Behavioural and Psychological Symptoms of Dementia Management


Almost all patients with dementia experience BPSD; these are also referred to as neuropsychiatric, non-cognitive symptoms. The symptoms vary between patients and over time and can include:

  • Mood disturbances (anxiety, apathy, depression, euphoria)
  • Hyperactivity-type symptoms (aberrant motor behaviour, aggression, agitation, disinhibition, irritability, restlessness)
  • Psychotic symptoms (delusions, hallucinations, paranoia)
  • Other behavioural symptoms (changes in appetite, hoarding, night-time behaviour disturbances, wandering)

These symptoms become more common as the dementia progresses and present a major cause of stress to carers.

When BPSD occur, assess factors that may cause, aggravate or reduce the behaviour. Assessment should first exclude physical causes, such as delirium (common in patients with dementia), urinary tract infections or a drug interaction. Other factors, such as the environment and behaviours of others, should also be considered.

The assessment considers:

  • Frequency of behaviour over time
  • Context and consequences of the behaviour
  • Mental health
  • Physical health
  • Medication side effects
  • Previous habits and beliefs
  • Psychosocial factors
  • Factors in physical environment
  • Possible undetected pain or discomfort