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Behavioral Disturbance in Dementia

  • Geriatric Disorders (DC Steffens, Section Editor)
  • Published:
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Abstract

Behavioral disturbances are frequently the most challenging manifestations of dementia and are exhibited in almost all people with dementia. Common behavioral disturbances can be grouped into four categories: mood disorders (e.g., depression, apathy, euphoria); sleep disorders (insomnia, hypersomnia, night–day reversal); psychotic symptoms (delusions and hallucinations); and agitation (e.g., pacing, wandering, sexual disinhibition, aggression). They are often persistent, greatly diminish quality of life of patients and their family caregivers, cause premature institutionalization, and pose a high economic burden on the patient, family, and society. Behavioral disturbances can be prevented and treated with a multifaceted approach that supports dignity and promotes comfort and quality of life of persons with dementia and their family members. Management involves prompt treatment of reversible factors and management of symptoms using primarily individualized nonpharmacological interventions. Pharmacological interventions need to be restricted to behavioral emergencies and for short-term treatment of behavioral disturbances that pose imminent danger to self or others.

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Disclosure

Dr Desai and Dr Schwartz reported no potential conflicts of interest relevant to this article.

Dr Grossberg has served as a consultant for Baxter, Forest Laboratories, Merck, and Novartis, and has received research funding from Baxter, Bristol-Myers Squibb, Forest Laboratories, Janssen, National Institutes of Health (NIH), Novartis, and Pfizer. Dr Grossberg has received payment for the development of educational presentations from Novartis; has had travel/accommodations expenses covered/reimbursed by Merck and Novartis; has received payment for serving on safety monitoring commissions for Abbot and Merck.

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Authors and Affiliations

  1. Department of Neurology and Psychiatry, Saint Louis University School of Medicine, 1438 S. Grand Blvd, St. Louis, MO, 63104, USA

    George T. Grossberg

  2. Department of Psychiatry, University of Maryland School of Medicine, 710 W Pratt St., 4th Floor, Baltimore, MD, 21201, USA

    Lori Schwartz

  3. Geriatric Psychiatry, Sheppard Pratt Health Systems, 6501 N Charles St, Baltimore, MD, 21285, USA

    Abhilash K. Desai

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  1. Abhilash K. Desai
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Correspondence to Abhilash K. Desai.

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Desai, A.K., Schwartz, L. & Grossberg, G.T. Behavioral Disturbance in Dementia. Curr Psychiatry Rep 14, 298–309 (2012). https://doi.org/10.1007/s11920-012-0288-5

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