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Dementia, behaviour and psychological symptoms of dementia, aggression, cognition

Ellen Van Leeuwen, Mirko Petrovic, Mieke L van Driel, An Im De Sutter, Robert Vander Stichele, Tom Declercq, Thierry Christiaens
BACKGROUND: Antipsychotic agents are often used to treat neuropsychiatric symptoms (NPS) in people with dementia although there is uncertainty about the effectiveness of their long-term use for this indication and concern that they may cause harm, including higher mortality. When behavioural strategies have failed and treatment with antipsychotic drugs is instituted, regular attempts to withdraw them have been recommended in guidelines. Physicians, nurses and families of older people with dementia may be reluctant to stop antipsychotics, fearing deterioration of NPS...
March 30, 2018: Cochrane Database of Systematic Reviews
Damiana Scuteri, Laura Rombola, Laura Tridico, Hirokazu Mizoguchi, Chizuko Watanabe, Tsukasa Sakurada, Shinobu Sakurada, Maria TIziana Corasaniti, Giacinto Bagetta, Luigi Antonio Morrone
1.1. BACKGROUND: Alzheimer's Disease (AD) accounts for approximately 50% of all cases of dementia and, in spite of the great effort for the development of disease-modifying drugs, a definitive treatment of cognitive impairment is not available yet. A perfect adherence to the current therapy of cognitive decline is needed for a better control of the disease and this is proven to reduce, though not completely abolish, the associated Behavioural and Psychological Symptoms of Dementia (BPSDs) from occurring...
March 6, 2018: Current Medicinal Chemistry
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
Nicolas Farina, Lucy Morrell, Sube Banerjee
OBJECTIVES: Antidepressants are commonly used in dementia. Depression is a frequent and important co-morbidity in dementia, and antidepressants are often used to treat depression and more widely. However, there are questions about their utility in depression in dementia and other behavioural and psychological symptoms of dementia. The aim of this narrative review is to summarize the evidence on whether there is therapeutic value in prescribing antidepressants to people with dementia. METHODS: A PubMed search was performed to identify randomized controlled trials that prescribed antidepressants to people with dementia, either in the treatment of behavioural and psychological symptoms of dementia (depression, anxiety, agitation/aggression, psychosis and apathy) or for secondary outcomes (quality of life, carer burden, activities of daily living, cognition, clinical severity and adverse events)...
January 2017: International Journal of Geriatric Psychiatry
S-M Paddick, A Kisoli, A Longdon, C Dotchin, W K Gray, P Chaote, A Teodorczuk, R Walker
OBJECTIVES: Behavioural and psychological symptoms (BPS) in dementia are common in high-income countries, but there are few data from sub-Saharan Africa. Our aim was to estimate the prevalence and pattern of BPS and associated caregiver distress in rural Tanzania. METHODS: Prevalent cases of dementia (aged 70 and over) were identified during a community-based door-to-door study in six rural villages in Tanzania. Following cognitive screening, a stratified sample (over-sampled for people with dementia) of cases underwent a detailed clinical assessment including the brief 12 item neuropsychiatric inventory (NPI-Q), which assesses BPS and associated caregiver distress over the preceding 30 days...
August 2015: International Journal of Geriatric Psychiatry
Mariola Bidzan, Leszek Bidzan
INTRODUCTION: AD and VD are preceded by a preclinical stage. Small but tangible cognitive impairments sometimes occur many years before the onset and diagnosis ofdementia. The ongoing degenerative process can be conductive to behavioural and psychological symptoms. AIM: The aim of the study was to investigate the rates of neurobehavioral symptoms in the preclinical stages of AD and VD. METHODS: Two hundred and ninety one residents of nursery homes were included in the study...
March 2014: Psychiatria Polska
Alfonso J Cruz-Jentoft, José-Antonio Burón, Jesús I Diago, Ricardo Gallego
Objective Studies have found that the atypical antipsychotic drug, risperidone, reduces non-cognitive symptoms, such as aggression, agitation, and psychosis, in patients with Alzheimer's disease. This study assessed whether these effects extend to patients with vascular or mixed-type dementia. Methods In this multicentre, open-label, prospective study, 75 elderly patients with vascular or mixed-type dementia and concomitant behavioural and psychological symptoms were treated with risperidone for up to 6 months...
