- Last edited on February 2, 2024
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geri:dementia:1-bpsd [on May 20, 2019] |
geri:dementia:1-bpsd [on April 24, 2020] |
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| == Prevalence == | == Prevalence == | ||
| BPSD is extremely common in the community (60%), and in nursing homes (80%). More than 90% of patients with dementia develop BPSD over 5 years, and the majority of cases have serious clinical implications.[([[https://www.ncbi.nlm.nih.gov/pubmed/17607801|Steinberg, M., Shao, H., Zandi, P., Lyketsos, C. G., Welsh‐Bohmer, K. A., Norton, M. C., ... & Tschanz, J. T. (2008). Point and 5‐year period prevalence of neuropsychiatric symptoms in dementia: the Cache County Study. International Journal of Geriatric Psychiatry: A journal of the psychiatry of late life and allied sciences, 23(2), 170-177.]])] | BPSD is extremely common in the community (60%), and in nursing homes (80%). More than 90% of patients with dementia develop BPSD over 5 years, and the majority of cases have serious clinical implications.[([[https://www.ncbi.nlm.nih.gov/pubmed/17607801|Steinberg, M., Shao, H., Zandi, P., Lyketsos, C. G., Welsh‐Bohmer, K. A., Norton, M. C., ... & Tschanz, J. T. (2008). Point and 5‐year period prevalence of neuropsychiatric symptoms in dementia: the Cache County Study. International Journal of Geriatric Psychiatry: A journal of the psychiatry of late life and allied sciences, 23(2), 170-177.]])] | ||
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| + | <HTML> | ||
| + | <script async src="https://pagead2.googlesyndication.com/pagead/js/adsbygoogle.js"></script> | ||
| + | <!-- Leaderboard --> | ||
| + | <ins class="adsbygoogle" | ||
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| + | data-ad-client="ca-pub-8020066590182443" | ||
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| ===== Symptoms ===== | ===== Symptoms ===== | ||
| <WRAP group> | <WRAP group> | ||
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| ===== Differential Diagnosis ===== | ===== Differential Diagnosis ===== | ||
| - | <callout type="success">{{fa>arrow-circle-right?color=green}} See also main articles: **[[cl:1-delirium|]], [[pain-medicine:home]], and [[mood:1-depression:home|]]**</callout> | + | <alert icon="fa fa-arrow-circle-right fa-lg fa-fw" type="success">See also main articles: **[[cl:1-delirium|]], [[pain-medicine:home]], and [[mood:1-depression:home|]]**</alert> |
| + | A broad differential diagnosis must be considered **at all times**: | ||
| <WRAP group> | <WRAP group> | ||
| <WRAP half column> | <WRAP half column> | ||
| - | A broad differential diagnosis must be considered **at all times**: | ||
| <panel type="info" title="BPSD Differential Diagnosis" no-body="true"> | <panel type="info" title="BPSD Differential Diagnosis" no-body="true"> | ||
| ^ [[cl:1-delirium|Delirium]] | Look for acute changes and fluctuations, and do a thorough delirium work up if suspected. Infections such as [[https://www.aafp.org/afp/2011/1001/p771.html|UTIs]] can be frequent culprits. | | ^ [[cl:1-delirium|Delirium]] | Look for acute changes and fluctuations, and do a thorough delirium work up if suspected. Infections such as [[https://www.aafp.org/afp/2011/1001/p771.html|UTIs]] can be frequent culprits. | | ||
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| - **Beverage**: are they hungry or thirsty? Have they been offered preferred beverages or food? | - **Beverage**: are they hungry or thirsty? Have they been offered preferred beverages or food? | ||
| - **Bottom** (to Top): a visual survey for obvious precipitants of distress and agitation | - **Bottom** (to Top): a visual survey for obvious precipitants of distress and agitation | ||
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| + | <script async src="https://pagead2.googlesyndication.com/pagead/js/adsbygoogle.js"></script> | ||
| + | <!-- Leaderboard --> | ||
| + | <ins class="adsbygoogle" | ||
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| + | data-ad-client="ca-pub-8020066590182443" | ||
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| + | <script> | ||
| + | (adsbygoogle = window.adsbygoogle || []).push({}); | ||
| + | </script> | ||
| + | </HTML> | ||
| </WRAP> | </WRAP> | ||
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| == Memantine == | == Memantine == | ||
| - | <callout type="success">{{fa>arrow-circle-right?color=green}} See main article: **[[meds:dementia:memantine|]]**</callout> | + | <alert icon="fa fa-arrow-circle-right fa-lg fa-fw" type="success">See main article: **[[meds:dementia:memantine|]]**</alert> |
| There is somewhat limited evidence for memantine, and prospective RCTs have been negative. | There is somewhat limited evidence for memantine, and prospective RCTs have been negative. | ||