Behavioral and Psychological Symptoms of Dementia (BPSD) James Warner St Charles Hospital & Imperial College, LondonSlide 2
Objectives to comprehend the study of disease transmission and presentation of the behavioral and mental side effects of dementia to comprehend the treatment ways to deal with the behavioral and mental manifestations of dementiaSlide 4
van der Flier and Scheltens 2005 JNNPSlide 5
Dementia the study of disease transmission 6% of people more than 65 1 20% of people more than 80 700,000 cases in UK right now 2 Current cost of dementia £14.3bn – more than stroke, coronary illness and tumor joined Number of individuals with dementia will increment by 40% in next 15 years Lobo et al 2001 Alzheimer\'s general public, 2007Slide 6
Dementia-the study of disease transmission Alzheimer\'s disease 50% Vascular dementia 20% Mixed AD/Vascular 20% Dementia with Lewy bodies 5%Slide 7
Alzheimer\'s infection… .. A confusion of memory?Slide 8
Extract from: Alzheimer A. Über eine eigenartige Erkrankung der Hirnrinde Allgemeine Zeitschrift hide Psychiatrie und Psychisch-gerichtliche Medizin . 1907 "One of the primary malady side effects of a 51-year-old lady was a solid sentiment desire towards her better half. Soon she indicated quickly expanding memory disabilities; she couldn\'t discover her way about her home, she dragged questions and fro, concealed herself, or once in a while imagined that individuals were out to kill her, then she would begin to shout noisily."Slide 9
"From time to time she was totally insane, dragging her covers and sheets back and forth, requiring her better half and little girl, and appearing to have sound-related fantasies. Regularly she would shout for a considerable length of time and hours in a ghastly voice."Slide 10
Behavioral and Psychological Symptoms of Dementia (BPSD) " Alzheimer\'s sickness is the most generally experienced reason for psychiatric pathology connected with particular neuropathological substrate " Merriam 1988Slide 11
BPSD Vague and under-looked into albeit depicted plainly by Alois Alzheimer Term approved by 1996 IPA agreement gathering Not completely perceived in current demonstrative frameworks Bypassed by dementia procedure 2008 Not tended to satisfactorily by a few rulesSlide 12
BPSD Seen in: ≈ 40% of mellow intellectual impedance ≈ 60% of patients in early phase of dementia influences 90-100% of patients with dementia eventually over the span of their disease Gets more incessant and troublesome with propelling dementiaSlide 13
BPSD-characterization Various frameworks conceivable Symptom based e.g. "depressive" "hallucinating" Psychological versus behavioral Syndrome based Alzheimer\'s, Lewy body and so onSlide 14
BPSD-behavioral indicationsSlide 15
BPSD-mental side effectsSlide 16
BPSD causes Physical Neuro-compound Environmental EmotionalSlide 19
BPSD outcomes Associated with more prominent utilitarian weakness Very troubling for individual Very upsetting for carers Institutional care Overmedication Elder mishandle Associated with expanded mortalitySlide 20
BPSD-appraisal physical wellbeing undetected agony or inconvenience symptoms of drug individual life history, including otherworldly and social personality psychosocial components physical ecological variables behavioral and practical examination directed by experts with particular aptitudes, in conjunction with carers and care specialists. Pleasant 2006Slide 21
BPSD ManagementSlide 22
Treatment choices Identify cause Wait and see? Instruction and advising Prophylaxis Environmental adjustment Direct behavioral methodologies MedicationSlide 23
Identify cause BPSD might be because of physical cause restorative audit to prohibit: Constipation Pain Medication (torment executioners, tranquilizers) Infection Heart disappointment/hypoxiaSlide 24
case #1 Erica 80, Alzheimer\'s ailment In proceeding with care Very serious dementia Usually no verbal reaction Staff saw increment in trouble frowning and not eatingSlide 25
Wait and see? May be brief and self-constrainingSlide 26
