All group members are listed in Appendix 1.
Updates in Aging
Management of Neuropsychiatric Symptoms of Dementia in Clinical Settings: Recommendations from a Multidisciplinary Expert Panel
Version of Record online: 17 MAR 2014
© Published 2014. This article is a U.S. Government work and is in the public domain in the U.S.A.
Journal of the American Geriatrics Society
Volume 62, Issue 4, pages 762–769, April 2014
How to Cite
J Am Geriatr Soc 62:762–769, 2014.
- Issue online: 14 APR 2014
- Version of Record online: 17 MAR 2014
- National Institutes of Health (NIH)
- Alzheimer's Association
- National Institute of Mental Health
- National Institute on Aging
- Associated Jewish Federation of Baltimore
- Weinberg Foundation
- National Football League (NFL)
- Functional Neuromodulation Inc.
- Johns Hopkins Alzheimer's Disease Research Center. Grant Number: P50AG005146
- behavioral management;
- non-pharmacological management
Noncognitive neuropsychiatric symptoms (NPS) of dementia (aggression, agitation, depression, anxiety, delusions, hallucinations, apathy, disinhibition) affect individuals with dementia nearly universally across dementia stages and etiologies. NPS are associated with poor outcomes for individuals with dementia and caregivers, including excess morbidity and mortality, greater healthcare use, and earlier nursing home placement, as well as caregiver stress, depression, and difficulty with employment. Although the Food and Drug Administration has not approved pharmacotherapy for NPS, psychotropic medications are frequently used to manage these symptoms, but in the few cases of proven pharmacological efficacy, significant risk of adverse effects may offset benefits. There is evidence of efficacy and limited potential for adverse effects of nonpharmacological treatments, typically considered first line, but their uptake as preferred treatments remains inadequate in real-world clinical settings. Thus, the field currently finds itself in a predicament in terms of management of these difficult symptoms. It was in this context that the University of Michigan Program for Positive Aging, working in collaboration with the Johns Hopkins Alzheimer's Disease Research Center and Center for Innovative Care in Aging sponsored and convened a multidisciplinary expert panel in Detroit, Michigan, in fall 2011 with three objectives: to define critical elements of care for NPS in dementia; to construct an approach describing the sequential and iterative steps of managing NPS in real-world clinical settings that can be used as a basis for integrating nonpharmacological and pharmacological approaches; and to discuss how the approach generated could be implemented in research and clinical care.