Troublesome and Disruptive Behaviors in Dementia

Swearer, Joan M.; Drachman, David A.; O’Donnell, Brian F.; Mitchell, Ann L.

doi:10.1111/j.1532-5415.1988.tb04260.x

Cited by 317 publications

(91 citation statements)

References 29 publications

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“…Second, the above study reported that 20% of patients exhibit aggressive behaviour and this figure is comparable with that of other studies (Swearer et al, 1988). Some of my own unpublished work had indicated comparatively low levels of violence (seven violent incidents in one year) on a long-stay psycho geriatric ward.…”

Section: Correspondencesupporting

confidence: 77%

Violence in Alzheimer's disease

Shah

1990

Br J Psychiatry

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CORRESPONDENCE spentless timeillthan patients ineitherofthe neurosis groupsâ€• (1990, p.13). Personality abnormality as judged at index admission accounted for 20% of the variation in these measures in the neurotic but not in the endogenous group. We have long argued that attempting to establish the independence of two syndromes on the basis of symptoms alone is foolish (Andrews et al, 1973). Syndromes that appear clinically distinct should be differentiated on the basis of aetiology, treatment response and/or natural history. In the present paper we simply report subtle differences in natural history, but not outcome, and relate these to a presumed aetiological factor (personality) that seems to act differently in the two disorders. Parker et al (1987) have previously shown that the parenting of our patients with endogenous depression differed from the parenting of patients with neurotic depression and that this was unlikely to be a reporting artefact. We agree with Dr Aspin that â€oe¿ the case for a dichotomy is not provenâ€•,but there are now three pieces of evidence derived from just this one study that â€oe¿ endogenous and neurotic depression are two illnessesâ€•.We claimed no more.

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Section: Correspondencesupporting

confidence: 77%

Violence in Alzheimer's disease

Shah

1990

Br J Psychiatry

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“…First, the use of x2 test with some analysis appeared to be inappropriate as the expected fre quency in the cells of some of the x2 tables was less than 5. Examples of this included Second, the above study reported that 20% of patients exhibit aggressive behaviour and this figure is comparable with that of other studies (Swearer et al, 1988 (Tunke & Dermer, 1977). There are other reports of association between violence and aggressive behaviour and abnormal EEGs (Maletzky, 1973;Shah, 1989).…”

supporting

confidence: 78%

[No Title]

Andrews

Neilson

1990

Br J Psychiatry

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“…The reactions are usually associated with frustration over failures or confrontations with family members and are extremely distressing to the caregiver. Agitation is more common in the late stages of AD but may occur earlier when cognitive impairment is not severe [7,8].…”

Section: Neuropsychiatric Manifestations Of Admentioning

confidence: 99%

Neuropsychiatric Symptoms and Cholinergic Therapy for Alzheimer’s Disease

Levy

Cummings

Kahn-Rose³

1999

Gerontology

110

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Neuropsychiatric abnormalities, as well as the commonly associated neuropsychological symptoms, are clinical characteristics of Alzheimer’s disease (AD), the most common form of dementia. Thus, in addition to a general cognitive and functional decline, neuropsychiatric manifestations, such as agitation, apathy, anxiety, psychoses and disinhibition, are frequently evident in AD patients. Such neuropsychiatric symptoms of AD are the source of considerable patient and caregiver distress, resulting in the prescription of neuroleptics, benzodiazepines or other psychotropic agents, and are a major factor in the decision to transfer the care of patients into nursing homes. Recent evidence suggests that some neuropsychiatric changes associated with AD are related to the cholinergic deficits in the brains of AD patients and that such abnormalities may be responsive to cholinergic therapy. Cholinergic drug therapies indicated for the symptomatic treatment of AD, for example tacrine and the newer cholinesterase (ChE) inhibitors such as donepezil, have been demonstrated to improve memory, language and praxis. Furthermore, although less is known about the effect of ChE inhibitors on the neuropsychiatric symptoms of AD, preliminary evidence suggests that they reduce apathy, anxiety, hallucinations, disinhibition and aberrant motor behaviour. Thus, the newer-generation ChE inhibitors that are well tolerated, easy to administer and show promise in reducing the cognitive, as well as neuropsychiatric disturbances of AD, may emerge as important treatments for some neuropsychiatric symptoms in patients with central cholinergic deficits, including AD.

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Troublesome and Disruptive Behaviors in Dementia

Cited by 317 publications

References 29 publications

Violence in Alzheimer's disease

Violence in Alzheimer's disease

[No Title]

Neuropsychiatric Symptoms and Cholinergic Therapy for Alzheimer’s Disease

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