Do Many of the Behavioral and Psychological Symptoms of Dementia Constitute a Distinct Clinical Syndrome? Current Evidence Using the BEHAVE-AD

2000 ◽  
Vol 12 (S1) ◽  
pp. 155-164 ◽  
Author(s):  
Barry Reisberg ◽  
Isabel Monteiro ◽  
Istvan Boksay ◽  
Stefanie Auer ◽  
Carol Torossian ◽  
...  
Keyword(s):  
Rating Scale ◽  
Psychological Symptoms ◽  
Clinical Syndrome ◽  
Current Data ◽  
Current Evidence ◽  
Pharmacologic Intervention ◽  
Dementia Patients ◽  
Placebo Intervention ◽  
And Function ◽  
Behavioral And Psychological Symptoms

The Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD) was specifically designed to assess behavioral and psychological symptoms of dementia (BPSD) that would be remediable to both psychologic and pharmacologic intervention. Furthermore, the BEHAVE-AD was designed to assess categories of symptoms that would respond in a cohesive (syndrome) manner in dementia patients, independently of effects of interventions on cognition and functioning. Current data indicate that the BEHAVE-AD does indeed assess a cohesive, cognition- and function independent syndrome in AD and in related dementias that is responsive to psychologic and appropriate pharmacologic intervention. Evidence is also increasing for differential responsiveness of this BPSD syndrome to select pharmacologic agents compared with nonspecific psychologic (placebo) intervention. This article reviews the evidence for this BPSD syndrome in dementia patients, as assessed with the BEHAVE-AD.

scholarly journals 404 - Effect of Psychoeducation Modul on the Administration of Psychotropic Drugs for Patients with Behavioral and Psychological Symptoms of Dementia at the RS Dr. H. Marzoeki Mahdi Bogor on Caregivers

2020 ◽  
Vol 32 (S1) ◽  
pp. 120-120
Keyword(s):  
Psychotropic Drugs ◽  
Cognitive Abilities ◽  
Health Workers ◽  
Psychological Symptoms ◽  
Clinical Syndrome ◽  
List Type ◽  
Study Program ◽  
Dementia Patients ◽  
Patients Experience ◽  
Behavioral And Psychological Symptoms

Name : Yuniar Pukuk KesumaStudy program : Psychiatry, Specialist II Geriatric PsychiatryCounsellor : Dr.dr. Martina Wiwie S. Nasrun, Sp.KJ(K)Background:Dementia is a clinical syndrome characterized by a decline in cognitive abilities and memory deficits globally. About 90% of patients experience behavioral and psychological symptoms. The use of psychotropic drugs is influenced by the patient symptoms, burden of the caregiver, and the habit of health workers.Objective:To determine the effect of psychoeducation modules to caregivers to increase knowledge, decrease of psychotropic drugs, reduce symptoms and burden of caregivers.Methods:There are 2 steps of studies. The first was a qualitative study to create psychoeducation module and the second was to conduct a pre-experimental study (one group pretest-posttest study). Psychoeducation is given in 2 consecutive weeks.Results:Fourty caregivers of dementia patients aged 41.3 (± 9.72) years. The psychoeducation modules is associated with decreasing symptoms and the use of psychotropic drugs, increasing knowledge and decreasing the burden of caregivers. At the end, 23% of patients were able to stop using psychotropic drugs and 62% of patients reduced their dose and/or the amount of psychotropic drugs.Conclusion:The psychoeducation modules to caregivers is associated with a decrease of patient symptoms and the use of psychotropic drugs. Psychoeducation also increases the knowledge of the caregiver and decreases the burden of the caregiver so that this psychoeducation module can be an additional therapy for patients with dementia.

Delirium superimposed on dementia: phenomenological differences between patients with and without behavioral and psychological symptoms of dementia in a specialized delirium unit

2016 ◽  
Vol 29 (3) ◽  
pp. 485-495
Author(s):  
Jennifer Abengaña ◽  
Mei Sian Chong ◽  
Laura Tay
Keyword(s):  
Rating Scale ◽  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Assessment Method ◽  
Dementia Patients ◽  
Psychological Disturbances ◽  
Functional Scores ◽  
Symptom Frequency ◽  
Behavioral And Psychological Symptoms ◽  
Delirium Superimposed On Dementia

