Behavioral and psychological symptoms of dementia and their management

PURPOSE: Behavioral and psychological symptoms of dementia (BPSD) are an integral part of dementia syndrome. They increase morbidity and burden, affect quality of life and impact cost of care. This review aims to study the features of BPSD, their assessment and management. COLLECTION AND ANALYSIS OF DATA: Literature of BPSD was searched in PUBMED and the relevant cross references were accessed. CONCLUSIONS: Available literature suggests that BPSD can manifest in multiple ways; the common components are of behavioral, affective, psychotic and somatic in nature. There are specific rating scales for assessing BPSD; however, there is need for developing cross-culturally validated instruments. Nonpharmacological interventions are preferred as first line, which mainly include environmental modification, social interactions, minimizing effect of sensory deficits and behavioral interventions. The judicious use of medications such as cognitive enhancers, atypical antipsychotics and antidepressants has been suggested in acute, emergent situations or when BPSD do not respond to other interventions. There is a research need to address etiologies, social and economic impact of BPSD, efficacy of pharmacological and nonpharmacological treatments and cost-effectiveness of these interventions.