ABSTRACT
The neuropsychiatric symptoms of dementia include agitation, aggression, delusions, hallucinations, apathy and depression. These disturbances, also referred to as behavioural and psychological symptoms of dementia (BPSD)1 are common serious problems that can impair the quality of life for both patient and caregiver. The epidemiology of BPSD varies depending on the type of dementia and the stage of the illness, but studies suggest that over 90 per cent of dementia patients will exhibit one or more of these behaviours at some point in their illness.2 For example, in a large community sample of elderly individuals with dementia, 61 per cent suffered from at least one symptom of BPSD and 32 per cent experienced at least moderate to severe symptoms.3 BPSD are even more common in long-term care residents4 and these behaviours are frequently significant risk factors for institutionalization.5,6 Studies which have focused on the correlates of BPSD suggest they are associated with more rapid cognitive and functional decline and possibly increased mortality.7-11 They are also associated with stress, burden and increased rates of depression in the caregiver.12-14 Finally, in addition to increasing the risk of institutionalization (the largest driver of total dementia care costs), BPSD, by themselves, may account for up to 30 per cent of the cost of care.15
