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Clinical and Economic Factors in the Treatment of Behavioural and Psychological Symptoms of Dementia

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Abstract

The prevalence of behavioural and psychological symptoms of dementia (BPSD) exceeds 50%. They cause distress to patients and caregivers, increase resource utilisation of various kinds, and form a high risk for accelerated psychiatric care through institutionalisation.

Although evidence for current pharmacological treatment is not strong and the construct of BPSD is still not very clear, future aspects of treatment of BPSD may be positive. If we look at overall success rates of the antipsychotics, the traditional antipsychotics have the highest combined success rate of 63.1%, whereas the novel antipsychotics have an overall success rate of 56.1%. Haloperidol is the drug with the highest success rate of 65.4%, although this drug is associated with parkinsonian adverse drug reactions. Newer antipsychotics show promise in treating BPSD, but more convincing evidence (e.g. from randomised clinical trials) is required.

We provide an overview of the clinical, epidemiological and economic aspects of BPSD and a review of the available literature on their pharmacological treatment. Although only 1 pharmacoeconomic study has been conducted on BPSD, it seems likely that these manifestations drastically increase the burden of dementia.

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Acknowledgements

K.L. Lanctôt is partially supported by the Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care.

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Authors and Affiliations

  1. Graduate Faculty of Pharmaceutical Sciences, University of Toronto, Toronto, Ontario, Canada

    Michiel E. H. Hemels

  2. Health Outcomes and PharmacoEconomics (HOPE) Research Centre and Geriatric Psychiatry, Sunnybrook and Women’s College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

    Krista L. Lanctôt

  3. PharmIdeas Research and Consulting Inc., Hamilton, Ontario, Canada

    Michael Iskedjian

  4. Faculty of Pharmacy and Department of Health Administration, Faculty of Medicine, University of Toronto, 19 Russell Street, Toronto, Ontario, M5S 2S2, Canada

    Thomas R. Einarson

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  1. Michiel E. H. Hemels
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Hemels, M.E.H., Lanctôt, K.L., Iskedjian, M. et al. Clinical and Economic Factors in the Treatment of Behavioural and Psychological Symptoms of Dementia. Drugs & Aging 18, 527–550 (2001). https://doi.org/10.2165/00002512-200118070-00006

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