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geri:dementia:1-bpsd [2019/05/20 03:34]
psychdb
geri:dementia:1-bpsd [2020/04/30 22:17] (current)
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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.]])]
 +
 +<​HTML>​
 +<script async src="​https://​pagead2.googlesyndication.com/​pagead/​js/​adsbygoogle.js"></​script>​
 +<!-- Leaderboard -->
 +<ins class="​adsbygoogle"​
 +     ​style="​display:​block"​
 +     ​data-ad-client="​ca-pub-8020066590182443"​
 +     ​data-ad-slot="​1227446251"​
 +     ​data-ad-format="​auto"></​ins>​
 +<​script>​
 +     ​(adsbygoogle = window.adsbygoogle || []).push({});​
 +</​script>​
 +</​HTML>​
 ===== 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
 +
 +
 +<​HTML>​
 +<script async src="​https://​pagead2.googlesyndication.com/​pagead/​js/​adsbygoogle.js"></​script>​
 +<!-- Leaderboard -->
 +<ins class="​adsbygoogle"​
 +     ​style="​display:​block"​
 +     ​data-ad-client="​ca-pub-8020066590182443"​
 +     ​data-ad-slot="​1227446251"​
 +     ​data-ad-format="​auto"></​ins>​
 +<​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.