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Understanding Dementia: Are Behavioural Problems Present? - DementiaGuide.com
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Understanding Dementia

Are Behavioural Problems Present?

This is an excerpt from the book Understanding Dementia, which is meant to be a practical manual for primary care physicians and other health care professionals. The issue of irritability and frustration is introduced in Chapter 5, in which physicians are encouraged to evaluate symptoms other than memory , in trying to understand whether a person with a memory complaint (which is very common) actually has dementia (which at most ages is - thankfully! - much less common than complaints about memory).

It is important to explore behaviour, as these are the symptoms which are often most distressing to the patient and family, and if present can support the diagnosis of dementia. These are also topics which patients usually deny and families feel uncomfortable discussing openly, so private discussions are necessary. Early behavioural symptoms include suspiciousness, apathy (e.g. staying in bed all day), increased emotional dependence, frustration and mood changes. The suspiciousness often centers around lost objects, the frustration with forgetfulness, and the low mood with the patient's awareness of decline. If depression is suspected it should be treated; occasionally it is the most prominent symptom and the 'dementia' will disappear as the depression improves. More often, depression coexists with dementia and the cognitive impairment will progress despite antidepressant therapy. Late symptoms include sexual disinhibition, wandering, hallucinations and agitation. If these later ones are present in early stage dementia it suggests that Alzheimer's disease is not the diagnosis or a second disorder is present.

Taken from Understanding Dementia: A Primer of Diagnosis and Management
Kenneth Rockwood & Chris MacKnight, 2001
Chapter 7, pp 91-92

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Last updated December 4, 2018
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