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Dementia and BPSD

Hiroaki Kazui
Previous systematic reviews of non-pharmacological interventions for clinical symptoms in dementia patients have confirmed the effectiveness of cognitive stimulation therapy (CST) for cognitive impairment, exercise therapy for activities of daily living, and music therapy and behavior management techniques for behavioral and psychological symptoms of dementia (BPSD). A Japanese version of CST has been developed and is available, but standardized exercise therapy and music therapy have not been developed. It is also important for informal and formal caregivers to learn behavior management techniques...
March 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
Britt Klein, Lisa Clinnick, Jessica Chesler, Andrew Stranieri, Adam Bignold, Richard Dazeley, Suzanne McLaren, Sue Lauder, Venki Balasubramanian
BACKGROUND: This regional pilot site 'end-user attitudes' study explored nurses' experiences and impressions of using the Nurses' Behavioural Assistant (NBA) (a knowledge-based, interactive ehealth system) to assist them to better respond to behavioural and psychological symptoms of dementia (BPSD) and will be reported here. METHODS: Focus groups were conducted, followed by a four-week pilot site 'end-user attitudes' trial of the NBA at a regional aged care residential facility (ACRF)...
2018: Studies in Health Technology and Informatics
Raquel Baeta-Corral, Björn Johansson, Lydia Giménez-Llort
Coffee or caffeine has recently been suggested as prophylaxis for dementia. Although memory problems are hallmarks of Alzheimer's disease, this dementia is also characterized by neuropsychiatric symptoms called Behavioral and Psychological Symptoms of Dementia (BPSD). The impact of preventive/therapeutic strategies on both cognitive and non-cognitive symptoms can be addressed in the 3xTg-AD mice, since they exhibit cognitive but also BPSD-like profiles. Here, we studied the long-term effects of a low dose of caffeine in male 3xTg-AD mice and as compared to age-matched non-transgenic (NTg) counterparts with normal aging...
2018: Frontiers in Pharmacology
Barbara Resnick, Ann Kolanowski, Kimberly Van Haitsma, Elizabeth Galik, Marie Boltz, Jeanette Ellis, Liza Behrens, Nina M Flanagan, Karen J Eshraghi, Shijun Zhu
Behavioral and psychological symptoms of dementia (BPSD) include aggression, agitation, resistiveness to care, depression, anxiety, apathy, and hallucinations. BPSD are common in nursing home residents and can be ameliorated using person-centered approaches. Despite regulatory requirements, less than 2% of nursing homes consistently implement person-centered behavioral approaches. In a National Institute of Nursing Research-funded research protocol, we are implementing a pragmatic cluster randomized clinical trial designed to enable staff in nursing homes to reduce BPSD using behavioral approaches while optimizing function, preventing adverse events, and improving quality of life of residents...
February 27, 2018: Research in Nursing & Health
J Kim, A De Bellis, L Xiao
PURPOSE: The South Korean government introduced the universal Long-Term Care Insurance (LTCI) program in 2008 that created a new employment category of 'paid family care worker' to assist the elderly with chronic illnesses including dementia. The aim of this study was to understand the lived experience of paid family care workers of people with dementia in South Korea. METHODS: The study was a qualitative research design underpinned by Interpretive Description principles involving eight paid family care workers...
February 5, 2018: Asian Nursing Research
Michelle L Yakimicki, Nancy E Edwards, Elizabeth Richards, Alan M Beck
This review discusses the relationship between animal-assisted interventions (AAI) and behavioral and psychological symptoms of dementia (BPSD). A systematic search was conducted within CINAHL, Web of Science CAB Abstracts, PubMed, Abstracts in Social Gerontology, Google Scholar, and PsycINFO for primary research articles. A total of 32 studies were included in the final review. Variation was noted in study designs and in study setting. Twenty-seven of 32 studies used dogs as the intervention. Agitation/aggression showed a significant decrease in nine of 15 studies...
