Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Mini Review Volume 4 Issue 11

Behavioural and Psychological Problems in Dementia

Swaleha Mujawar1, Miliind Sose2, Chetan Dewan2, Suprakash Chaudhury1*,and Daniel Saldanha1

1Department of Psychiatry, Dr D Y Patil Medical College, Hospital and Research Centre, Dr D Y Patil University, Pune, India
2Karve Institute of Social Service, Pune, India

*Corresponding Author:Suprakash Chaudhury, Department of Psychiatry, Dr D Y Patil Medical College, Hospital and Research Centre, Dr D Y Patil University, Pune, India.

Received: September 30, 2020; Published: October 12, 2020



  Behavioural disturbances in the form of agitation and aggression occur frequently in persons with dementia. Mean prevalence of behavioural disturbances in dementia is reported to be as high as 46.2%. Various psychological and behavioural symptoms reported in dementia apart from agitation and aggression include apathy, delusions, hallucinations, irritability, eating disturbances and sleep disorders. Other symptoms seen include hyperactivity, affective symptoms including depression and anxiety. The neurobiological changes seen in dementia include decrease in cholinergic and serotonergic activity, alterations in the noradrenergic systems; decrease in the norepinephrine level and an increase in the level of its major metabolite 3-methoxy-4-hydroxyphcnylglycol. Tools used for assessing include the behavioral pathology in Alzheimer's disease rating scale (BFHAVE-AD), the Cohen-Mansfield Agitation Inventory (CMAI), the neuropsychiatric inventory (NPI) and the behavioral rating scale for dementia (BRSD). A variety of treatments are available to alleviate the behavioural symptoms. Antipsychotics have been found to be the treatment of choice for behavioural disturbances. Treatment of depression in dementia comprises pharmacotherapy and nonpharmacological strategies, such as psychological interventions to enhance quality of life. Psychological intervention begins with the development of a daily routine and the organization of activities which the patient enjoys. A detailed treatment regime is discussed in the article below.

Keywords: Alzheimer's Disease; Cognitive Deficits; Psychological Symptoms; Apathy; Aggression; Delusions; Psychosis; Hallucinations; Irritability; Sleep Disorders



  1. Gustafson L. “What is dementia?” Acta Neurologica Scandinavica 168 (1996): 22-24.
  2. Purandare N., et al. “Behavioural and psychological symptoms of dementia”. Journal of Clinical Gerontology and Geriatrics 3 (2000): 245-260.
  3. Honig LS and Mayeux R. “Natural history of Alzheimer's disease”. Aging 3 (2001): 171-182.
  4. Bush A and Beail N. “Risk factors for dementia in people with down syndrome: issues in assessment and diagnosis”. American Journal of Mental Retardation 2 (2004): 83-97.
  5. Watchman K. “Learning Disabilities and Dementia” (2008).
  6. Burt DB., et al. “Depression and the onset of dementia in adults with mental retardation”. American Journal of Mental Retardation 5 (1992): 502-511.
  7. Cooper SA. “High prevalence of dementia among people with learning disabilities not attributable to Down's syndrome”. Psychological Medicine 3 (1997): 609-616.
  8. McKeith I and Cummings J. “Behavioural changes and psychological symptoms in dementia disorders”. The Lancet Neurology 11 (2005): 735-742.
  9. Van der Linde RM., et al. “Grouping of behavioural and psychological symptoms of dementia”. International Journal of Geriatric Psychiatry 6 (2014): 562-568.
  10. Eastwood R and Reisberg B. “Mood and behaviours”. In: Gauthier S, ed. Clinical Diagnosis and Management of Alzheimer's Disease”. London, UK: Martin Dunitz (1996): 175-190.
  11. Ravona-Springer R and Davidson M. “Depression and apathy in dementia”. Romanian Journal of Psychopharmacology 49 (2009): 183-190.
  12. Deutsch LH., et al. “Psychosis and physical aggression in probable Alzheimer's disease”. The American Journal of Psychiatry 9 (1991): 1159-1163.
  13. Mychack P., et al. “The influence of right frontotemporal dysfunction on social behavior in frontotemporal dementia”. Neurology11-4 (2001): S11-S15.
  14. Müller-Spahn F and Hock C. “Behavioral disturbances in old age”. In: Lader M, Naber D, eds. Difficult Clinical Problems in Psychiatry. London, UK: Martin Dunitz (1999): 181-198.
  15. Sandman PO. “Influence of the patient's environment on the progression of Alzheimer's disease”. Neurobiology of Aging 6 (1995): 871-882.
  16. Raskind MA and Peskind ER. “Neurobiologic bases of noncognitive behavioral problems in Alzheimer disease”. Alzheimer Disease and Associated Disorders 3 (1994): 54-60.
  17. Bondareff W. “Neuropathology of psychotic symptoms in Alzheimer's disease”. International Psychogeriatric 3 (1996): 233-272.
  18. Zaudig M. “Behavioral and psychological symptoms of dementia in the International Classification of Diseases (ICD-10) and beyond (ICD-11)”. International Psychogeriatric 1 (2000): 29-40.
  19. Reisberg B., et al. “Behavioral symptoms in Alzheimer's disease: phenomenology and treatment”. The Journal of Clinical Psychiatry 48 (1987): 9-15.
  20. Cohen-Mansfield JJ. “Agitated behaviors in the elderly. II. Preliminary results in the cognitively deteriorated”. Journal of the American Geriatrics Society 10 (1986): 722-727.
  21. Cohen-Mansfield J., et al. “A description of agitation in a nursing home”. The Journals of Gerontology 3 (1989): M77-M84.
  22. Cummings JL., et al. “The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia”. Neurology12 (1994): 2308-2314.
  23. Tariot PN., et al. “The Behavior Rating Scale for Dementia of the Consortium to Establish a Registry for Alzheimer's Disease. The Behavioral Pathology Committee of the Consortium to Establish a Registry for Alzheimer's Disease”. The American Journal of Psychiatry 9 (1995): 1349-1357.
  24. Alzheimers Association, What is Dementia (2015).
  25. Cowles C. “Nursing Home Statistical Yearbook”. Anacortes, Wash: Cowles Research Group (1997).
  26. Devanand DP., et al. “A randomized, placebo-controlled dose-comparison trial of haloperidol for psychosis and disruptive behaviors in Alzheimer's disease”. The American Journal of Psychiatry 11 (1998): 1512-1520.
  27. Small GW., et al. “Diagnosis and treatment of Alzheimer disease and related disorders. Consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society”. The Journal of the American Medical Association 16 (1997): 1363-1371.
  28. Lyketsos CG and Olin J. “Depression in Alzheimer's disease: overview and treatment”. Biological Psychiatry 3 (2002): 243-252.
  29. Montgomery SA and Kasper S. “Comparison of compliance between serotonin reuptake inhibitors and tricyclic antidepressants: a meta-analysis”. International Clinical Psychopharmacology 4 (1995): 33-40.
  30. Rabins PV. “Behavioral disturbances of dementia: practical and conceptual issues”. International Psychogeriatric 3 (1996): 281-291.


Citation: Suprakash Chaudhury., et al. “Behavioural and Psychological Problems in Dementia". Acta Scientific Medical Sciences 4.11 (2020): 32-35.


Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.403

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is May 30, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US