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

BPSD is an abbreviation commonly used in the field of Alzheimer's disease and dementia. BPSD stands for Behavioral and Psychological Symptoms of Dementia. Another term used is neuropsychiatric symptoms. Frequently identified issues that are part of BPSD are 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

BPSD include:

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

How Common Are BPSD?

It's estimated that around 90 percent of people with dementia experience BPSD. Much attention is given to trying to figure out what interventions are helpful for BPSD since these symptoms can be more frustrating and challenging to deal with than the actual cognitive impairment.

The Best Treatment for BPSD

It depends. 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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  • BCMJ, Vol. 55, No. 2, March, 2013, page(s) 90-95. Therapeutic approaches in the management of behavioral and psychological symptoms of dementia in the elderly. http://www.bcmj.org/articles/therapeutic-approaches-management-behavioral-and-psychological-symptoms-dementia-elderly.

  • Frontiers in Neurology. 2012 May 7;3:73. Behavioral and psychological symptoms of dementia. http://www.ncbi.nlm.nih.gov/pubmed/22586419.