treatment of behavioral and psychological symptoms of frontotemporal dementia. The contribution of neuropsychiatric symptoms to the cost of dementia care. Psychiatry 21, — Hirono, N.
Stroke 31, — Neurology 50, — Hollingworth, P. Holmes, C. The efficacy of donepezil in the treatment of neuropsychiatric symptoms in Alzheimer disease. Neurology 63, — Holroyd, S. Neuropsychiatry Clin. Hope, T.
Behaviour changes in dementia. Psychiatry 12, — Howard, R. Hsieh, C. Psychiatry 24, — Huang, S. Caregiver burden associated with behavioral and psychological symptoms of dementia BPSD in Taiwanese elderly.
Ikeda, M. Dementia associated mental and behavioural disturbances in elderly people in the community: findings from the first Nakayama study. Ismail, Z. Psychiatry Rep. Iwata, B. Repp, and N. Jeste, D. Research agenda for DSM-V: diagnostic categories and criteria for neuropsychiatric syndromes in dementia. Kales, H. Risk of mortality among individual antipsychotics in patients with dementia. Psychiatry , 71— Kang, H. Karlawish, J. Alzheimers Dement. Karttunen, K. Psychiatry 26, — Katona, C.
International Psychogeriatric Association consensus statement on defining and measuring treatment benefits in dementia. Kim, J. Kong, E. Nonpharmacological intervention for agitation in dementia: a systematic review and meta-analysis.
Aging Ment. Health 13, — Konovalov, S. Anticonvulsants for the treatment of behavioral and psychological symptoms of dementia: a literature review. Korczyn, A. Reasons for psychiatric consultation referrals in dutch nursing home patients with dementia: a comparison with normative data on prevalence of neuropsychiatric symptoms. Monetary costs of agitation in older adults with alzheimer's disease in the Uk: prospective cohort study. Cost-benefit analysis of second-generation antipsychotics and placebo in a randomized trial of the treatment of psychosis and aggression in alzheimer disease.
Arch Gen Psychiatry. Behavioural and psychiatric symptoms in people with dementia admitted to the acute hospital: prospective cohort study. Br J Psychiatry. Health care utilization and costs of alzheimer's disease: the role of co-morbid conditions, disease stage, and pharmacotherapy. Fam Med. PubMed Google Scholar. Treatments for behavior. Behavioral symptoms. Accessed 30 Aug Parsons C. Polypharmacy and inappropriate medication use in patients with dementia: an underresearched problem.
Ther Adv Drug Saf. The association between polypharmacy and dementia: a nested case-control study based on a year longitudinal cohort database in South Korea. PLoS One. Polypharmacy and potentially inappropriate medication use among community-dwelling elders with dementia. Alzheimer Dis Assoc Disord. Polypharmacy, adverse drug reactions, and geriatric syndromes. Clin Geriatr Med. Reducing neuropsychiatric symptoms in persons with dementia and associated burden in family caregivers using tailored activities: design and methods of a randomized clinical trial.
Contemp Clin Trials. Review of clinical guidelines on use of antipsychotic drugs in the treatment of behavioral symptoms in alzheimer's disease and their impact on patient outcomes. Patterns of healthcare utilization and costs for vascular dementia in a community-dwelling population. J Alzheimers Dis. Neuropsychiatric symptoms in alzheimer's disease and vascular dementia. Neuropsychiatric symptoms in elderly subjects with dementia: a comparison between vascular and neurodegenerative types. Acta Psychiatr Scand.
Neuropsychiatric profiles in dementia. Anxiety, depression and psychosis in vascular dementia: prevalence and associations. J Affect Disord. Download references. Research and editorial support were funded by Otsuka America Pharmaceutical, Inc. The sponsor and study advisor participated in the study design, data analysis and interpretation, article preparation, and the decision to submit this article for publication.
You can also search for this author in PubMed Google Scholar. Correspondence to Myrlene Sanon Aigbogun. This study was exempt from review by an institutional review board because the database was compliant with the Health Insurance Portability and Accountability Act and because the data do not include any identifiable patient information. The data used for this study did not involve the interaction or interview with any subjects and the data does not include any individually identifiable data e.
Furthermore, this study used existing fully de-identified and the investigator s cannot be identified, directly or through identifiers linked to subjects and as such is exempt from 45 CFR AH is an employee of Lundbeck. HF received consulting fees from Lundbeck. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Individual medical comorbidities collected for patients with and without BD.
This table lists all of the ICDCM diagnostic codes for the comorbid medical disorders observed in the study population. DOCX 13 kb. All medications including antipsychotics and anti-dementia treatments collected for patients with and without BD.
This table lists all of the medications taken by patients in the study, including antipsychotics and anti-dementia therapeutics. DOCX 17 kb. Reprints and Permissions. Aigbogun, M. Treatment patterns and burden of behavioral disturbances in patients with dementia in the United States: a claims database analysis. BMC Neurol 19, 33 Download citation.
Received : 13 February Accepted : 19 February Published : 28 February Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background Although patients with dementia frequently experience neuropsychological symptoms NPS such as agitation, which profoundly impacts patients, caregivers, and the healthcare system, few studies have evaluated the associated burden of agitation or agitation-related symptoms in dementia.
Results From a starting sample of 6. Conclusions Patients with dementia with BD had a higher prevalence of comorbidities, greater use of comedications, and greater healthcare utilization and costs than patients with dementia without BD. Background Dementia, characterized by widespread progressive decline in cognitive and functional abilities and a wide range of challenging behavioral symptoms that occur throughout the disease process [ 1 ], is one of the major causes of disability and dependency among older people [ 2 , 3 ].
Common medical comorbidities at baseline At baseline, common medical comorbidities among patients with and without BD were analyzed. Healthcare costs All-cause total, inpatient, outpatient, ambulatory, and pharmacy costs were calculated PPPY.
Results Baseline patient demographics From a starting sample of 6.
0コメント