ABSTRACT
It is estimated from population studies that up to 80 to 90% of older people with dementia manifest one or more psychiatric symptoms (Lyketsos et al.,
2002; Sink, Covinsky, Newcomer, & Yaffe, 2004), which commonly include symptoms of depression (Gilley, Wilson, Bienias, Bennett, & Evans, 2004; Verdelho, Henon, Lebert, Pasquier, & Leys, 2004), anxiety (Teri et al., 1999), agitation (Senanarong et al., 2004), delusions and hallucinations (Bassiony & Lyketsos, 2003), and aberrant motor behavior (Steinberg et al., 2003). The progression of these symptoms is variable; however, it is apparent that some symptoms can be transient while others may be persistent. Further, these symptoms can be intertwined, such that depression may increase the risk of aggression, and vice versa. These psychiatric symptoms have serious effects on patients, including reduced quality of life (Novella et al., 2001), increased nursing home placements (Chan, Kasper, Black, & Rabins, 2003), greater disability (Forsell & Winblad, 1998; Griffiths et al., 1987), and higher rates of morbidity from medical illness and suicide (Arfken, Lichtenberg, & Tancer, 1999; Bruce et al., 2004; Gallo & Lebowitz, 1999; Hughes, Ross, Mindham, & Spokes, 2004; Katz, Striem, & Parmelee, 1994; Teri et al., 1999). Psychiatric symptoms have also been shown to negatively affect caregivers of patients with dementia (Garre-Olmo et al., 2002; Pang et al., 2002) and are commonly linked to caregiver depression and distress (Danhauer et al., 2004; Drinka, Smith, & Drinka, 1987).
