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Brain Sciences
Special Issues
The Future Management of Behavioral and Psychological Symptoms of Dementia
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The Future Management of Behavioral and Psychological Symptoms of Dementia

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurodegenerative Diseases".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 4657

Special Issue Editors

Prof. Dr. Magda Tsolaki

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Guest Editor
1st Department of Neurology, Aristotle University of Thessaloniki, 44 Salaminos Street, Halandri, 15232 Athens, Greece
Interests: dementia; Alzheimer's disease; neuropsychology; biological markers; non-pharmacological interventions; new technologies for patients and caregivers; post-COVID-19 neurological complications
Dr. John D. Papatriantafyllou

E-Mail Website
Guest Editor
3rd Age Center IASIS and 2nd Neurology Department, Attikon Hospital, 16562 Athens, Greece
Interests: dementia; frontotemporal degeneration; psychogeriatrics; depression of third age, MR and SPECT neuro-correlations of neuropsychiatric symptoms; non-pharmacological interventions for patients and caregivers; the implementation of new technologies on diagnosis and treatment; genetics
Prof. Dr. Antonios M. Politis

E-Mail Website
Guest Editor
First Department of Psychiatry, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
Interests: dementia; Alzheimer's disease; neuropsychology; biological markers; non-pharmacological interventions; new technologies for patients and caregivers

Special Issue Information

Dear Colleagues,

Neuropsychiatric symptoms, commonly referred to as behavioral and psychological symptoms of dementia (BPSD), include numerous non-cognitive symptoms and behaviors demonstrated by dementia patients. These substantially correlate with the level of functional and cognitive impairment, making them just as clinically meaningful as cognitive effects. The symptoms of BPSD include agitation, abnormal motor behavior, anxiety, elation, irritability, depression, apathy, disinhibition, delusions, hallucinations, and changes in sleep or appetite. According to studies, BPSD affects up to 90% of dementia patients, and is independently associated with serious complications such patient and caregiver stress, prolonged hospitalization, medication misuse, higher health care costs, early institutionalization, and death.

Currently, the etiology of BPSD is not fully known, but it is known to be the result of psychological, environmental, and genetic factors. Recent research has highlighted the importance of neurochemical, neuropathological, and molecular components in the development of BPSD's clinical symptoms, and awareness of these factors may bring us closer to more efficient management of BPDS.

The main goal of this Special Issue is to present the state of the art in this field, including clinical features, current and emerging diagnostic approaches, leading to improved management in future.

Currently, there is no approved medication or non-pharmacological intervention for BPSD. However, many efforts are being undertaken to treat the condition, either with new medications in clinical trials or suggested new non-pharmacological interventions in tailored services (Special Care units for Behavior—SCUBs).

Prof. Dr. Magda Tsolaki
Dr. John D. Papatriantafyllou
Prof. Dr. Antonios M. Politis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • early diagnosis in dementing disorders
  • mild cognitive impairment
  • Alzheimer’s disease
  • Dementia with Lewy Bodies
  • BPSD

Published Papers (3 papers)

