Management of psychological and behavioral symptoms in patients with dementia

Behavioural and psychological symptoms of dementia are very common and stressful for patients and caregivers. The causes include biological, psychological, environmental, and social factors that have to be addressed in an individualized and multidisciplinary way. The approach should include the following: a) providing the best treatment for the cause of dementia; b) evaluating and treat medical or environmental triggers; c) providing psychological support and education for patients and caregivers, in order to prevent and minimize its impact; d) offering non-pharmacological therapies, tailored to the patient preferences and needs; e) using pharmacological treatments in moderate or severe cases. Limited evidence exists when it comes to deciding which medication to use for many behavioural symptoms. The decision should be based on the predominant neuropsychiatric syndrome, and all drugs must be prescribed in a gradual and step-wise way, trying to choose as first-line treatments those with fewer side-effects