2005: International Journal of Psychiatry in Clinical Practice
Naofumi Tanaka, Masahiro Nakatsuka, Hiroshi Ishii, Rie Nakayama, Ryoko Hosaka, Kenichi Meguro
AIM: The aim of this study was to investigate the clinical utility of the Functional Independence Measure (FIM), and especially FIM-Cognition (FIM-C) scores, in patients with Alzheimer's disease (AD) and vascular dementia (VaD), and to determine the influence of behavioural and psychological symptoms of dementia (BPSD) on FIM-C scores. METHODS: This was a cross-sectional survey of 37 AD and 40 VaD patients. Cognitive function was assessed with the Cognitive Abilities Screening Instrument...
December 2013: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
M Kołaczkowski, P Mierzejewski, P Bieńkowski, A Wesołowska, A Newman-Tancredi
BACKGROUND AND PURPOSE: Many dementia patients exhibit behavioural and psychological symptoms (BPSD) that include psychosis, aggressivity, depression and anxiety. Antipsychotic drugs are frequently prescribed but fail to significantly attenuate mood deficits, may interfere with cognitive function and are associated with motor and cardiac side effects, which are problematic in elderly patients. A need therefore exists for drugs that are better suited for the treatment of BPSD. EXPERIMENTAL APPROACH: We used in vitro cellular and in vivo behavioural tests to characterize ADN-1184, a novel arylsulfonamide ligand with potential utility for treatment of BPSD...
February 2014: British Journal of Pharmacology
A Maubert, C Hanon, J-P Metton
INTRODUCTION: Niemann-Pick type C disease (NPC) is a rare hereditary disease, which psychiatrists do not face often in France. Indeed, only a couple of articles specifically describing the psychiatric-disorders in the adult form have been published. And for the most part, they were not written by psychiatrists. This comprehensive international literature review aims at providing knowledge on this disease to French psychiatrists. METHODS: To achieve this literature review, we used the "PubMed" search engine, looking for the following keywords: Niemann-Pick type C AND (schizophrenia OR psychosis)...
October 2013: L'Encéphale
Tanja Richter, Gabriele Meyer, Ralph Möhler, Sascha Köpke
BACKGROUND: Antipsychotic medication is regularly prescribed in care homes to control 'behavioural and psychological symptoms of dementia' despite moderate efficacy, significant adverse effects, and available non-pharmacological alternatives. OBJECTIVES: To evaluate the effectiveness of psychosocial interventions to reduce antipsychotic medication in care home residents. SEARCH METHODS: The Cochrane Dementia and Cognitive Improvement Group's Specialized Register, MEDLINE, EMBASE, CINAHL, PsycINFO, LILACS, a number of trial registers and grey literature sources were searched on 19th December 2011...
2012: Cochrane Database of Systematic Reviews
Renaud David, Julie Piano, Philippe Robert
Behavioural and psychological symptoms (BPSD) are now known to be frequently associated to cognitive and functional decline in Alzheimer's disease and related disorders. Recommendations for the management of BPSD have been proposed. Non-pharmacological interventions should be the first-line treatment. Anti-dementia agents (cholinesterase inhibitors, memantine) and psychotropic drugs (antipsychotics, antidepressants and anticonvulsivants) could be associated to non-pharmacological interventions only in case of limited response with non pharmacologic approaches...
September 2011: La Revue du Praticien
Ashok Krishnamoorthy, David Craufurd
Apathy is one of the most prevalent neurobehavioral symptoms in Huntington's disease (HD), occurring in approximately 70% of the symptomatic HD population. Apathy scores in patients with HD are highly correlated with duration of illness, suggesting that apathy is an inevitable consequence of advanced disease. Although less distressing than symptoms like depression and less disruptive than irritability or aggression, apathy has a considerable adverse impact on those affected with HD because it leads to a decrease of the goal-directed behaviors that contribute much to the day-to-day quality of life...
October 2011: Current Treatment Options in Neurology
Francesco Panza, Vincenza Frisardi, Davide Seripa, Grazia D'Onofrio, Andrea Santamato, Carlo Masullo, Giancarlo Logroscino, Vincenzo Solfrizzi, Alberto Pilotto
Neuropsychiatric symptoms (NPS) in dementia, previously denominated as behavioural and psychological symptoms of dementia, are often more distressing, impairing, and costly than cognitive symptoms, representing a major health burden for older adults. These symptoms are common features of Alzheimer's disease (AD), and are one of the major risk factors for institutionalization. There is a high prevalence of neuropsychiatric disturbances in patients with AD, including depression, anxiety, apathy, psychosis, aggression, and agitation...
