Pharmacological Treatment of Neuropsychiatric Symptoms of Dementia A Review of the Evidence

UP TO 50% OF COMMUNITYdwelling elderly individuals older than 85 years have dementia, with Alzheimer disease (AD), vascular dementia, and dementia with Lewy bodies accounting for most cases. Although cognitive deficits are the clinical hallmark of dementing illnesses, noncognitive symptoms are common and can dominate disease presentation. These include an array of neuropsychiatric symptoms, such as agitation, aggression, delusions, hallucinations, repetitive vocalizations, and wandering, among other symptoms. Neuropsychiatric symptoms have been observed in 60% to 98% of patients with dementia, especially in later stages, and are associated with caregiver stress and depression, as well as reduced caregiver employment and income. Neuropsychiatric symptoms are also associated with increased hospital lengths of stay and commonly lead to nursing home placement. Federal expenditures for dementia are expected to triple in the next 10 years and 30% of the cost of caring for patients with AD is attributed directly to the management of neuropsychiatric