scholarly journals Prevalence, correlates and course of behavioural and psychological symptoms of dementia in the population

2009 ◽  
Vol 194 (3) ◽  
pp. 212-219 ◽  
Author(s):  
George M. Savva ◽  
Julia Zaccai ◽  
Fiona E. Matthews ◽  
Julie E. Davidson ◽  
Ian McKeith ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Sleep Problems ◽  
Psychological Symptoms ◽  
Population Based ◽  
Anxiety And Depression ◽  
Factor Solution ◽  
People With Dementia ◽  
Sleeping Problems ◽  
Behavioural And Psychological Symptoms ◽  
Reported Health

BackgroundBehavioural and psychological symptoms of dementia (BPSD) are major contributors to the burden of dementia.AimsTo describe the prevalence, correlates and course of BPSD in the population of England and Wales.MethodThe prevalence of 12 symptoms was estimated in 587 participants with dementia and 2050 participants without dementia as part of a population-based longitudinal study of ageing. The effect of risk factors and the factor structure were estimated using 1782 interviews provided by participants with dementia throughout the study.ResultsEach symptom apart from sleeping problems was more common in the population with dementia. The co-occurrence of the symptoms was explained by a four-factor solution, corresponding to psychosis/apathy, depression/anxiety, irritability/persecution and wandering/sleep problems. Psychosis occurred more frequently with declining cognition. Anxiety and depression were more common in younger individuals and in those with poor self-reported health. Persistence varied between symptoms.ConclusionsBehavioural and psychological symptoms of dementia affect nearly all people with dementia. Symptoms co-occur, and the symptoms that affected individuals experience are related to their socio-demographic and clinical characteristics.

scholarly journals Training needs on behavioural and psychological symptoms of dementia for professional caregivers in residential homes: a qualitative study

2020 ◽  
Vol 10 ◽  
pp. 384-393
Author(s):  
Carolina Pinazo
Keyword(s):  
Qualitative Study ◽  
Psychological Symptoms ◽  
The Elderly ◽  
Training Needs ◽  
Residential Setting ◽  
Residential Homes ◽  
Ongoing Training ◽  
People With Dementia ◽  
Behavioural And Psychological Symptoms ◽  
Low Levels

The behavioural and psychological symptoms of dementia are very predominant in the disease, aggravating the suffering of people with dementia and increasing the physical and emotional burden professional caregivers are exposed to. Despite being so present in nursing homes, professional caregivers do not always have adequate training or the tools needed to deal with these situations. Objectives: to determine what knowledge professional caregivers in residential centres have about behavioural and psychological symptoms of dementia; to evaluate how behavioural and psychological symptoms associated with dementia are managed by professional caregivers in residential centres; and to know the training needs perceived by professional caregivers in behavioural and psychological symptoms of dementia. Professionals (in the fields of psychology, nursing coordination and geriatric assistance) from residential centres for the elderly were interviewed and a qualitative analysis of the interviews was carried out. The results show that most professionals do not know the behavioural and psychological symptoms of dementia or how to cope with them and have low levels of knowledge. This study highlights the need to design and provide ongoing training in the residential setting on the management of these symptoms.

scholarly journals Sequential drug treatment algorithm for agitation and aggression in Alzheimer’s and mixed dementia

2018 ◽  
Vol 32 (5) ◽  
pp. 509-523 ◽  
Author(s):  
Simon JC Davies ◽  
Amer M Burhan ◽  
Donna Kim ◽  
Philip Gerretsen ◽  
Ariel Graff-Guerrero ◽  
...  
Keyword(s):  
Drug Treatment ◽  
Psychological Symptoms ◽  
Treatment Algorithm ◽  
Future Research ◽  
Evidence Based ◽  
Hospital Inpatient ◽  
Mixed Dementia ◽  
People With Dementia ◽  
Behavioural And Psychological Symptoms ◽  
Sequential Trials

Introduction: Behavioural and psychological symptoms of dementia (BPSD) include agitation and aggression in people with dementia. BPSD is common on inpatient psychogeriatric units and may prevent individuals from living at home or in residential/nursing home settings. Several drugs and non-pharmacological treatments have been shown to be effective in reducing behavioural and psychological symptoms of dementia. Algorithmic treatment may address the challenge of synthesizing this evidence-based knowledge. Methods: A multidisciplinary team created evidence-based algorithms for the treatment of behavioural and psychological symptoms of dementia. We present drug treatment algorithms for agitation and aggression associated with Alzheimer’s and mixed Alzheimer’s/vascular dementia. Drugs were appraised by psychiatrists based on strength of evidence of efficacy, time to onset of clinical effect, tolerability, ease of use, and efficacy for indications other than behavioural and psychological symptoms of dementia. Results: After baseline assessment and discontinuation of potentially exacerbating medications, sequential trials are recommended with risperidone, aripiprazole or quetiapine, carbamazepine, citalopram, gabapentin, and prazosin. Titration schedules are proposed, with adjustments for frailty. Additional guidance is given on use of electroconvulsive therapy, optimization of existing cholinesterase inhibitors/memantine, and use of pro re nata medications. Conclusion: This algorithm-based approach for drug treatment of agitation/aggression in Alzheimer’s/mixed dementia has been implemented in several Canadian Hospital Inpatient Units. Impact should be assessed in future research.

