Behavioural and Psychological Symptoms of Dementia: An Overview.

The issue of mental and behavioural manifestations in patients diagnosed with Alzheimer's disease has seen an evolution of enormous proportions. This is why a new acronym has been introduced into contemporary literature and everyday language: BPSD (Behavioural and Psychological Symptoms of Dementia). BPSD is classified as “non-cognitive” symptoms of dementia. The symptoms usually appear heterogeneous and individual compared to the cognitive deficit itself. BPSD shows a high interindividual variability in the various types mental and behavioural symptoms, in their severity and the stage at which they appear. The pathogenic mechanism of mental and behavioural disorders is complex: the combination of strictly individual biological and mental factors (genetic predisposition, pre-morbid personality) with interpersonal and environmental factors (reduced social relations, hospitalisation, institutionalisation) can in part explain the triggering of such symptomatology. BPSD is conventionally divided into clusters, which include apathy, depression, psychosis, agitation and aggression. They are not a diagnosis in the categorical sense, but have an operative significance as they allow for the identification of targets for drug therapy. The need to define the characteristics of BPSD accurately has motivated the creation of numerous psychometric instruments: global scales that examine a wide behavioural and psychotic range and more specific scales aimed at particular symptomatologies.