Behavioral and psychological symptoms occur in over 90% of people with dementia at some time during the course of their illness. Symptoms are heterogeneous, have multiple interacting etiologies and require creative eclectic management solutions often in combination. Pharmacological interventions can be beneficial but per se have limited efficacy as well as the potential for adverse effects. Psychological, social and environmental strategies are usually indicated as the first line of management or to complement drug treatment.
We review the evidence for the effectiveness of psychosocial interventions in the management of BPSD. Empirical evidence that such interventions can decrease aberrant behaviors exists but is limited by methodological weaknesses and small numbers of subjects. Of the many management methods examined, none is clearly superior to others, nor is there a logical framework for choosing interventions beyond practitioner preferences and individualized case by case treatment planning. We conclude by proposing a framework for the organisation of services for the management of BPSD.
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