ABSTRACTBackground: Overlap between neuropsychiatric symptoms of dementia and delirium complicates diagnosis of delirium superimposed on dementia (DSD). This study sought to examine differences in delirium presentation and outcomes between DSD patients with and without pre-existing behavioral and psychological symptoms of dementia (BPSD).Methods: This was a prospective cohort study of older adults with DSD admitted to a specialized delirium unit (December 2010–August 2012). We collected data on demographics, comorbidities, illness severity, delirium precipitants, and cognitive and functional scores. Delirium severity was assessed using Delirium Rating Scale Revised-98 (DRS-R-98) and Cognitive Assessment Method severity score (CAM-sev). Patients were categorized as DSD–BPSD+ and DSD–BPSD− based on elicited behavioral and psychological disturbances.Results: We recruited 174 patients with DSD (84.4 +/−7.4 years) with 37 (21.3%) having BPSD. At presentation, delirium severity and symptom frequency on DRS-R98 were similar, but DSD–BPSD+ more often required only a single precipitant (40.5% vs. 21.9%, p = 0.07), and had significantly longer delirium duration (median days: 7 vs. 5, p < 0.01). At delirium resolution, DSD–BPSD+ exhibited significant improvement in sleep–wake disturbances (89.2% vs. 54.1%, p < 0.01), affect lability (81.1% vs. 56.8%, p = 0.05), and motor agitation (73% vs. 40.5%, p < 0.01), while all non-cognitive symptoms except motor retardation were improved in DSD–BPSD−. Pharmacological restraint was more prevalent (62.2% vs. 40.1%, p = 0.03), and at higher doses (chlorpromazine equivalents 0.95 +/−1.8 vs. 0.40 +/−1.2, p < 0.01) in DSD–BPSD+.Conclusions: BPSD may increase vulnerability of dementia patients to delirium, with subsequent slower delirium recovery. Aggravation of sleep disturbance, labile affect, and motor agitation should raise suspicion for delirium among these patients.

scholarly journals Yokukansankachimpihange Is Useful to Treat Behavioral/Psychological Symptoms of Dementia

2021 ◽  
Vol 7 ◽  
Author(s):  
Eiichi Katsumoto ◽  
Toru Ishida ◽  
Kenji Kinoshita ◽  
Miho Shimizu ◽  
Toshihito Tsutsumi ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Daily Living ◽  
Rating Scale ◽  
Psychological Symptoms ◽  
Gastrointestinal Symptoms ◽  
Multicenter Studies ◽  
Dementia Patients ◽  
Loss Of Appetite ◽  
Behavioral And Psychological Symptoms

Yokukansankachimpihange is a Japanese herbal medicine reported to benefit anxiety and sleep disorders, and it has recently been introduced to treat behavioral and psychological symptoms of dementia. There are no multicenter studies of its effectiveness regarding dementia in Japan, and this study's main objective was to clarify the effects of Yokukansankachimpihange on behavioral and psychological symptoms of dementia in a sample of patients from multiple healthcare centers. Nine facilities affiliated with Osaka Association of Psychiatric Clinics participated in November 2013 through April 2015 and provided 32 Alzheimer's disease patients to whom Yokukansankachimpihange was orally administered for 8 weeks. During the study, the patients continued their regular medication regimens. Behavioral and psychological symptoms of dementia (Behavioral Pathology in Alzheimer's Disease Rating Scale [Behave-AD]), core symptoms [Mini-Mental State Examination (MMSE)], activities of daily living [Nishimura Activity of Daily Living Scale (N-ADL)], and gastrointestinal symptoms (nausea/vomiting, loss of appetite, gastric discomfort, constipation, and diarrhea) were measured at baseline, after 4 weeks of treatment and after 8 weeks of treatment. Yokukansankachimpihange was orally administered at a dosage of 7.5 g twice daily before or between meals for 8 weeks. The Behave-AD mean score significantly improved after 8 weeks of treatment. There were no significant changes in MMSE, N-ADL, or gastrointestinal symptoms; however, decreased gastrointestinal scores were observed after 8 weeks. There were no side effects related to Yokukansankachinpihange. Pharmaceutical treatments are important for treating behavioral and psychological symptoms of dementia, and this study confirmed Yokukansankachimpihange's efficacy for treating Alzheimer's disease. Because the aggressiveness and sleep disorder components of the Behave-AD construct were the symptoms most improved and those symptoms are known to significantly burden dementia patients' caregivers, Yokukansankachimpihange's efficacy might indirectly relieve these caregivers' burden of care.

scholarly journals Shen-Zhi-Ling Oral Liquid Improves Behavioral and Psychological Symptoms of Dementia in Alzheimer’s Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Weidong Pan ◽  
Qiudong Wang ◽  
Shin Kwak ◽  
Yu Song ◽  
Baofeng Qin ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Rating Scale ◽  
Psychological Symptoms ◽  
Fluctuation Analysis ◽  
Double Blind ◽  
Oral Liquid ◽  
Detrended Fluctuation ◽  
Behavioral And Psychological Symptoms

We evaluated the effects of the traditional Chinese medicine (TCM) Shen-Zhi-Ling oral liquid (SZL) on the behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer’s disease (AD). Among 98 patients with AD and BPSD enrolled (mean age, 57.2 ± 8.9 years old), 91 (M = 55,F = 36; mean age, 57.2 ± 9.7 years old) completed the study. Patients took either SZL (n=45) or placebo granules (n=46) in a double-blind manner for 20 weeks while maintaining other anticognitive medications unchanged. Changes in BPSD between week 0, week 10, week 20, and week 25 were assessed using the behavioral pathology in Alzheimer’s disease (BEHAVE-AD) rating scale and the neuropsychiatric inventory (NPI), detrended fluctuation analysis (DFA) represented by diurnal activity (DA), evening activity (EA), and nocturnal activity (NA) according to actigraphic recordings. SZL but not placebo oral liquid delayed the development of BPSD significantly according to the changes in some of the clinical scores and the EA and NA parameters of DFA at week 20 compared with week 0. No side effects were observed in laboratory tests. The results indicate that SZL might delay the development of BPSD in AD patients and thus is a potentially suitable drug for long-term use.