January 2012: Ageing Research Reviews
Atsushi Hamuro, Satona Saito
The aim of the present study was to determine the efficacy, side-effects and tolerability of blonanserin for treating refractory behavioural psychological symptoms of dementia (BPSD). The present study was a 12-week, prospective, structured clinical trial of blonanserin for the treatment of BPSD. The degree of cognitive function, activities of daily living score, and the degree of BPSD were determined using the Mini-Mental State Examination (MMSE), Disability Assessment for Dementia (DAD), Neuropsychiatric Inventory (NPI) and the Rating Scale for Aggressive Behaviour in the Elderly (RAGE)...
December 2010: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
Gaukhman Alexander, Amanda Hanna, Vanida Serna, Linda Younkin, Steve Younkin, Christopher Janus
Behavioural and psychological signs and symptoms of dementia encompass a wide range of neuropsychiatric disturbances which coincide with progressing cognitive decline in Alzheimer's disease (AD). Physical aggression and agitation, which occurs in 20-65% of AD patients, is physically and emotionally stressful, not only to patients but also to immediate family and caregivers. The exact mechanisms underlying the increased aggressive behaviour in AD has yet to be elucidated. We used a transgenic mouse model, denoted Tg2576, which over-expresses a mutated human amyloid precursor protein (APP) gene implicated in familial AD, to investigate aggressive behaviour of males at the stage of amyloid beta pathology preceding overt amyloid plaque deposition in the brain...
January 1, 2011: Behavioural Brain Research
Barbara Borroni, Chiara Costanzi, Alessandro Padovani
Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive cognitive decline including loss of memory, orientation and reasoning. However, a relevant aspect of AD is the presence of a variety of behavioural and psychological symptoms in dementia (BPSD), beyond the well-known progressive cognitive impairment. Approximately 50% to 80% of patients diagnosed with AD present behavioural or psychiatric disturbances such as psychosis, depression, agitation, disinhibition, aggression, hyperactivity, and socially intrusive behaviours...
March 2010: Current Alzheimer Research
Manuela Kerer, Josef Marksteiner, Hartmann Hinterhuber, Guerino Mazzola, Reinhard Steinberg, Elisabeth M Weiss
Patients suffering from dementia are nevertheless still able to render exceptional musical performances. For example, they can recognize music from childhood and reproduce lyrics and melodies of songs with four verses. Furthermore, behavioural symptoms such as psycho- motor agitation and crying, but also aggressive behaviour can be positively influenced by music and motivation and positive emotions can be increased. A variety of physiological and psychological changes occur when patients are listening to music...
2009: Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation
Katsuyoshi Mizukami, Takashi Asada, Toru Kinoshita, Katsuaki Tanaka, Kazuki Sonohara, Ryuhei Nakai, Kiyoshi Yamaguchi, Haruo Hanyu, Kiyoshi Kanaya, Tetsuya Takao, Masakatsu Okada, Sumio Kudo, Hayato Kotoku, Masahiko Iwakiri, Hirofumi Kurita, Toshihiro Miyamura, Yosuke Kawasaki, Koji Omori, Kazumasa Shiozaki, Toshinari Odawara, Tatsuya Suzuki, Shizuru Yamada, Youichi Nakamura, Kenji Toba
The effectiveness and safety of yokukansan (TJ-54), a traditional Japanese medicine (kampo) for the treatment of the behavioural and psychological symptoms of dementia (BPSD), were evaluated in 106 patients diagnosed as having Alzheimer's disease (AD) (including mixed-type dementia) or dementia with Lewy bodies. Patients were randomly assigned to group A (TJ-54 treatment in period I and no treatment in period II; each period lasting 4 wk) or group B (no treatment in period I and TJ-54 treatment in period II)...
March 2009: International Journal of Neuropsychopharmacology
E Salmon
Behavioural and psychological disorders are frequent not only in frontotemporal dementia (FTD), but also in Alzheimer's disease (AD), and many of them are related to serotoninergic dysfunction. In vitro biochemical measurements on brain samples show both pre- and post-synaptic impaired brain serotoninergic function in degenerative dementia, sometimes related to hyperactivity or aggressive behaviour. To date, few studies have explored in vivo 5HT2A and 5HT1A brain receptors in AD and FTD. They suggest that brain cells are lost in the associative cortices (5HT2A) and hippocampus (5HT1A) of AD patients, and in the medial prefrontal and orbitofrontal cortices of FTD subjects (5HT2A)...
September 2007: Journal of Neural Transmission
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