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17 - Treatment of behavioral symptoms in vascular dementia

from Section 3 - Treatment

Published online by Cambridge University Press:  15 September 2009

By
Catherine Cole  and
Alistair Burns
Edited by
Lars-Olof Wahlund ,
Timo Erkinjuntti  and
Serge Gauthier
Lars-Olof Wahlund
Affiliation:
Karolinska Institutet, Stockholm
Timo Erkinjuntti
Affiliation:
University of Helsinki
Serge Gauthier
Affiliation:
McGill University, Montréal
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Summary

Behavioral and psychological symptoms are common in vascular dementia (VaD), and carry a significant burden for patients and carers. The symptoms are divided into those usually assessed at the patient/carer interview and symptoms usually assessed by behavioral observation of the patient/relative. The mechanisms for development of behavioral and psychological symptoms in dementia (BPSD) are unclear. It has been postulated that different factors may operate in Alzheimer's disease (AD) and VaD, suggesting that different treatment strategies may be appropriate for BPSD in different types of dementia. The first line of treatment should usually be non-pharmacological. If the patient is presenting with apparent manic symptoms, agitation or aggressive behavior, it is appropriate to treat with an anticonvulsant. Antipsychotics have been used in the treatment of agitation and non-specific behavioral disturbance in dementia as well as psychotic symptoms. Inhibition of cholinesterase enzymes partially corrects the cholinergic deficit.

Keywords

Alzheimer's diseaseangiitisarterial dissectionatherosclerosislarge-vessel vascular dementiamoyamoya diseasepathophysiological mechanismscognitive deterioration
Type
Chapter
Information
Vascular Cognitive Impairment in Clinical Practice , pp. 206 - 219
Publisher: Cambridge University Press
Print publication year: 2009

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