Behavioural and psychological symptoms of dementia

2020 ◽  
pp. 247-258
Author(s):  
Rianne van der Linde ◽  
Tom Dening
Keyword(s):  
Quality Of Life ◽  
Environmental Factors ◽  
Psychological Symptoms ◽  
Symptom Clusters ◽  
Psychotic Symptoms ◽  
Mixed Group ◽  
People With Dementia ◽  
Affective Symptoms ◽  
Behavioural And Psychological Symptoms

The term: ‘behavioural and psychological symptoms of dementia’ (BPSD) refers to a mixed group of phenomena. BPSD are the non-cognitive features of dementia and include depression, anxiety, psychotic symptoms, apathy, irritability, aggression, and sleep and eating problems. They occur in around 80% of people with dementia at some stage, several of them becoming more frequent as dementia progresses. Some BPSD, notably apathy, are very persistent. BPSD often limit the person’s quality of life and can be stressful for carers. Causes of BPSD include biological, psychological, social, and environmental factors. This chapter explores how they are assessed and measured, and how they may usefully grouped together in symptom clusters. Usually four symptom groups are found: affective symptoms, psychosis, hyperactivity, and euphoria. However, these are not always consistent and in particular apathy does not consistently belong in one group. Approaches to management of BPSD are outlined.

scholarly journals Use of parametric speaker for older people with dementia in a residential care setting: A preliminary study of two cases

2018 ◽  
Vol 31 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Yuko Nishiura ◽  
Minoru Hoshiyama ◽  
Yoko Konagaya
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Psychological Symptoms ◽  
Personal Space ◽  
Acoustic Environment ◽  
People With Dementia ◽  
Behavioural And Psychological Symptoms ◽  
Technological Intervention ◽  
Narrow Space

Objective/Background Older people with dementia often show behavioural and psychological symptoms of dementia such as agitation, aggression, and depression that affect their activities of daily living, and hence reduce the quality of life of their caregivers. The aim of this study was to investigate the effects of a new technological intervention—a parametric speaker, creating a narrow personal acoustic environment, which may reduce the manifestation of behavioural and psychological symptoms of dementia symptoms. Methods A parametric speaker was placed on the ceiling of a large day room, and personally selected pieces of music were provided in a narrow space just under the speaker during the intervention. Two older residents with behavioural and psychological symptoms of dementia participated in the experiment. Results Playing pieces of favorite music via the parametric speaker decreased their behavioural and psychological symptoms of dementia during the intervention. In addition, this intervention reduced the burden on caregivers. One of the advantages of using parametric speaker was being able to create a personal space in a common room. Conclusion We considered that the parametric speaker might be useful to reduce behavioural and psychological symptoms of dementia and the burden on caregivers, providing individualized rehabilitation for the improved quality of life of residents.

scholarly journals Occupational therapy for people with dementia and their family carers provided at home: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e026308 ◽  
Author(s):  
Sally Bennett ◽  
Kate Laver ◽  
Sebastian Voigt-Radloff ◽  
Lori Letts ◽  
Lindy Clemson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Occupational Therapy ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Family Carers ◽  
Moderate Quality ◽  
People With Dementia ◽  
Behavioural And Psychological Symptoms ◽  
Randomised Controlled ◽  
At Home

ObjectiveTo determine the effect of occupational therapy provided at home on activities of daily living, behavioural and psychological symptoms of dementia (BPSD) and quality of life (QOL) for people with dementia, and the effect on family carer burden, depression and QOL.DesignSystematic review and meta-analysis.MethodsEight databases were searched to February 2018. Randomised controlled trials of occupational therapy delivered at home for people with dementia and their family carers that measured ADL, and/or BPSD were included. Two independent reviewers determined eligibility, risk of bias and extracted data.ResultsFifteen trials were included (n=2063). Occupational therapy comprised multiple components (median=8 sessions). Compared with usual care or attention control occupational therapy resulted in improvements in the following outcomes for people with dementia: overall ADL after intervention (standardised means difference (SMD) 0.61, 95% CI 0.16 to 1.05); instrumental ADL alone (SMD 0.22, 95% CI 0.07 to 0.37; moderate quality); number of behavioural and psychological symptoms (SMD −0.32, 95% CI −0.57 to −0.08; moderate quality); and QOL (SMD 0.76, 95% CI 0.28 to 1.24) after the intervention and at follow-up (SMD 1.07, 95% CI 0.58 to 1.55). Carers reported less hours assisting the person with dementia (SMD −0.33, 95% CI −0.58 to −0.07); had less distress with behaviours (SMD −0.23, 95% CI −0.42 to −0.05; moderate quality) and improved QOL (SMD 0.99, 95% CI 0.66 to 1.33; moderate quality). Two studies compared occupational therapy with a comparison intervention and found no statistically significant results. GRADE ratings indicated evidence was very low to moderate quality.ConclusionsFindings suggest that occupational therapy provided at home may improve a range of important outcomes for people with dementia and their family carers. Health professionals could consider referring them for occupational therapy.PROSPERO registration numberCRD42011001166.

