Curriculum · Elderly / Community care
Behavioural and psychological symptoms of dementia
What it is
Behavioral and psychological symptoms are the behavioral half of dementia. In Alzheimer's disease the description is memory with executive function impairment, visuospatial plus language deficits, and behavioral and psychological labiality. Each dementia has its own behavior. Lewy body dementia gives visual hallucinations and fluctuating cognition with parkinsonism and autonomic dysfunction, and is characterized initially by dementia and visual hallucinations followed by parkinsonian features. Frontotemporal dementia, or Pick disease, gives behavioral disinhibition, perseveration and apathy with progressive non-fluent aphasia, and personality change and disinhibition followed by early dementia is suggestive of it.
Causes and risk
Before the behavior is put down to the dementia itself, reversible organic causes are ruled out: hypothyroidism, B12 deficiency, HIV and syphilis infections. The medications chart is reviewed and the patient is assessed for substance misuse. Depression must also be ruled out as a cause of dementia, where it is known as pseudodementia. Where drugs are considered, the evaluation should not reveal any treatable underlying conditions before antipsychotics are used.