Abstract
Many neurodegenerative conditions are associated with neuropsychiatric symptoms. The origin of these symptoms is complex, and includes neuroanatomical, neurochemical, psychological, and social factors. Management of neuropsychiatric symptoms in neurologic disease is challenging, as there is a dearth of evidence-based data. This chapter explores the neurobiology of the most common neuropsychiatric symptoms encountered in clinical practice, and outlines current approaches toward their pharmacological and behavioral management.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Daffner, K. & Wolk, D. (2010). Behavioral neurology and dementia. In Samuels, M.A. (Eds.) The Manual of Neurologic Therapeutics, Philadelphia: Lippincott, Williams, and Wilkins.
Farber N.B., Rubin E.H., Newcomer J.W., Kinscherf D.A., Miller J.P., Morris J.C., Olney J.W., & McKeel D.W., Jr. (2000). Increased neocortical neurofibrillary tangle density in subjects with Alzheimer disease and psychosis. Arch Gen Psychiatry, 57, 1165–1173.
Livingston G., Johnston K., Katona C., Paton J., & Lyketsos C.G. (2005). Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. Am J Psychiatry, 162, 1996–2021.
Lyketsos C.G., Steinberg M., Tschanz J.T., Norton M.C., Steffens D.C., & Breitner J.C. (2000). Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. Am J Psychiatry, 157, 708–714.
Mendez M.F. (2009). Frontotemporal dementia: therapeutic interventions. Front Neurol Neurosci, 24, 168–178.
Proulx GB. Management of disruptive behaviors in the cognitively impaired elderly: integrating neuropsychological and behavioral approaches. In: Conn DK, Greg A, Sadavey J, editors. Psychiatric consequences of brain disease in the elderly: a focus on management. New York, NY: Plenum Press; 1989. p. 147.
Suggested Reading
Ballard C., Brown R., Fossey J., Douglas S., Bradley P., Hancock J., James I.A., Juszczak E., Bentham P., Burns A., Lindesay J., Jacoby R., O’Brien J., Bullock R., Johnson T., Holmes C., & Howard R. (2009). Brief psychosocial therapy for the treatment of agitation in Alzheimer disease (the CALM-AD trial). Am J Geriatr Psychiatry, 17, 726–733.
Ballard C., Hanney M.L., Theodoulou M., Douglas S., McShane R., Kossakowski K., Gill R., Juszczak E., Yu L.M., & Jacoby R. (2009). The dementia antipsychotic withdrawal trial (DART-AD): long-term follow-up of a randomised placebo-controlled trial. Lancet Neurol, 8, 151–157.
Ballard C., Margallo-Lana M., O’Brien J.T., James I., Howard R., & Fossey J. (2009). Top cited papers in International Psychogeriatrics: 6a. Quality of life for people with dementia living in residential and nursing home care: the impact of performance on activities of daily living, behavioral and psychological symptoms, language skills, and psychotropic drugs. Int Psychogeriatr, 21, 1026–1030.
Ballard C.G., Gauthier S., Cummings J.L., Brodaty H., Grossberg G.T., Robert P., & Lyketsos C.G. (2009). Management of agitation and aggression associated with Alzheimer disease. Nat Rev Neurol, 5, 245–255.
Campbell N., Ayub A., Boustani M.A., Fox C., Farlow M., Maidment I., & Howards R. (2008). Impact of cholinesterase inhibitors on behavioral and psychological symptoms of Alzheimer’s disease: a meta-analysis. Clin Interv Aging, 3, 719–728.
Chahine L.M., Acar D., & Chemali Z. (2010). The elderly safety imperative and antipsychotic usage. Harv Rev Psychiatry 18, 158–172.
Craig D., Mirakhur A., Hart D.J., McIlroy S.P., & Passmore A.P. (2005). A cross-sectional study of neuropsychiatric symptoms in 435 patients with Alzheimer’s disease. Am J Geriatr Psychiatry, 13, 460–468.
Cummings J.L., Mega M., Gray K., Rosenberg-Thompson S., Carusi D.A., & Gornbein J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.
Finger, E. & Daffner, K. (in press). Behavioral and cognitive neurology. In Burneo, J., Demaerschalk, B., & Jenkins, M. (Eds.) Neurology—An Evidence Based Approach, Springer Science.
Forstl H., Burns A., Levy R., Cairns N., Luthert P., & Lantos P. (1993). Neuropathological correlates of behavioural disturbance in confirmed Alzheimer’s disease. Br J Psychiatry, 163, 364–368.
Gauthier S., Cummings J., Ballard C., Brodaty H., Grossberg G., Robert P., & Lyketsos C. (2010). Management of behavioral problems in Alzheimer’s disease. Int Psychogeriatr, 1–27.
Gitlin L.N., Winter L., Dennis M.P., & Hauck W.W. (2007). A non-pharmacological intervention to manage behavioral and psychological symptoms of dementia and reduce caregiver distress: design and methods of project ACT3. Clin Interv Aging, 2, 695–703.
O’Connor D.W., Ames D., Gardner B., & King M. (2009). Psychosocial treatments of behavior symptoms in dementia: a systematic review of reports meeting quality standards. Int Psychogeriatr, 21, 225–240.
Rodda J., Morgan S., & Walker Z. (2009). Are cholinesterase inhibitors effective in the management of the behavioral and psychological symptoms of dementia in Alzheimer’s disease? A systematic review of randomized, placebo-controlled trials of donepezil, rivastigmine and galantamine. Int Psychogeriatr, 21, 813–824.
Salzman C., Jeste D.V., Meyer R.E., Cohen-Mansfield J., Cummings J., Grossberg G.T., Jarvik L., Kraemer H.C., Lebowitz B.D., Maslow K., Pollock B.G., Raskind M., Schultz S.K., Wang P., Zito J.M., & Zubenko G.S. (2008). Elderly patients with dementia-related symptoms of severe agitation and aggression: consensus statement on treatment options, clinical trials methodology, and policy. J Clin Psychiatry, 69, 889–898.
Selwood A., Johnston K., Katona C., Lyketsos C., & Livingston G. (2007). Systematic review of the effect of psychological interventions on family caregivers of people with dementia. J Affect Disord, 101, 75–89.
Acknowledgments
The authors would like to thank Ms. Katie Gartner for her help in editing and preparing this manuscript. This work was enabled in part by generous support from D. Wimberly and S. Muss.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag London Limited
About this chapter
Cite this chapter
Chemali, Z.N., Daffner, K.R. (2011). Managing Neuropsychiatric Symptoms of Neurodegenerative Diseases. In: Hardiman, O., Doherty, C. (eds) Neurodegenerative Disorders. Springer, London. https://doi.org/10.1007/978-1-84996-011-3_12
Download citation
DOI: https://doi.org/10.1007/978-1-84996-011-3_12
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-84996-010-6
Online ISBN: 978-1-84996-011-3
eBook Packages: MedicineMedicine (R0)