J Korean Med Assoc.  2009 Nov;52(11):1048-1054. 10.5124/jkma.2009.52.11.1048.

Diagnosis and Treatment for Behavioral and Psychological Symptoms of Dementia

  • 1Department of Psychiatry, Yonsei University College of Medicine, Korea. drobh@yuhs.ac


Dementia is a common neuropsychiatric disorder characterized by progressive impairment of cognitive abilities and distinct behavioral and psychological symptoms. In particular, various behavioral and psychological symptoms of dementia (BPSD) add to the burden of family and society. Moreover, the number of dementia patients is rapidly growing with increasing elderly population. The main symptoms of BPSD are anxiety, depression, delusions and hallucinations. BPSD produce significant problems for both patients and caregivers. Aggravated BPSD accelerates impairment of cognitive function and induces early nursing home placement, increasing cost for care while decreasing quality of life. The pathophysiology of BPSD is determined by genetic, structural, or environmental factors. Diagnosis of BPSD used "NPI, BEHAVE-AD and BRSD of CERAD". The management of BPSD requires both pharmacological and non-pharmacological treatment. When BPSD are mild, non-pharmacological strategies are essential, but for patients with moderate to severe BPSD, pharmacological intervention should also be emphasized.


Dementia; BPSD; Pathophysiology; Diagnosis; Management

MeSH Terms

Nursing Homes
Quality of Life

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1. Oh BH. Geriatric Psychiatry, Dementia. 2004. Jungang Pub.
2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 1994. 4th ed. Washington DC:
3. IPA Behavioral and Psychological Symptoms of Dementia (BPSD) Education Pack, Module 5: Non-pharmacological management. 2002.
4. Reisberg B, Borenstein J, Salob SP, Ferris SH, Franssen E. Behavioral symptoms in Alzheimer's disease:phenomenology and treatment. J Clin Psychiatry. 1987. 48:Suppl. 9–15.
5. Finkel SI, Costa SJ, Cohen G, Miller S, Satorius N. Behavioral and psychological sings and symptoms of dementia: a concensus statement on current knowledge and implications for research and treatment. International Journal of Psychogeriatrics. 1996. 8:497–500.
6. Son EJ. Pathophysiology of behavioral and psychological symptoms of dementia. Dementia and Neurocognitive Disorders. 2004. 3:508.
7. Sweet RA, Nimgaonkar VL, Devlin B, Jeste DV. Psychotic symptoms in Alzheimer's disease. Evidence for a distinct phenotype. Mol Psychiatry. 2003. 8:383–392.
8. Cummings JL, Meg M, Gray K, Rosenberg TS, Carusi DA. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994. 44:2308–2314.
9. Tariot PN, Mack JL, Patterson MB, Edland SD, Weiner MF. The Behavioral Rating Scale for Dementia of the Consortium to Establish a Registry for Alzheimer's Disease. The Behavioral Pathology Committee of the Consortium to Establish a Registry for Alzheimer's Disease. Am J Psychiatry. 1995. 152:1349–1357.
10. Burns A, Jacoby R, Levy R. Progression of cognitive impairment in Alzheimer's disease. J Am Geriatr Soc. 1991. 39:39–45.
11. Birks J. Cholinesterase inhibitors for Alzheimer's disease. Cochrane Database Syst Rev. 2006. CD005593.
12. Panza F, Solfrizzi V, D'Introno A. Higher total cholesterol, cognitive decline, and dementia. Neurobiol Aging. 2008.
13. Herrman N. Recommendation for the management of behavioral and psychological symptoms of dementia. Can J Neurol Sci. 2001. 28:Suppl 1. 96–107.
14. Knibe JA, Kipps CM, Hodges JR. Frontotemporal dementia. Curr Opin Neurol. 2006. 19:565–571.
15. Potagas C, Papageorgious S. Phenomenology and management of cognitive and behavioral disorders in Parkinson's disease. Rise and logic of dementia in Parkinson's disease. Arch Gen Psychiatry. 2006. 5:12–20.
16. Burn DJ. Cortical Lewy body disease and Parkinson's disease dementia. Curr Opin Neurol. 2006. 19:572–579.
17. Leon CJ. Dementia due to head trauma: An obscure name for a clear neurocognitive syndrome. NeuroRehabilitation. 2002. 17:115–122.
18. Bird M, Jones RH, Korten A. A controlled trial of a predominantly psychosocial approach to BPSD: treating causality. Int Psychogeriatr. 2007. 19:874–891.
19. Torta R, Badino E, Scalabrino A. Therapeutic strategies for behavioral and psychological symptoms (BPSD) in demented patients. Arch Gerontol Geriatr. 2004. Suppl. 443–454.
20. Opie J, Rosewarne R, O'Conner DW. The efficacy of psychosocial approaches to behaviour disorders in dementia: a systematic literature review. Aust N Z J Psychiatry. 1999. 33:789–799.
21. Carlson DL, Fleming KC, Smith GE. Management of dementia-related behavioral disturbances: a nonpharmacologic approach. Mayo Clin Proc. 1995. 70:1108–1115.
22. Beier MT. Pharmacotherapy for behavioral and psychological symptoms of dementia in the elderly. Am J Health Syst Pharm. 2007. 64:9–17.
23. Daiello LA, Beier MT, Hoffmann VP, Kennedy JS. Pharmacotherapy of behavioral and psychological symptoms of dementia: a review of atypical antipsychotics. Consult Pharm. 2003. 18:138–152. 155–157.
24. Oh BH, Lee JH, Cheon JS, Yoo KJ. Newer neuroleptic treatment for behavioral and psychological symptom (BPSD) of dementia. J Can Geriatr Soc. 2001. 2:24–27.
25. Oh BH. Geriatric Dementia, Newer neuroleptic treatment of behavioral and psychological symptoms of dementia. Psychiatry Invest. 2007. 4:6–8.
26. Fernandez HH, Wu CK, Ott BR. Pharmacotherapy of dementia with Lewy bodies. Expert Opin Pharmacother. 2003. 4:2027–2037.
27. Bains J, Birks JS, Dening TR. The efficacy of antidepressants in the treatment of depression in dementia. Cochrane Database Syst Rev. 2002. CD003944.
28. Daiello LA. Current issues in dementia pharmacotherapy. Am J Manag Care. 2007. 13:Suppl 8. 198–202.
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