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Cognitive impairment is the hallmark of dementia. Behavioral disturbances are
universally experienced by persons with dementia throughout the course of the
illness. Behavioral and Psychological symptoms of dementia (BPSD) cause a significant
negative impact on quality of life, health care outcomes, caregiver stress and burden.
BPSD (Behavioral and psychological symptoms of dementia) is the collective term used
to describe the group of non cognitive symptoms experienced in dementia. These can
include psychosis, agitation and mood disorder and affects 50% - 80% of patients to
varying degrees (Ashlen.P. et al) (Lyketsos CG). Behavioral disturbances can often trigger
hospitalization resulting in increased hospital length of stay (WancataJ.2003). The various
types of dementia are classified according to the different disease process affecting the
brain. The most common cause of dementia is Alzheimer’s Disease, accounting for around
60% of all cases. Vascular dementia and dementia with Lewy bodies are responsible for
most other cases. Alzheimer’s Disease and vascular dementia may co-exist and are difficult
to separate clinically. Dementia is also encountered in about 30% - 70% of patients with
Parkinson’s Disease. Vascular dementia is a consequence of ischemic or hemorrhagic
damage of area of the brain involved in memory and cognition. Alzheimer’s disease
and related dementias are among the most costly and distressing medical conditions for
patients and their caregivers. (Hebert LE etal 2013). Although dementia is often thought
as a disease of memory, 97% of individuals with dementia experience one or more
behavioral disturbance (Steinberg M. et al 2014). BPSD, the known neuropsychiatric
symptoms occurs in clusters or syndromes identified as psychosis, depression, agitation,
aggression, sleep disturbances and apathy. Socially and sexually inappropriate behaviors
are seen. Agitation can be manifested as restlessness, arguing, disruptive vocalization
and rejection of care. Aggression can include verbal insults such as shouting, physical
aggression such as biting and hitting others and throwing objects (Rose KC et al 2017).
BPSD is seen throughout the course of dementia; symptoms may occur intermittently
or fluctuate greatly in severity. These behaviors are seen in all types of dementia but
psychosis and visual hallucinations are more common in Lewy body dementia.
Biography
Amarnath Mallik MBBS DGO DPM FCCP graduated from RGKar Medical College Calcutta is a practicing Psychiatrist. Trained in Stepping Hill Hospital Stokport UK is consultant to Kothari Super Speciality Hospital, Woodlands Hospital and Belle Vue Clinik Calcutta. Conduct and Participate TV, Radio programme on Mental health for community awareness. Author of books in regional language and participated in many National and International conferences.