Behavioural and Psychological Symptoms of Dementia

Question 1

What are some of the common presentations of BPSD?

Answer 1

• Agitation
  
  • Anxiety, irritability, motor restlessness, pacing, “wandering”, aggression, shouting, night time disturbance
• Psychosis
  
  • Hallucinations, delusions, misidentifications
• Mood disorders
  
  • Depression, anxiety, mania
• Sexual disinhibition (especially males)
• Eating problems
• Abnormal or inappropriate vocalisations
  
  • Shouting, screaming, demanding attention

Question 2

Outline the management of BPSD in dementia

Answer 2

• Remove noxious stimuli, deprescribe
• Assess behaviours in context, identify treatable symptoms
• Psychosocial interventions
  
  • Activity programs, alter physical environment, educate staff, expose to daylight
• Pharmacological treatments
  
  • Atypical antipsychotics
  • Anticholinesterases (may slow onset)
  • Antidepressants (in mild depression)