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Behavioral and Psychological Symptoms of Dementia
Open accessAbstract
Behavioral and psychological symptoms of dementia (BPSD), also known as neuropsychiatric symptoms, represent a heterogeneous group of non-cognitive symptoms and behaviors occurring in subjects with dementia. BPSD constitute a major component of the dementia syndrome irrespective of its subtype. They are as clinically relevant as cognitive symptoms as they strongly correlate with the degree of functional and cognitive impairment. BPSD include agitation, aberrant motor behavior, anxiety, elation, irritability, depression, apathy, disinhibition, delusions, hallucinations, and sleep or appetite changes. It is estimated that BPSD affect up to 90% of all dementia subjects over the course of their illness, and is independently associated with poor outcomes, including distress among patients and caregivers, long-term hospitalization, misuse of medication, and increased health care costs. Although these symptoms can be present individually it is more common that various psychopathological features co-occur simultaneously in the same patient. Thus, categorization of BPSD in clusters taking into account their natural course, prognosis, and treatment response may be useful in the clinical practice. The pathogenesis of BPSD has not been clearly delineated but it is probably the result of a complex interplay of psychological, social, and biological factors. Recent studies have emphasized the role of neurochemical, neuropathological, and genetic factors underlying the clinical manifestations of BPSD. A high degree of clinical expertise is crucial to appropriately recognize and manage the neuropsychiatric symptoms in a patient with dementia. Combination of non-pharmacological and careful use of pharmacological interventions is the recommended therapeutic for managing BPSD. Given the modest efficacy of current strategies, there is an urgent need to identify novel pharmacological targets and develop new non-pharmacological approaches to improve the adverse outcomes associated with BPSD.
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“Abnormalities in neuropsychiatric states were common among the VEEV TC-83 inoculated WT and Tg2576 mice and were exaggerated responses to the normal, indicating anxiety-like behavior, irritability, or dementia, which are associated with the sequelae of alphaviruses (Reisberg et al., 1987) and with AD (Cerejeira et al., 2012).”
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Pharmacological management of agitation in dementia: An evidence-based review with expert consensus
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Metadata
- Authors
- Cerejeira, J., Lagarto, L., & Mukaetova-Ladinska, E. B.
- Affiliations
- Unidade Local de Saúde de Coimbra (PT)
- ORCID
- Cerejeira, J.
- Venue
- Frontiers in Neurology
- Publisher
- Frontiers Media SA
- Published
- 2012
- Volume
- 3
- Pages
- 73-73
- ISSN
- 1664-2295 (ISSN-L)
- PMC
- PMC3345875
- OpenAlex
- W2120296399
- Cited by
- 1,425
- References
- 214
- Citations by year
- 2026: 111 · 2025: 138 · 2024: 144 · 2023: 188 · 2022: 129 · 2021: 150 · 2020: 122 · 2019: 92 · 2018: 90 · 2017: 78 · 2016: 59 · 2015: 38 · 2014: 32 · 2013: 27 · 2012: 13
- FWCI
- 25.13
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- Frontiers in Neurology (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
- Newcastle University ePrints (Newcastle Univesity) (cc-by-nc)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- behavioral and psychological symptoms of dementia, neuropsychiatric symptoms, dementia, agitation, anxiety, depression, apathy, delusions, hallucinations, sleep disorders, non-pharmacological treatment, pharmacotherapy, pathogenesis, genetic factors, neuropathology, caregiver burden
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