What Are the Behavioral and Psychological Symptoms of Dementia (BPSD)?

Behavioral and psychosocial symptoms of dementia (BPSD), or neuropsychiatric symptoms, are general terms used in the field of Alzheimer's disease and dementia to describe the challenging behaviors of dementia.

Isn't Dementia a Cognitive Disorder?

Yes. It's a condition where the functioning of the brain deteriorates, causing impaired ability to think and interact appropriately with others and the environment. This brain deterioration frequently causes personality, behavioral, psychological, and emotional changes, which can be referred to as BPSD.

Symptoms of BPSD

Symptoms of BPSD include:

• Agitation
• Wandering
• Euphoria
• Anxiety
• Irritability
• Depression
• Apathy
• Disinhibition
• Delusions
• Hallucinations
• Sleep or appetite changes

How Common Are BPSD Symptoms?

The most common BPSD symptoms include apathy and agitation, irritability, sleep and appetite disorders, and mood disorders. In a 2017 study, 99.1% of 107 people with dementia exhibited at least one BPSD symptom and 71% had four or more symptoms. These symptoms can be very frustrating and challenging for those with dementia and their caregivers.

Treatment Options for BPSD Symptoms

In many cases, non-drug approaches are the safest and most effective way to manage these symptoms. Strategies such as attempting to determine the cause of the behavior and meet or prevent that need may be helpful.

For example, is the person pacing, wandering, and agitated because they are experiencing boredom and loneliness? Then we need to provide them with meaningful activities, not just a bingo game. Are they unsafely trying to get up out of a chair repeatedly? We need to determine if they need to use the bathroom or stretch their legs by going for a walk.

In other situations, medications might be more appropriate. For example, if someone is experiencing distressing hallucinations, delusions, or paranoia, an antipsychotic medication might be appropriate to relieve the distress. However, these medications do have the potential for significant side effects, so careful monitoring is a must.