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Feature Article

Managing behavioural problems in dementia

Gerard J Byrne
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Abstract

Most people with dementia exhibit behavioural or psychological symptoms at some point in their illness, and about half will require some form of intervention. Successful management of these symptoms will reduce the burden of distress experienced by both patients and caregivers.

Key Points

  • Behavioural and psychological symptoms are common in people with dementia. These symptoms can occur in mild, moderate and severe dementia.
  • General medical problems can exacerbate existing confusion and induce behavioural and/or psychological symptoms in dementia. For this reason, patients should be assessed for intercurrent illness, adverse effects of prescription medications, drug and alcohol abuse and dehydration before being treated for behavioural and psychological symptoms.
  • A variety of nonpharmacological treatments are worth trying in patients who present with behavioural and psychological symptoms.
  • Antidepressant medication can be effective in patients with dementia and depression.
  • Low-dose antipsychotic medication is sometimes useful in patients with dementia complicated by marked agitation, aggression or psychosis.

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