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Case 6 - “Leave Me Alone”

Agitation in MNCD

Published online by Cambridge University Press:  31 October 2024

Matthew Gibfried
Affiliation:
Saint Louis University School of Medicine, Missouri
George T. Grossberg
Affiliation:
Saint Louis University School of Medicine, Missouri
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Summary

Agitation is a neuropsychiatric syndrome that is commonly seen in those with major neurocognitive disorders. Those demonstrating agitation can show increase in motor activity, restlessness, emotional distress, and physical or verbal aggression. Agitation is the third most common neuropsychiatric symptom in dementia after apathy and depression. Up to 80% of people with dementia experience some degree of agitation at some point during the course of the illness. The pharmacologic management of agitation in those with major neurocognitive disorders is complex and many studies have shed light on the topic.

Type
Chapter
Information
Clinical Case Studies in Long-Term Care Psychiatry
Navigating Common Mental Health Challenges in Geriatric Care
, pp. 24 - 27
Publisher: Cambridge University Press
Print publication year: 2024

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References

References

Rosen, J., Burgio, L., Kollar, M., Cain, M., Allison, M., Fogleman, M., & Zubenko, G. S. (1994). The Pittsburgh Agitation Scale: A user‐friendly instrument for rating agitation in dementia patients. The American Journal of Geriatric Psychiatry, 2 (1), 5259.CrossRefGoogle Scholar
Cohen‐Mansfield, J., & Libin, A. (2004). Assessment of agitation in elderly patients with dementia: Correlations between informant rating and direct observation. International Journal of Geriatric Psychiatry, 19 (9), 881891.CrossRefGoogle ScholarPubMed
Pedersen, S. K., Andersen, P. N., Lugo, R. G., Andreassen, M., & Sütterlin, S. (2017). Effects of music on agitation in dementia: A meta-analysis. Frontiers in Psychology, 8, 742.CrossRefGoogle ScholarPubMed
Grossberg, G. T., Kohegyi, E., Mergel, V., Josiassen, M. K., Meulien, D., Hobart, M., Slomkowski, M., Baker, R. A., McQuade, R. D., & Cummings, J. L. (2020). Efficacy and safety of brexpiprazole for the treatment of agitation in Alzheimer’s dementia: Two 12-week, randomized, double-blind, placebo-controlled trials. American Journal of Geriatric Psychiatry, 28 (4), 383400. doi: 10.1016/j.jagp.2019.09.009. Epub 2019 Oct 1. PMID: 31708380.CrossRefGoogle ScholarPubMed
Hershey, L. A., & Coleman-Jackson, R. (2019). Pharmacological management of dementia with Lewy bodies. Drugs Aging, 36 (4), 309319. doi: 10.1007/s40266-018-00636-7. PMID: 30680679; PMCID: PMC6435621.CrossRefGoogle ScholarPubMed

Further Reading

Desai, A., & Grossberg, G. (2018). Psychiatric Consultation in Long-Term Care. A Guide for Healthcare Professionals. 2nd ed. (Cambridge University Press.)Google Scholar
Gitlin, L. N., Kales, H. C., & Lyketsos, C. G. (2012). Nonpharmacologic management of behavioral symptoms in dementia. JAMA, 308 (19), 20202029. doi: 10.1001/jama.2012.36918. PMID: 23168825; PMCID: PMC3711645.CrossRefGoogle ScholarPubMed
Haight, R. J., Di Polito, C. N., Payne, G. H., Bostwick, J. R., Fulbright, A., Lister, J. F., & Williams, A. M. (2023). Psychotropic stewardship: Advancing patient care. Mental Health Clinician, 13 (2), 3648. doi: 10.9740/mhc.2023.04.036. PMID: 37063939; PMCID: PMC10094994.CrossRefGoogle ScholarPubMed
Keszycki, R. M., Fisher, D. W., & Dong, H. (2019). The hyperactivity–impulsivity–irritiability–disinhibition–aggression–agitation domain in Alzheimer’s disease: Current management and future directions. Frontiers in Pharmacology, 10, 1109. doi: 10.3389/fphar.2019.01109. PMID: 31611794; PMCID: PMC6777414.CrossRefGoogle ScholarPubMed
Salzman, C., Jeste, D. V., Meyer, R. E., Cohen-Mansfield, J., Cummings, J., Grossberg, G. T., Jarvik, L., Kraemer, H. C., Lebowitz, B. D., Maslow, K., Pollock, B. G., Raskind, M., Schultz, S. K., Wang, P., Zito, J. M., & Zubenko, G. S. (2008). Elderly patients with dementia-related symptoms of severe agitation and aggression: Consensus statement on treatment options, clinical trials methodology, and policy. Journal of Clinical Psychiatry, 69 (6), 889898. doi: 10.4088/jcp.v69n0602. PMID: 18494535; PMCID: PMC2674239.CrossRefGoogle ScholarPubMed
Testad, I., Corbett, A., Aarsland, D., Lexow, K., Fossey, J., Woods, B., & Ballard, C. (2014). The value of personalized psychosocial interventions to address behavioral and psychological symptoms in people with dementia living in care home settings: A systematic review. International Psychogeriatrics, 26 (7), 10831098. doi:10.1017/S1041610214000131CrossRefGoogle ScholarPubMed

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  • “Leave Me Alone”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.007
Available formats
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Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • “Leave Me Alone”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.007
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • “Leave Me Alone”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.007
Available formats
×