The impact of behavioral and psychological symptoms of dementia

Abstract

Dementia is a complex syndrome associated with cognitive, behavioral and psychological symptoms, which affects the daily life of the whole world, it can be called as a rupture of the patient from society, from the life he was leading until its appearance, with serious consequences both for himself , as well as for family and society. It is characterized by executive dysfunction, slowed information processing, memory deficits, and mood and personality disorders. Behavioral and psychological symptoms of dementia include changes in behavior, perception, content of thoughts, as well as mood disorders. These symptoms are commonly found in various dementia disorders, such as Alzheimer's disease, vascular dementia, dementia with Lewy bodies, Parkinson's disease dementia or frontotemporal dementia. These symptoms not only threaten patients' safety and degrade their quality of life, but also lead to a burden on family caregivers. Therefore, support is needed for people at potential risk of dementia living in the community and their families to understand the characteristics of psychopathological symptoms and to promote early identification of symptoms. To carry out the literature synthesis study, an advanced search was carried out in the electronic libraries PubMed and Google Scholar, using keywords: dementia, psychopathology, psychological symptoms. 1800 titles and abstracts were analyzed, including 150 full-text articles, from 2019 to 2024, in English and Romanian, with open access, literature synthesis, meta-analysis, research articles. Observational studies report an estimated prevalence of psychopathological symptomatology in patients with dementia ranging from 25% to 80%. The most commonly observed symptoms include agitation, apathy, depression, anxiety, and delusions, while disinhibition, hallucinations, aggression, wandering, and eating disorders are less common. Considering the clinical course of dementia, irritability, apathy, depression are commonly observed from the early stages of the disease. In contrast, psychotic symptoms and confusion are more typical of patients in a more advanced stage of dementia. 1. Early detection of the disease reduces the risk of the appearance of psychopathological symptoms and improves the quality of life of the patient as well as the family member. 2. The most common symptom of dementia at diagnosis is apathy/indifference, which is easily overlooked by families, followed by irritability/lability and depression/dysphoria. 3. Increased use of antipsychotic medications has been associated with increased psychotic symptomatology in patients with dementia, special care is required regarding patient prescriptions.