BPSD

Question 1

Dementia definition. 3 things

Answer 1

Decline in cognitive function
Decline in prev. level of function
Occupational/functional decline

Question 2

Motor symptoms in dementia to present? 4

Answer 2

Physical aggression
Restlessness
Verbal outbursts
Wandering/pacing

Question 3

BPSD def’n

Answer 3

Disturbed perception, thought content, mood, behaviour that occurs in dementia

Question 4

BPSD, 4 main symptoms

Answer 4

Somatic
Behavioural
Affective
Psychotic

Question 5

Most common symptom of dementia?

Answer 5

Apathy

Agitation/aggression
Depression
Irritability

Question 6

Which dementia has more depression vs. delusions

Answer 6

Depression: Vascular
Delusions: Alzheimer’s

Question 7

What is the unmet need model?

Answer 7

unmet bio psychosocial + cognitive impairment = BPSD

Patient centered model.

Question 8

What genetic risk factor allele show higher risk of delusions, agitation/aggression?

Answer 8

ApoE e4

Question 9

3 common neurotransmitter abnormalities

Answer 9

5HT
ACH
GABA

Question 10

BPSD assessment scales?

Answer 10

Cohen-Masnfield Agitation
Inventory
BEHAV-AD
Neurophsychiatric inventory (NPI)

Question 11

What is A-B-C analysis?

Answer 11

Antecedents
Behaviour
Consequences

Question 12

Meds for BPSD? 4 key types

Answer 12

Antidepressants
Anti-psychotics
Cognitive enhancers
Mood stabilizers

Question 13

SSRIs for BPSD?

Answer 13

Citalopram
Mirtazapine

Mainly for AGITATION

Question 14

What mirtazapine SFx are good for dementia?

Answer 14

Appetite
Weight gain
Sedation
No serotonergic syndrome

Question 15

only licensed Antipsychotic for BPSD?

Answer 15

Risperidone

Question 16

4 Antipsychotics for BPSD?

Answer 16

Haloperidol
Risperidone*
Olanzipine
Quetiapine

*only one on PBS

Question 17

Risk of antipsychotics in BPSD, agitation/psychosis

Answer 17

Risk of CVA, stroke. More likely if given to someone with aggression but not psychosis

Question 18

NMDA antagonist?

Answer 18

Memantine

Question 19

3 Anti cholinesterase inhibitors?

Answer 19

Donepezil
Rivastigmine
Galantamine

Question 20

Memantine indications 3As

Answer 20

Aggression
Agitation
Anxiety

Question 21

Don’t forget about what in BPSD?

Answer 21

Analgesia

Aperients

Question 22

Non pharmacological model of BPSD?

Answer 22

Minimize triggers - routine, rest periods
Optimize Environment - mobility, lighting, sensory, caregiver edu
De escalation strategies

Question 23

How to optimize environment?

Answer 23

EDUCATION for caregivers
Lighting
Mobility
Routine, rest, manage

Question 24

De escalation: 2 things

Answer 24

Music therapy

Videos of family members (FaceTime)