The Japanese journal of neuropsychology

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ArticleTitle	Comprehension and treatment of behavioral and psychological symptoms of dementia (BPSD)
Language	J
AuthorList	Hiroaki Kazui¹⁾, Shunsuke Sato²⁾, Kenji Yoshiyama³⁾, Naoto Kamimura¹⁾, Tetsuo Kashibayashi¹⁾
Affiliation	¹⁾Department of Neuropsychiatry, Kochi Medical School, Kochi University ²⁾Department of Psychiatry, Osaka General Medical Center ³⁾Department of Psychiatry, Osaka University Graduate School of Medicine
Publication	Japanese Journal of Neuropsychology: 35 (2), 97-108, 2019
Received
Accepted
Abstract	Behavioral and psychological symptoms of dementia (BPSD) include noncognitive symptoms and behaviors that commonly occur in patients with dementia. BPSD include agitation, irritability, delusions, hallucinations, anxiety, apathy, disinhibition, sleep disturbance, and appetite changes. It is estimated that BPSD affect up to 90% of all dementia subjects over the course of their illness, and are independently associated with poor outcomes, including distress among patients and caregivers, and long-term hospitalization. It is very important that BPSD can be prevented and treated, unlike the causative disease for dementia itself and cognitive impairment. The treatment for BPSD is started with appropriate management skills for BPSD. However, it is a current issue to develop appropriate and effective management skills for various types of BPSD and to let caregivers such as family caregivers and care experts to know the skills. We think that specialists with knowledge of neuropsychology are required to participate in developing and evangelizing the appropriate and effective management skills. In this paper, we showed examples of some appropriate and effective management skills which were developed under consideration of the symptoms (memory impairment in patients with Alzheimer's disease (AD), apathy in patients with mild cognitive impairment due to AD, visual hallucinations in patients with dementia with Lewy bodies, and stereotyped behaviors in frontotemporal lobar degeneration) from the view point of neuropsychology. In addition, we introduced a website which we developed and called "circle of wisdom about dementia care net" ("Ninchisho Chienowa net" in Japanese). The aim of the web site is to calculate success rates of various management methods for various BPSD based on actual care experiences. We ask caregivers throughout Japan to submit their care experiences, including what happened (what types of BPSD), the management method used, and whether the method improved the BPSD (effective or ineffective) to this website. On the website, we make a group of the care experiences with both the same kind of BPSD and the same kind of management method. In this group, this management method is effective in some care experiences, and ineffective in others. Then, we calculate the success rate for these care experiences. We also introduced the frame work of our comprehensive and practical prevention and treatment guidelines for BPSD in this paper.
Keywords	dementia, behavioral and psychological symptoms of dementia (BPSD), non-pharmacological treatment, treatment guidelines, Ninchisho Chienowa-net (circle of wisdom about dementia care net)