February 1, 2018: Clinical Nursing Research
Yukiko Suzuki, Hiroaki Kazui, Kenji Yoshiyama, Shingo Azuma, Hideki Kanemoto, Shunsuke Sato, Takashi Suehiro, Manabu Ikeda
BACKGROUND: It is assumed that care services effectively reduce behavioural and psychological symptoms of dementia (BPSD). However, it is unclear which care services are effective for reducing specific BPSD. The aim of this study was to clarify which care services were recognized by care specialists as being effective for reducing each of 11 BPSD. METHODS: We sent unsigned questionnaires to care specialists in Japan. The questionnaires asked specialists to choose from 12 kinds of care services the most, second-most, and third-most effective service for reducing each of 11 BPSD...
February 7, 2018: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
Susan Macaulay
For the past 20 years, the behaviors of people who live with dementia (PLWD) that others find challenging or problematic have primarily been ascribed to Alzheimer disease and related dementias and have been assessed through the biomedical lens of Behavioral and Psychological Symptoms of Dementia (BPSD). This has led to the root causes of these behaviors being overlooked, which in turn leaves them unaddressed. Further, using the artificial construct of BPSD has led to many PLWD being inappropriately prescribed (off-label) medications that are largely ineffective in resolving the behaviors because they do nothing to remedy the underlying psychosocial and environmental causes...
February 2018: Journal of the American Medical Directors Association
Lauren B Gerlach, Helen C Kales
Behavioral and psychological symptoms of dementia (BPSD) are universally experienced by people with dementia throughout the course of the illness and cause a significant negative impact on quality of life for patients and caregivers. Nonpharmacologic treatments have been recommended as first-line treatment of BPSD by multiple professional organizations and should target patients with dementia factors, caregiver factors, and environmental factors. Psychotropic medications are often prescribed off-label without significant evidence to support their use...
March 2018: Psychiatric Clinics of North America
Courtney A Polenick, Laura M Struble, Barbara Stanislawski, Molly Turnwald, Brianna Broderick, Laura N Gitlin, Helen C Kales
OBJECTIVES: Behavioral and psychological symptoms of dementia (BPSD) are common, often challenging to manage, and may erode caregivers' well-being. Few studies have explored caregivers' perspectives of what causes these behaviors, but such attributions may be important-particularly if they negatively impact the care dyad. This study examined causal attributions about BPSD among individuals caring for a family member with dementia. DESIGN: In-depth qualitative data were obtained from family caregivers of older adults with dementia...
December 13, 2017: American Journal of Geriatric Psychiatry
Tatsuru Kitamura, Shigehito Shiota, Shigetoshi Jinkawa, Maki Kitamura, Shoryoku Hino
BACKGROUND: During hospitalization for behavioural and psychological symptoms of dementia (BPSD), it is imperative to build a support system for each patient in the community for after they obtain symptom remission. To this end, patients lacking adequate family support are less likely to be discharged to their own homes and need stronger support systems to be established. This study therefore investigated the effects of home-visit nursing before admission on time to home discharge among patients with limited familial care who were hospitalized for treatment of BPSD...
January 2018: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
Miho Murata, Toshinari Odawara, Kazuko Hasegawa, Sayaka Iiyama, Masatoshi Nakamura, Masaaki Tagawa, Kenji Kosaka
OBJECTIVE: To investigate the efficacy and safety of zonisamide as an adjunct to levodopa therapy for parkinsonism in patients with dementia with Lewy bodies (DLB). METHODS: This phase 2, placebo-controlled, randomized, double-blind study consisted of run-in (placebo, 4 weeks) and treatment (placebo or zonisamide 25 or 50 mg once daily, 12 weeks) periods. Outpatients diagnosed with probable DLB were eligible for inclusion. The primary endpoint was the change from baseline in Unified Parkinson's Disease Rating Scale (UPDRS) part 3 total score at week 12...
February 20, 2018: Neurology
Simon Jc Davies, Amer M Burhan, Donna Kim, Philip Gerretsen, Ariel Graff-Guerrero, Vincent L Woo, Sanjeev Kumar, Sarah Colman, Bruce G Pollock, Benoit H Mulsant, Tarek K Rajji
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...
