Managing Behavioral and Psychological Symptoms of Dementia

Gerlach, Lauren B.; Kales, Helen C.

doi:10.1016/j.psc.2017.10.010

Cited by 68 publications

(57 citation statements)

References 50 publications

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“…Telecommunication and virtual communication with their families and friends are encouraged to maintain social connections. 79 Web-based home programs for cognition, exercise, and counseling can help to improve dementia patient health. At the same time, dedicated employees have been conducting regular telephone consultations to monitor patient health and provide consultation about COVID-19.…”

Section: Strategy For Managing Dementia During the Covid-19 Pandemicsmentioning

confidence: 99%

Coping with Dementia in the Middle of the COVID-19 Pandemic

et al. 2020

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Multiple neurological complications have been associated with the coronavirus disease-19 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2. This is a narrative review to gather information on all aspects of COVID-19 in elderly patients with cognitive impairment. First, the following three mechanisms have been proposed to underlie the neurological complications associated with COVID-19: 1) direct invasion, 2) immune and inflammatory reaction, and 3) hypoxic brain damage by COVID-19. Next, because the elderly dementia patient population is particularly vulnerable to COVID-19, we discussed risk factors and difficulties associated with cognitive disorders in this vulnerable population. We also reviewed the effects of the patient living environment in COVID-19 cases that required intensive care unit (ICU) care. Furthermore, we analyzed the impact of stringent social restrictions and COVID-19 pandemic-mediated policies on dementia patients and care providers. Finally, we provided the following strategies for working with elderly dementia patients: general preventive methods; dementia care at home and nursing facilities according to the activities of daily living and dementia characteristics; ICU care after COVID-19 infection; and public health care system and government response. We propose that longitudinal follow-up studies are needed to fully examine COVID-19 associated neurological complications, such as dementia, and the efficacy of telemedicine/telehealth care programs.

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Section: Strategy For Managing Dementia During the Covid-19 Pandemicsmentioning

confidence: 99%

Coping with Dementia in the Middle of the COVID-19 Pandemic

et al. 2020

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“…Nonpharmacological and pharmacological psychiatric interventions were chosen based on best practices documented in systematic reviews and the evidence-based recommendations of Kales et al [ 15 ], Tible et al [ 16 ], and Cohn-Mansfield [ 17 ]. Recommendations to prefer nonpharmacological interventions to pharmacological ones were based on the literature [ 15 , 18 , 19 ]. Nonpharmacological interventions also aimed to orient and organize care with and for the patient and the caregivers in order to prevent admission to a psychiatric hospital or shorten the time spent there.…”

Section: Methodsmentioning

confidence: 99%

Demographics, Clinical Characteristics, and Therapeutic Approaches among Older Adults Referred to Mobile Psychiatric Crisis Intervention Teams: A Retrospective Study

Pélichy

Ebbing

Queirós³

et al. 2018

Dement Geriatr Cogn Disord Extra

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Background / Aims: The advent of mobile old age psychiatry intervention teams supports policies maintaining older adults in their habitual living environments, even those who are very old and suffering from acute cognitive and psychiatric impairments. Analyzing sociodemographic data, clinical and health characteristics, reasons for crisis-oriented psychiatric consultations, and other therapeutic suggestions for supporting home- or nursing home-dwelling older adult patients suffering from an onset of a psychiatric crisis. Methods: Reviews of the medical records and discharge letters of home- or nursing home-dwelling older adults who had undergone a consultation with the Lausanne region’s Mobile Old Age Psychiatry Teams (MOAPTs), between May 2016 and December 2017. Results: Of 570 older adult patients referred for consultation with MOAPTs, 333 had medical records and discharge letters eligible for retrospective analysis (59%). The majority of these older adult patients were women aged over 80 years suffering from dementia, mood disorders with and without a risk of suicide, and delirium. Challenging behaviors related to different stages of cognitive impairment were the most important clinical reason for crisis consultations. Nonpharmacological and pharmacological treatments were delivered concurrently in 68% of crisis consultations. Conclusion: Appropriate responses by dual nurse-psychiatrist teams using crisis-oriented nonpharmacological and pharmacological interventions decreased hospitalization.

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“…Although non-pharmacological interventions are considered first line for BPSD, pharmacologic interventions may be warranted particularly when psychotic symptoms pose a potential threat to the individual or caregivers[ 27 , 28 ]. In the United States, there are currently no Federal Drug Administration (FDA)- approved medications for the treatment of psychosis in AD.…”

Section: Introductionmentioning

confidence: 99%

Pimavanserin for the treatment of psychosis in Alzheimer’s disease: A literature review

Srinivasan

Tampi

Balaram

et al. 2020

WJP

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BACKGROUND Alzheimer’s disease (AD) is among the most prevalent forms of dementia in the world and neuropathological studies suggest similar high prevalence of mixed (AD + vascular) dementias. Approximately 25%-50% of individuals with AD develop psychosis sometime during their illness. The presence of psychosis in AD worsens outcomes. Currently there are no United States Food and Drug Administration (FDA) approved medications for the treatment of psychosis in AD. Pimavanserin, a novel atypical antipsychotic medication, was approved by the FDA for the treatment of hallucinations and delusions associated with Parkinson disease psychosis and is currently in clinical trials for the treatment of psychosis in AD. AIM To evaluate the existing literature regarding the use of pimavanserin for treating psychosis among individuals with AD. METHODS A literature review of clinical studies of pimavanserin treatment for psychosis in individuals with AD was performed using the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Trials were identified by systematically searching PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus through October 2019. The 5-point Jadad scoring system was used to assess the methodologic quality of the randomized placebo-controlled trials. RESULTS A total of 499 citations were retrieved and pooled in EndNote and de-duplicated to 258 citations. This set was uploaded to Covidence for screening. Two separate screeners (Srinivasan S and Tampi RR) evaluated the titles, abstracts, and full text of eligible articles. Of the identified 258 abstracts, 98 articles underwent full text review and 2 publications from 1 randomized controlled trial (RCT) were included in the final analysis. The quality of evidence was assessed to be of good methodologic quality, scoring 4 out of 5 using the 5-point Jadad questionnaire with the Jadad Scoring calculation. This systematic review found only one RCT that evaluated the use of pimavanserin for the treatment of psychosis among individuals with AD. This phase 2 trial resulted in two publications, the second of which was a subgroup analysis from the original study. The evidence from these two publications showed that pimavanserin improves psychotic symptoms among individuals with AD when compared to placebo at week 6. CONCLUSION Pimavanserin may be a pharmacologic consideration for the treatment for psychosis in AD. Additional RCTs are needed to assess the evidence of effectiveness before pimavanserin is considered a standard treatment.

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Managing Behavioral and Psychological Symptoms of Dementia

Cited by 68 publications

References 50 publications

Coping with Dementia in the Middle of the COVID-19 Pandemic

Coping with Dementia in the Middle of the COVID-19 Pandemic

Demographics, Clinical Characteristics, and Therapeutic Approaches among Older Adults Referred to Mobile Psychiatric Crisis Intervention Teams: A Retrospective Study

Pimavanserin for the treatment of psychosis in Alzheimer’s disease: A literature review

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