Prophylaxis Sleep-wake cycle Sleep cleanliness Exposure to sunshine Melatonin Exercise StimulationSlide 27
Education and bolster Important May help carers comprehend and endure indications Facilitates improvement of imaginative diversionsSlide 28
Case illustration # 2 Greta, 68 Vascular/Alcohol dementia Living with spouse Husband in extensive trouble "she declines to flush the latrine" "she won\'t make some tea appropriately" Frustration prompted struggleSlide 29
BPSD-administration Environmental change Sleep cleanliness Stimulation/commotion levels Exercise Food/hydration Lighting Grid-design flooring Relate issue to individual\'s biographySlide 30
case # 3 Jenny, 79, living in cellar level with accomplice Alzheimer\'s malady analyzed 8 years prior Developed sundowning disorder Partner: " she\'s going frantic specialist " Locked front entryway Wrestled Plied liquorSlide 31
case # 4 Ted, 74, Alzheimer\'s illness Living in private home "forceful and brutal", particularly at mealtimesSlide 32
BPSD administration fragrance based treatment multisensory incitement remedial utilization of music or potentially moving creature helped treatment rub NICE 2006Slide 33
BPSD administration Behavioral methodologies Individually custom fitted Driven by examination Delivered via prepared staff Sustained exertionSlide 34
case # 5 Ben, 78, In private home after wife\'s passing Vascular dementia 3 years Constantly calling staff, day and night Not in trouble "ABC investigation"Slide 35
BPSD administration Drug treatment Last resort Should target particular side effects Specialist start Regular surveySlide 36
BPSD administration Depression/Anxiety Antidepressants? Unsettling/animosity Antipsychotics-NO! Anticholinesterases? Benzodiazepines? Mind-set stabilizers? Fancies/mental trips Antipsychotics?Slide 37
case # 6 Anne, 78 living alone Alzheimer\'s infection 4 years Paranoid Delusions neighbors and child taking Hearing "commotions" from roof Carbamazepine 100mg bdSlide 38
conclusions Behavioral and Psychological indications are center components of dementia BPSD expands trouble, carer weight and mortality Drug treatment ought to be a final resort Far more research is required on BPSD the study of disease transmission, cause and administration … one more slideSlide 39
EVIDEM-E 6-week randomized controlled trial Community abiding people with dementia (any stage, any sort) At minimum one BPSD manifestation Tailored practice bundle Individualized resultsSlide 40
Set up clinical agreement criteria (McKeith et al., Neurology 1996;47:1113-1124) ... those of or ...
Torment and Hypochondriasis. Body Dysmorphic Disorder. Somatoform manifestations ... jumble, man ...
Official capacities: SDSA Square Matrices & Road Sign Recognition; BADS Rule Shift & Key ... 6. ...
Seat, The Society for the Arts In Dementia Care (Australia) Inc. ... was tried to support the cr ...
DSM IV-R Definition. Dementia: memory hindrance (aphasia, apraxia, agnosia or aggravation in off ...
Presentation Objectives. DementiaFocus on long haul parts of tending to persons with dementiaEmp ...
DEMENTIA – An Easy Guide. By Connie Smith. De- (away) Mentia (mind). Dementia is a loss o ...
DEMENTIA. DEFINITION:Group of indications that can be brought on by more than 60-70 issue. Disor ...
Goals. To see how mental status changes like dementia and wooziness effect care toward the end o ...
Julia Poole CNC Aged Care RNSH. 2. Supports. RNSH Department of Aged Care
Diagram. What are delusions?What causes dreams in dementia?Risk elements Common sorts of daydrea ...
Positive responders to CBT. The individuals who react best are :Anxious
DEMENTIA. A disorder portrayed by obtained, dynamic psychological impairmentAffects 10% of peopl ...
Points. To give carers a fundamental comprehension of dementia.. Learning Outcomes. Comprehend w ...
Goals. Welcome that different sorts of dementia exist that have their own particular extra disab ...
Dementia. Dynamic crumbling of keenness, conduct and identity as an outcome of diffuse malady of ...
Presentation MeReC Bulletin 2007;18 (1). Dementia is a troubling and crippling condition influen ...