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.

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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
  • Restlessness, pacing and wandering
  • Anxiety
  • Elation
  • Irritability
  • Depression
  • Apathy
  • Disinhibition
  • Delusions
  • Hallucinations
  • Sleep or appetite changes

How Common Are BPSD Symptoms?

The majority of people—up to 97%—with dementia experience at least one BPSD symptom at some point. The most common BPSD symptoms include depression and apathy, although delusions, agitation, and aberrant motor behaviors (like fidgeting, repetitive behaviors, and wandering) happen in about one-third of patients. These symptoms can be very frustrating and challenging for both patients 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 can be very effective at times.

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

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.

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  1. Cloak N, Al Khalili Y. Behavioral And Psychological Symptoms In Dementia. [Updated 2020 Dec 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan.