Magazine article Clinical Psychiatry News

Agitation Might Be First Indication of Dementia

Magazine article Clinical Psychiatry News

Agitation Might Be First Indication of Dementia

Article excerpt

EXPERT ANALYSIS FROM A PSYCHOPHARMACOLOGY CONFERENCE SPONSORED BY THE NEVADA PSYCHIATRIC ASSOCIATION

LAS VEGAS - The impact of behavioral disturbances such as agitation and aggression in patients with moderate to severe dementia is substantial.

According to Dr. Rajesh R. Tampi, an estimated 65% of community-dwelling patients with dementia have at least one disruptive behavior and 40% have at least three. In the nursing home setting, he added, 90% of patients with dementia have at least one disruptive behavior while 45% have at least four such behaviors.

"These behaviors are often chronic, with different symptoms emerging as the illness progresses," Dr. Tampi of the psychiatry department at Yale University, New Haven, Conn., said at the psychopharmacology conference.

"They also fluctuate with psychomotor agitation being the most persistent. However, the most common behavioral symptom is apathy, which is seen in about 90% of patients with Alzheimer's disease."

The emergence of such behaviors may be the first indication of dementia. "Most of the patients I see in the clinic come to me because they have had behavioral problems, especially agitation," said Dr. Tampi, who is also director of behavioral health services at Masonicare in Wallingford, Conn. "They may cause significant caregiver burden and burnout, especially symptoms like paranoia aggression, and sleep-wake disturbance, so you always need to talk to the caregiver to find out how they are doing."

Behavioral manifestations of dementia may prompt admission to an assisted living facilit, a skilled nursing facility, or a hospital, and they also may indicate rapid progression or worse prognosis. They also add to the direct and indirect cost of care of the illness.

"In terms of management, an individualized treatment plan is essential," Dr. …

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