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Research

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12 pages, 1398 KiB  
Article
Post-Diagnostic Support for Behaviour Changes in Young-Onset Dementia in Australia
by Claire J. Cadwallader, Dennis Velakoulis and Samantha M. Loi
Brain Sci. 2023, 13(11), 1529; https://doi.org/10.3390/brainsci13111529 - 30 Oct 2023
Viewed by 967
Abstract
Behaviour changes (BCs) are common in young-onset dementia (YOD). Access to knowledgeable and age-appropriate support services is needed to assist with the appropriate management of BCs. We sought to investigate the types of YOD-related BCs that most commonly require support, the formal services [...] Read more.
Behaviour changes (BCs) are common in young-onset dementia (YOD). Access to knowledgeable and age-appropriate support services is needed to assist with the appropriate management of BCs. We sought to investigate the types of YOD-related BCs that most commonly require support, the formal services being accessed for support, and the experiences of those seeking support in Australia. We employed a cross-sectional online questionnaire for individuals living with YOD as well as individuals providing informal or formal care for someone with YOD. Thirty-six questionnaire responses were recorded. Of the total sample, 83% reported YOD-related BCs requiring support, the most common being appetite/eating changes, followed by agitation/aggression and apathy/indifference. Seventy-six percent of these individuals had attempted to seek support from a formal service, with Dementia Australia, Dementia Support Australia, and general practitioners most commonly approached. Responses suggested that the support access pathway is suboptimal, with a lack of clarity about what services to approach for support and long wait times. Furthermore, 28% of participants had not gained access to support utilizing non-pharmacological strategies. Individuals who need support for YOD-related BCs demonstrated a high rate of help-seeking from formal support services; however, the support access pathway is slow, is difficult to navigate, and does not result in the best-practice management of BCs. Formal services resourced to provide efficient support with the implementation of behavioural strategies are needed, along with clear, accessible guidelines on the pathway to access them. Full article
(This article belongs to the Special Issue The Future Management of Behavioral and Psychological Symptoms of Dementia)
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10 pages, 583 KiB  
Article
Perceptions of Knowledge, Disease Impact and Predictive Genetic Testing in Family Members at Risk to Develop Early-Onset Alzheimer’s Disease (EOAD) and Their Levels of Suicidal Ideation: A Mixed Study
by Yesica Arlae Reyes-Domínguez, Luis E. Figuera and Aniel Jessica Leticia Brambila-Tapia
Brain Sci. 2023, 13(3), 501; https://doi.org/10.3390/brainsci13030501 - 16 Mar 2023
Viewed by 1256
Abstract
Early-onset Alzheimer’s disease (EOAD) is an autosomal dominantly inherited disease, in which a founder effect has been described for A431E mutation in the PSEN1 gene, with most of the affected patients being residents of a small town in the state of Jalisco in [...] Read more.
Early-onset Alzheimer’s disease (EOAD) is an autosomal dominantly inherited disease, in which a founder effect has been described for A431E mutation in the PSEN1 gene, with most of the affected patients being residents of a small town in the state of Jalisco in Mexico. To date, no studies have been performed in order to know the impact of the disease on this population. Therefore, the objective of this study was to investigate the perceptions in the knowledge, the impact of the disease and the intention to take the predictive genetic testing in the population at genetic risk of Jalisco. For this objective, we performed a mixed study that included a qualitative methodology (semi-structured interviews), and, in addition, we measured suicidal ideation, stress and depression with quantitative instruments in order to compare them with a control group. Of the 28 invited individuals, 9 accepted to participate, from which, 5 (55.56%) participants did not know their genetic risk to develop the disease and 5 (55.56%) would want to take the predictive genetic testing in order to be prepared to face the disease; however, among those who did not want to know, 2 individuals (22.22%) mentioned that they would consider suicide if they were positive for the pathogenic variant. On the impact of the disease, we detected that the adaptation to the familiar’s needs was the most frequent answer, including changes in their lifestyle (being responsible since very young, changes in social life and familiar dynamic), this being their main stressor, followed by changes in plans for the future and contemplating the possibility of being affected. Although no differences in stress and depression between groups were observed, we detected that suicidal ideation was significantly higher in the group of cases. These results highlight the importance to involve all the family in genetic counseling in order to clarify any doubts and also to attend to them psychologically to prevent suicidal ideation and attempts. Full article
(This article belongs to the Special Issue The Future Management of Behavioral and Psychological Symptoms of Dementia)
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Review

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22 pages, 665 KiB  
Review
A Systematic Review of Pharmacological Interventions for Apathy in Aging Neurocognitive Disorders
by Christos Theleritis, Kostas Siarkos, Anastasios Politis, Nikolaos Smyrnis, Charalabos Papageorgiou and Antonios M. Politis
Brain Sci. 2023, 13(7), 1061; https://doi.org/10.3390/brainsci13071061 - 12 Jul 2023
Cited by 2 | Viewed by 1731
Abstract
Objective: Apathy, a frequent neuropsychiatric symptom in aging neurocognitive disorders, has been associated with cognitive decline and functional disability. Therefore, timely provision of pharmacological interventions for apathy is greatly needed. Design: A systematical literature review of existing studies was conducted up to 30 [...] Read more.
Objective: Apathy, a frequent neuropsychiatric symptom in aging neurocognitive disorders, has been associated with cognitive decline and functional disability. Therefore, timely provision of pharmacological interventions for apathy is greatly needed. Design: A systematical literature review of existing studies was conducted up to 30 May 2023 in several databases (PubMed, PsychInfo, Cochrane, Google Scholar, etc.) that included randomized controlled trials (RCTs) and meta-analyses assessing pharmacological treatments for apathy in aging neurocognitive disorders. The quality of the studies was appraised. Results: In patients with Alzheimer’s Disease (AD), donepezil, galantamine, rivastigmine, methylphenidate, and gingko biloba were proven efficacious for apathy, while rivastigmine, cognitive enhancer IRL752 and piribedil were found to be beneficial in patients with Parkinson’s Disease (PD) and agomelatine in patients with Frontotemporal Dementia (FD). The extensive proportion of RCTs in which apathy was used as a secondary outcome measure, along with the considerable methodological heterogeneity, did not allow the evaluation of group effects. Conclusions: Pharmacological interventions for apathy in aging neurocognitive disorders are complex and under-investigated. The continuation of systematic research efforts and the provision of individualized treatment for patients suffering from these disorders is vital. Full article
(This article belongs to the Special Issue The Future Management of Behavioral and Psychological Symptoms of Dementia)
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