January 1, 2018: Journal of Psychopharmacology
J William Kerns, Jonathan D Winter, Katherine M Winter, Terry Boyd, Rebecca S Etz
BACKGROUND: Guidelines, policies, and warnings have been applied to reduce the use of medications for behavioral and psychological symptoms of dementia (BPSD). Because of rare dangerous side effects, antipsychotics have been singled out in these efforts. However, antipsychotics are still prescribed "off label" to hundreds of thousands of seniors residing in nursing homes and communities. Our objective was to evaluate how and why primary-care physicians (PCPs) employ nonpharmacologic strategies and drugs for BPSD...
January 2018: Journal of the American Board of Family Medicine: JABFM
Melanie Isabella Selvadurai, Robyn Waxman, Omar Ghaffar, Ilan Fischler
We report a novel electroconvulsive therapy (ECT) regimen for sustaining the resolution of behavioural and psychological symptoms of dementia (BPSD) using alternating acute and maintenance ECT (M-ECT) trials. A 64-year-old man presenting with major neurocognitive disorder was admitted for acute behavioural disturbances and physical aggression. With few treatment options, the impact on patients' quality of life often supersedes cognitive symptoms and is a predictor of long-term institutionalisation. Recent studies indicate that ECT may be an effective and safe way to address BPSD...
January 5, 2018: BMJ Case Reports
Adreesh Mukherjee, Atanu Biswas, Arijit Roy, Samar Biswas, Goutam Gangopadhyay, Shyamal Kumar Das
Aims: To evaluate the behavioural and psychological symptoms of dementia (BPSD), to determine their correlation with types and stages of dementia and patient demographics, and to assess the impact on caregiver distress. Methods: This cross-sectional study recruited consecutive dementia patients and caregivers who attended our cognitive clinic. Standard criteria were used to classify types of dementia. BPSD were assessed with the Neuropsychiatric Inventory, and its distress scale was used for caregiver distress...
September 2017: Dementia and Geriatric Cognitive Disorders Extra
Joshana K Goga, Antonio Depaolo, Sunil Khushalani, J Ken Walters, Robert Roca, Marc Zisselman, Christopher Borleis
OBJECTIVE: To Evaluate the Effects of Applying Lean Methodology-Improving Quality Increasing Efficiency by Eliminating Waste and Reducing Costs-An Approach To Decrease the Prescribing Frequency of Antipsychotics for The Indication of Agitation. DESIGN: Historically Controlled Study. SETTING: Bheppard Pratt Health System is the Largest Private Provider of Psychiatric Care in Maryland With a Total Bed Capacity of 300. There Were 4 337 Patient Days From November 1 2012 to October 31 2013 on the Dementia Unit...
January 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Aisling A Jennings, Tony Foley, Sheena McHugh, John P Browne, Colin P Bradley
Background: general practitioners (GPs) have identified the management of behavioural and psychological symptoms of dementia (BPSD) as a particularly challenging aspect of dementia care. However, there is a paucity of research on why GPs find BPSD challenging and how this influences the care they offer to their patients with dementia. Objectives: to establish the challenges GPs experience when managing BPSD; to explore how these challenges influence GPs' management decisions; and to identify strategies for overcoming these challenges...
March 1, 2018: Age and Ageing
Rajesh R Tampi, Corey Hassell, Pallavi Joshi, Deena J Tampi
The objective of this review was to assess the efficacy and tolerability of analgesics in reducing behavioral and psychological symptoms of dementia (BPSD) among older adults from published randomized controlled trials (RCTs). A literature search was conducted of PubMed, MEDLINE, SCOPUS, PsycINFO, and Cochrane collaboration databases for RCTs in the English language that evaluated the use of analgesics in reducing the severity of BPSD among older adults. Additionally, references of full-text articles that were included in this review were searched for extra studies...
2017: Drugs in Context
Mitchell McMaster, Elaine Fielding, David Lim, Wendy Moyle, Elizabeth Beattie
BACKGROUND: Behavioral and psychological symptoms of dementia (BPSD) are a common problem in long-term care facilities (LTC). Clinical guidelines dictate that first-line treatments for BPSD are psychosocial and behavioral interventions; if these are unsuccessful, psychotropic medications may be trialed at low doses and their effects can be monitored. METHODS: There have previously been no studies with nationally representative samples to investigate psychotropic administration in LTCs in Australia...
December 4, 2017: International Psychogeriatrics
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