scholarly journals Acupressure and Dementia - A Review of Current Evidence

2021 ◽  
Author(s):  
Soo Liang Ooi ◽  
Gillian Drew ◽  
Sok Cheon Pak
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Sleep Disturbances ◽  
Psychological Symptoms ◽  
Pharmacological Therapy ◽  
Current Evidence ◽  
High Quality Research ◽  
Dementia Patients ◽  
Moderate Dementia

Introduction: Dementia is a cognitive decline with patients often exhibit behavioural and psychological symptoms, severely affecting the quality of life and placing a heavy burden on caregivers. Acupressure has reported benefits for dementia. This study aims to critically review the available evidence for its use as a non-pharmacological therapy. Methods: Systematic search of major research databases for human clinical trials using acupressure as an intervention for dementia patients was conducted. Results were synthesised for the effects of acupressure on various outcome measures of interest for dementia.Results: Twelve clinical trials (N=973), including eight randomised control studies, were included in this review. The study sample was predominantly institutionalised residents with moderate to severe dementia. Baihui (GV20), Shenmen (HT7), Fengchi (GB20), Neiguan (PC6), Sanyinjiao (SP6), and Yingtang (EX-HN3) were the most used acupoints for intervention. Acupressure techniques employed in these clinical trials vary greatly with no standardised approach. This review finds inconsistent evidence in the effectiveness of acupressure in reducing agitation and behavioural disturbances. However, the treatment appears to improve their ease of care and reduce physical stress. Affixing acupressure devices on selected acupoints can also potentially improve psychiatric pain, anxiety, and depression. Long-term (6 months) treatment can potentially improve the cognitive function, activities of daily living, and quality of life of patients with mild to moderate dementia. The effect of acupressure on sleep disturbances remains unclear. Conclusion: More high-quality research on acupressure is needed to fill the gaps in knowledge and inform better care for dementia patients in the future.

scholarly journals Prevalence of Behavioral and Psychological Symptoms of Dementia in Community-Dwelling Dementia Patients: A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Chan-Young Kwon ◽  
Boram Lee
Keyword(s):  
Systematic Review ◽  
Eating Disorder ◽  
Sleep Disorders ◽  
Motor Behavior ◽  
Psychological Symptoms ◽  
Community Dwelling ◽  
Dementia Patients ◽  
Pooled Prevalence ◽  
Severity Of Dementia ◽  
Behavioral And Psychological Symptoms

Background: Identifying the characteristics of behavioral and psychological symptoms of dementia (BPSD) associated with different dementia types may be a promising strategy to effectively deal with BPSD. We aimed to synthesize the prevalence rates of BPSD characteristics in community-dwelling dementia patients.Methods: We searched Medline, EMBASE, and PsycARTICLES databases for original clinical studies published until December 2020 that enrolled at least 300 community-dwelling dementia patients. The methodological qualities of prevalence studies were assessed using the Joanna Briggs Institute's critical appraisal checklist.Results: Thirty studies were included. The prevalence of the BPSD characteristic ranged from 4 (elation and mania) to 32% (apathy) in the pooled samples. The prevalence of delusions, anxiety, apathy, irritability, elation and mania, and aberrant motor behavior in Alzheimer's disease patients was 1.72–2.88 times greater than that in vascular dementia (VD) patients, while the prevalence of disinhibition in VD patients was 1.38 times greater. The prevalence of anxiety, irritability, and agitation and aggression, delusion, hallucinations, apathy, disinhibition, and aberrant motor behavior tended to increase as the severity of dementia increased, while that of depression, eating disorder, sleep disorders, and elation and mania tended to stable. In community-dwelling patients with dementia, the pooled prevalence of apathy, depression, anxiety, irritability, agitation and aggression, sleep disorders, and eating disorder was higher than 20%, while that of disinhibition and elation and mania was lower than 10%.Conclusion: Overall, the pooled prevalence of apathy, depression, anxiety, irritability, agitation and aggression, sleep disorders, and eating disorder was generally high in patients with dementia. Also, the prevalence of some BPSD characteristics differed according to the type and the severity of dementia. The methodological quality of the included studies is not the best, and high heterogeneity may affect the certainty of the findings. However, the results of this review can deepen our understanding of the prevalence of BPSD.Systematic Review Registration:https://osf.io/dmj7k, identifier: 10.17605/OSF.IO/DMJ7K.

Day Care for older dementia patients: favorable effects on behavioral and psychological symptoms and caregiver stress

2008 ◽  
Vol 23 (10) ◽  
pp. 1066-1072 ◽  
Author(s):  
Enrico Mossello ◽  
Veronica Caleri ◽  
Elena Razzi ◽  
Mauro Di Bari ◽  
Claudia Cantini ◽  
...  
Keyword(s):  
Day Care ◽  
Psychological Symptoms ◽  
Dementia Patients ◽  
Behavioral And Psychological Symptoms
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