Journal
DEMENTIA AND GERIATRIC COGNITIVE DISORDERS
Volume 38, Issue 1-2, Pages 89-146Publisher
KARGER
DOI: 10.1159/000357839
Keywords
Dementia; Alzheimer's disease; Behavioral and psychological symptoms of dementia; Psychiatric status rating scales; Assessments; Pharmacotherapy; Management; Antipsychotics; Anxiolytics; Patient outcome assessment
Categories
Funding
- United States Department of Health and Human Services (DHHS) [P30 AG08051, AG03051, AG09127, AG11505]
- National Institute on Aging
- National Institute of Mental Health of the U.S. National Institutes of Health [MH43486]
- U.S. DHSS Administration on Aging [90AZ2791, 90AM2552, 90AR2160]
- Forest Laboratories, Inc.
- Fisher Center for Alzheimer's Research Foundation
- Hagedorn Fund
- Louis J. Kay and June E. Kay Foundation
- Stringer Foundation
- Forest Research Institute
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Background: Behavioral and psychological symptoms of dementia (BPSD) and associated disturbances in Alzheimer's disease (AD) are a source of distress and burden for spouses, professional caregivers, and others with responsibilities for the care of individuals with AD. BPSD with behavioral disturbances are also associated with more rapid institutionalization and increased morbidity and mortality for persons with AD. Objectives: In this review and commentary, we discuss the history of the development of BPSD and behavioral disturbance assessments, which are distinct from those evaluating cognitive and functional symptoms of AD. In particular, we review the informant-based Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), the related, potentially more sensitive, BEHAVE-AD Frequency-Weighted Severity Scale (BEHAVE-AD-FW), and the direct subject evaluation-based Empirical BEHAVE-AD Rating Scale (E-BEHAVE-AD). The kinds of medications that alleviate behavioral symptoms on these measures as well as the problems and possibilities for further advances with these medications are discussed. Finally, the importance of distinguishing BPSD and behavioral disturbance remediation in AD from the treatment of cognitive decline and other aspects of AD is emphasized in the context of appropriate assessment methodology. The objective of this
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