Behavioral Disturbances in Dementia and Beyond: Time for a New Conceptual Frame?

Int J Mol Sci. 2019 Jul 25;20(15):3647. doi: 10.3390/ijms20153647.

Abstract

Alzheimer's disease and vascular dementia are estimated to be the most common causes of dementia, although mixed dementia could represent the most prevalent form of dementia in older adults aged more than 80 years. Behavioral disturbances are common in the natural history of dementia. However, so far, there is a paucity of studies that investigated the causal association between behavioral psychological symptoms of dementia and dementia sub-types, due to the high heterogeneity of methodology, study design and type of clinical assessment. To understand the scant evidence on such a relevant clinical issue, it could be hypothesized that a new shifting paradigm could result in a better identification of the relationship between behavioral disturbances and dementia. This narrative review provides an update of evidence on the behavioral patterns associated with different dementia sub-types and offers a potential future perspective as common ground for the development of new translational studies in the field of behavioral disturbances in dementia and the appropriateness of psychoactive treatments.

Keywords: Alzheimer’s disease; antipsychotics; behavioral disturbances clusters; mixed dementia; vascular dementia.

Publication types

  • Review

MeSH terms

  • Antipsychotic Agents / pharmacology
  • Antipsychotic Agents / therapeutic use
  • Dementia / complications*
  • Dementia / diagnosis
  • Dementia / drug therapy
  • Dementia / etiology
  • Diagnosis, Differential
  • Humans
  • Mental Disorders / diagnosis
  • Mental Disorders / drug therapy
  • Mental Disorders / etiology*
  • Mental Disorders / psychology*
  • Neuroimaging / methods
  • Neuropsychological Tests
  • Symptom Assessment
  • Treatment Outcome

Substances

  • Antipsychotic Agents