Dementia: behavioural and psychological symptoms
The term dementia refers to a group of conditions that cause a progressive widespread decline in brain function. There are 4 main types of dementia, of which the most common is Alzheimer's disease.
What are the behavioural and psychological symptoms?
Loss of memory and intellectual function are frequent symptoms, but dementia can also cause changes in behaviour and mood. In fact, at least 90 per cent of people with the disorder will develop behavioural and psychological symptoms of dementia (BPSD).
Some examples of BPSD are:
- repetitive behaviour;
- mood disturbance (e.g. depression);
- social inappropriateness;
- psychosis, which may include delusions (false beliefs) and hallucinations (seeing or hearing things that are not actually there);
- physical aggression; and
- sleep disturbance.
Why do these symptoms occur?
BPSD can be due to a number of different causes. Some of these symptoms are part of the underlying dementing process, but it is important to try to determine if any other factors might be contributing.
If carers notice a change in behaviour of a person with dementia, they should discuss it with their doctor. The doctor will be able to assess whether the person may be suffering from a psychological disorder such as depression.
They will also be able to assess whether an underlying physical disorder has brought about the change in behaviour, for example, physical discomfort due to ongoing constipation or urinary incontinence.
How can these symptoms be managed?
Behavioural symptoms can often be quite challenging to cope with for carers of people with dementia.
Carers should discuss with the doctor ways in which they can best help manage these symptoms. Some simple examples of this may include:
- maintaining a familiar environment;
- large face clocks, calendars and signs to improve orientation;
- providing pleasant stimulating activities;
- encouraging exercise and group activities;
- following set routines for daily tasks; and
- providing a calm clear explanation about any changes to the routine.
Alzheimer's Australia also provides information regarding behavioural changes in dementia and offers education and support for carers. These behaviours can be very stressful for those dealing with them.
If a person with dementia is found to have depression, antidepressant medicines can be effective. There is also some evidence that medications called cholinesterase inhibitors may decrease the development of behavioural disturbances in Alzheimer's disease.
Other medicines may be helpful for symptoms such as agitation and aggression or for psychotic symptoms, but these need to be used with caution because of side effects. They are therefore usually only used in severe cases, when immediate treatment is needed or when other attempts at management have failed.
2. Alzheimer's Australia. Drug Treatments for Alzheimer's disease: cholinesterase inhibitors. http://www.fightdementia.org.au/understanding-dementia/update-sheets.aspx (accessed Feb 2013).
3. Alzheimer's Australia. Drugs used to relieve behavioural and psychological symptoms of dementia. http://www.fightdementia.org.au/understanding-dementia/update-sheets.aspx (accessed Feb 2013).