Behavioural and Psychological Problems in Dementia (original) (raw)

Behavioural disturbances in the form of agitation and aggression occur frequently in persons with dementia. Mean prevalence of behavioural disturbances in dementia is reported to be as high as 46.2%. Various psychological and behavioural symptoms reported in dementia apart from agitation and aggression include apathy, delusions, hallucinations, irritability, eating disturbances and sleep disorders. Other symptoms seen include hyperactivity, affective symptoms including depression and anxiety. The neurobiological changes seen in dementia include decrease in cholinergic and serotonergic activity, alterations in the noradrenergic systems; decrease in the norepinephrine level and an increase in the level of its major metabolite 3-methoxy-4-hydroxyphcnylglycol. Tools used for assessing include the behavioral pathology in Alzheimer's disease rating scale (BFHAVE-AD), the Cohen-Mansfield Agitation Inventory (CMAI), the neuropsychiatric inventory (NPI) and the behavioral rating scale for dementia (BRSD). A variety of treatments are available to alleviate the behavioural symptoms. Antipsychotics have been found to be the treatment of choice for behavioural disturbances. Treatment of depression in dementia comprises pharmacotherapy and nonpharmacological strategies, such as psychological interventions to enhance quality of life. Psychological intervention begins with the development of a daily routine and the organization of activities which the patient enjoys. A detailed treatment regime is discussed in the article below.