Katarina Ceranic NinicUniversity Medical Centre Maribor, Slovenia
Title: Challenge to manage behavioral and psychological symptoms of dementia
Dementia is a brain disease resulting from chronic, incurable degeneration of brain cells. The individuals have difficulties in carrying out daily activities and cannot manage their usual life. In addition to memory disorders, we observe a decrease in cognitive functions, such as: the ability to think, orient, understand, calculate, learn, speak and judge. Deterioration of cognitive functions is usually accompanied by changes in social behavior and engagement, a decrease in the ability to manage emotions, or a decrease in motivation.
We know several types of dementia. In people over the age of 65, the most common cause is Alzheimer's disease, which causes more than two-thirds of all dementias. Behavioral and psychological symptoms of dementia (BPSD), also known as neuropsychiatric symptoms are extremely common and often much more troubling than cognitive symptoms. These symptoms include agitation, aggression, delusions, hallucinations, paranoia, wandering, depression, apathy, disinhibition, and sleep disturbances. One or more of these symptoms are observed in 60 to 90 percent of patients with dementia; the prevalence increases with disease severity. The presence of neuropsychiatric symptoms leads to greater functional impairment in patients with dementia and cognitive impairment. The complexity of these symptoms means that there is no “one size fits all solution,” and approaches are tailored to the patient. A step-by-step process is usually helpful in treating BPSD. Whether there is a possibility we check physical or external causes (e.g. pain, infection, injury, hearing and vision impairment, dehydration, constipation, recent change in medication therapy, environmental factor – cold, noise, disorder, lack of activity, boredom, inadequate communication of relatives or caregivers, moving, lack of routine in daily activities...). The following steps are directly aimed at removing the cause, if possible, otherwise combination of non-pharmacological and careful use of pharmacological interventions is the recommended therapeutic for managing BPSD. This presentation will focus on pharmacological treatment of behavioral disturbance and other neuropsychiatric symptoms related to dementia.
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