The management of behavioural and psychological symptoms of dementia in residential homes: Does Tai Chi have any role for people with dementia?

Dementia ◽  
2011 ◽  
Vol 12 (2) ◽  
pp. 268-279 ◽  
Author(s):  
George Tadros ◽  
Sara Ormerod ◽  
Penny Dobson-Smyth ◽  
Mark Gallon ◽  
Donna Doherty ◽  
...  
Keyword(s):  
Tai Chi ◽  
Psychological Symptoms ◽  
Residential Homes ◽  
People With Dementia ◽  
Behavioural And Psychological Symptoms

scholarly journals Managing behavioural and psychological symptoms in community dwelling older people with dementia: 2. A systematic review of qualitative studies

Dementia ◽  
2018 ◽  
Vol 18 (7-8) ◽  
pp. 2950-2970 ◽  
Author(s):  
Andreas Braun ◽  
Daksha P Trivedi ◽  
Angela Dickinson ◽  
Laura Hamilton ◽  
Claire Goodman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Psychological Symptoms ◽  
Community Dwelling ◽  
Qualitative Studies ◽  
Future Research ◽  
Care Providers ◽  
Family Carers ◽  
People With Dementia ◽  
Behavioural And Psychological Symptoms ◽  
At Home

Background People living with dementia often develop distressing behavioural and psychological symptoms (BPSD) that can affect their quality of life and the capacity of family carers and staff providing support at home. This systematic review of qualitative studies considers the views and experiences of people living with dementia and care providers about these symptoms and what helps to reduce their impact. Methods The two-stage review involved (a) An initial mapping of the literature to understand the range of BPSD, and how it is operationalised by different groups, to develop a search strategy; (b) A search of electronic databases from January 2000 to March 2015, updated in October 2016. Included studies focused on people living in their own homes. Data extraction and thematic analysis were structured to provide a narrative synthesis of the evidence. Results We retrieved 17, 871 records and included relevant qualitative papers (n = 58) targeting community-dwelling people with dementia and family carers around the management of BPSD. Five key themes were identified: (1) Helpful interventions/support for BPSD management, (2) Barriers to support services for BPSD management, (3) Challenges around recognition/diagnosis of BPSD, (4) Difficulties in responding to aggression and other BPSD, and (5) Impact of BPSD on family carers and people living with dementia. Conclusions Family carers sometimes feel that their experiences of BPSD may not be evident to professionals until a crisis point is reached. Some helpful services exist but access to support, lack of knowledge and skills, and limited information are consistently identified as barriers to their uptake. The lack of common terminology to identify and monitor the range of BPSD that people with dementia living at home may experience means that closer attention should be paid to family carer accounts. Future research should include qualitative studies to evaluate the relevance of interventions.

scholarly journals Antipsychotic prescribing for behavioural and psychological symptoms of dementia

2007 ◽  
Vol 31 (5) ◽  
pp. 176-178 ◽  
Author(s):  
Ayodeji Soyinka ◽  
David Lawley
Keyword(s):  
Old Age ◽  
Antipsychotic Drugs ◽  
Psychological Symptoms ◽  
People With Dementia ◽  
Behavioural And Psychological Symptoms ◽  
Audit Cycle ◽  
Two Phases ◽  
Evidence Based Guidelines ◽  
Discharge Summaries

Aims and MethodTo review the quality of information and advice contained in correspondence from old age psychiatrists to general practitioners (GPs) regarding the prescription of antipsychotic drugs for the management of behavioural and psychological symptoms of dementia. Discharge summaries (n=22) and subsequent out-patient review letters were examined and compared with evidence-based guidelines in two phases of an audit cycle; first in 2002 and latterly in 2005.ResultsPractice was below acceptable standards during both phases of the audit cycle, with an actual drop in the quality of explicit advice given to GPs in 2005, despite national publicity about the issues and guidance from the Royal College of Psychiatrists.Clinical ImplicationsThe prescription of antipsychotic drugs is associated with an adverse prognosis for people with dementia. As such, it is imperative that such treatment is regularly reviewed and time limited. Old age psychiatrists need to ensure that this message is communicated to their primary care colleagues.

scholarly journals Ethical dilemmas: should antipsychotics ever be prescribed for people with dementia?

2010 ◽  
Vol 197 (2) ◽  
pp. 88-90 ◽  
Author(s):  
Adrian Treloar ◽  
Monica Crugel ◽  
Aparna Prasanna ◽  
Luke Solomons ◽  
Chris Fox ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Psychological Symptoms ◽  
Ethical Dilemmas ◽  
Evidence Based ◽  
People With Dementia ◽  
Behavioural And Psychological Symptoms ◽  
Evidence Based Guidelines

SummaryThe use of antipsychotics for the treatment of behavioural and psychological symptoms of dementia (BPSD) is controversial. Antipsychotics cause harm and evidence-based guidelines advise against their use. We argue that antipsychotics may be justified using a palliative model: by reducing severe distress in those whose life expectancy is short.

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