Treatment of behavioral and psychological symptoms of Alzheimer-type dementia with Yokukansan in clinical practice

Author(s):  
Yoshihito Hayashi ◽  
Yasushi Ishida ◽  
Teruhiko Inoue ◽  
Mitsutaka Udagawa ◽  
Kouzou Takeuchi ◽  
...  
2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Zhanjie Zheng ◽  
Jindong Wang ◽  
Lei Yi ◽  
Hui Yu ◽  
Lingli Kong ◽  
...  

The relationship between plasma homocysteine and behavioral and psychological symptoms of dementia (BPSD) has not been specifically investigated in previous research. In this study, we compared plasma homocysteine (Hcy) among 40 Alzheimer’s disease (AD) patients with BPSD, 37 AD patients without BPSD, and 39 healthy controls. Our results evidenced that the plasma homocysteine levels in AD patients with BPSD and without BPSD were higher than healthy controls and that the plasma homocysteine concentration in AD patients with BPSD was the highest among the three groups. Significant correlation between plasma homocysteine concentration and cognitive decline and duration of dementia was observed, but there was no correlation between BPSD and cognitive dysfunction or duration of dementia. In conclusion, this study showed for the first time that BPSD were associated with plasma homocysteine concentration in Alzheimer's dementia, and the results supported that hyperhomocysteine may take part in the pathogenesis of BPSD.


2004 ◽  
Vol 49 (4) ◽  
pp. 201-204 ◽  
Author(s):  
Tokumi Fujikawa ◽  
Terumichi Takahashi ◽  
Akiko Kinoshita ◽  
Hiroaki Kajiyama ◽  
Akiko Kurata ◽  
...  

2020 ◽  
Vol 32 (S1) ◽  
pp. 61-61
Author(s):  
Willem S. Eikelboom ◽  
Jana Koch ◽  
Elizabeth Beattie ◽  
Nicola Lautenschlager ◽  
Colleen Doyle ◽  
...  

Background:Behavioral and psychological symptoms of dementia (BPSD) are very prevalent among individuals with dementia living in residential aged care. The development and implementation of new non-pharmacological interventions to reduce BPSD requires knowledge on the current perception and clinical practice of the care staff. We analyzed clinical care notes to examine the way residential aged care staff reported and managed BPSD in their daily clinical practice.Methods:We examined semi-structured care notes relating to the presentation and management of behaviors of 76 older residents (67% female; aged 67-101; 75% with formal dementia diagnosis) prior to participating in the Australian BPSDPLUS Program. As part of standard clinical practice in three residential aged care facilities, staff document the presentation and management of behaviors amongst residents. Using an inductive thematic analytical approach, we analyzed the reported data in the one and a half months prior to commencing participation in the BPSDPLUS Program. Care notes were coded and analyzed by two independent assessors and they discussed themes until consensus was reached.Results:A total of 465 behavior charts were completed in the one and a half months prior to the commencement of the BPSDPLUS Program. The number of behavioral charts varied widely across residents (Mean=7.3, range 0–93). Behaviors such as refusal of care, repetitive verbal behaviors, and wandering were most often mentioned, while apathy and affective and psychotic symptoms were seldomly reported. When confronted with BPSD, the clinical care notes indicated that care staff tend to respond in a reactive manner by reassuring, redirecting, or distracting the resident. Furthermore, it seems that staff did not routinely investigate potential underlying causes of the BPSD.Conclusions:These results suggest that the residential care staff primarily detected and responded to externalizing behaviors, while more internalizing behaviors were not reported. Potential underrecognition of internalizing behaviors, as well as the fact that the staff did not routinely examine causes of BPSD are vital observations for the development and implementation of nonpharmacological interventions and care programs targeting BPSD in residential aged care.


2005 ◽  
Vol 17 (4) ◽  
pp. 605-616 ◽  
Author(s):  
Alexander Kurz ◽  
Susanne Schwalen S ◽  
Andreas Schmitt

Background: Risperidone significantly improves behavioral and psychological symptoms of dementia (BPSD), including aggression, agitation and psychosis, as shown by randomized, placebo-controlled trials.MethodsAn 8-week, multicenter, naturalistic, open-label study was carried out to examine whether the benefits of risperidone apply to clinical practice. A total of 4499 patients were treated with risperidone at flexible doses chosen by physicians, and were included in the safety evaluation. Of these, 3909 patients met the intended study criteria (at least 65 years of age, dementia, and the presence of BPSD) and were included in the efficacy analyses.Results:At the end of the study (after 8 weeks of treatment), risperidone (average final dose 1.6 mg/day) significantly improved all symptoms studied (agitation, aggressiveness, disturbance of the sleep–wake rhythm, social withdrawal, suspiciousness and delusions) as rated by physicians on a five-point scale of severity. On a four-point scale of global efficacy, more than 90% of patients were rated improved by both physicians and caregivers after 8 weeks of treatment. A significant improvement in sleep-wake cycle disturbances was also noted. A total of 422 adverse events were documented in 346 of the 4499 patients (7.7%); these included insufficient efficacy (2.6%), extrapyramidal symptoms (0.89%), deterioration of psychiatric symptoms (0.73%), sedation (0.56%), gastrointestinal disturbances (0.49%), cardiovascular disorders (0.38%), and cerebrovascular adverse events (0.36%).Conclusions: Risperidone is an effective and well-tolerated treatment for BPSD in routine clinical practice.


2019 ◽  
pp. 197-224
Author(s):  
Anne W. Lipe ◽  
Molly Edmonston

This umbrella review summarizes and compares evidence from existing systematic reviews on the effectiveness of music and music-therapy interventions in addressing behavioural and psychological symptoms of dementia (BPSD) among individuals with dementia. Characteristics of 14 reviews are presented and findings from these reviews are organized and described by individual symptoms (anxiety, agitation, and depression). The results of this umbrella review suggest that music and music-therapy interventions have a positive effect on the short-term reduction of BPSD. Recommendations for best clinical practice are generated from these findings. Sources of heterogeneity in the reviews make it difficult to formulate meaningful conclusions on the effectiveness of music and music-therapy interventions for BPSD symptoms at specific stages of dementia. Best practice dictates that music and music-therapy interventions within the context of a person-centered approach are likely to be the most successful in reducing BPSD for individuals with dementia.


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