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Psychiatric Manifestations In Dementia

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Pramod Krishnan
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PSYCHIATRIC MANIFESTATIONS IN DEMENTIA
Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object]
Definitions ,[object Object],[object Object],[object Object],[object Object]
Definitions ,[object Object],[object Object],[object Object],[object Object]
Definitions ,[object Object],[object Object],[object Object],[object Object]
Mild Cognitive Impairment ,[object Object],[object Object],[object Object],[object Object],[object Object]
Mild Cognitive Impairment ,[object Object],[object Object],[object Object],[object Object]
Alzheimer's Disease- Apathy ,[object Object],[object Object],[object Object],[object Object],[object Object]
Alzheimer's Disease- Apathy ,[object Object],[object Object],[object Object],[object Object]
Alzheimer's Disease- Anxiety ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Alzheimer's Disease- Agitation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Alzheimer's Disease- Depression ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Alzheimer's Disease- Depression ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Alzheimer's Disease- Psychosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prevalence of neuropsychiatric symptoms in MCI and AD 4 15 3 15 <1 10 20 11 1 3 MCI (n=320) Community Study % Tertiary Care Centre study % 27 14 16 Aberrant motor behaviour 38 29 27 Irritability 21 18 13 Disinhibition 51 39 27 Apathy 8 11 3 Euphoria 35 25 22 Anxiety 50 39 32 Dysphoria 34 18 30 Agitation 6 0 11 Hallucination 26 4 18 Delusion AD (n=124) MCI (n=28) AD (n=362) Symptom
Alzheimer's Disease Variants ,[object Object],[object Object],[object Object]
Dementia With Lewy Bodies ,[object Object],[object Object],[object Object]
Dementia With Lewy Bodies ,[object Object],[object Object],[object Object]
Dementia With Lewy Bodies ,[object Object],[object Object],[object Object],[object Object]
Dementia With Lewy Bodies ,[object Object],[object Object],[object Object],[object Object]
Dementia With Lewy Bodies ,[object Object],[object Object],[object Object],[object Object]
Delusional misidentification syndromes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Dementia With Lewy Bodies ,[object Object],[object Object],[object Object],[object Object]
Frontotemporal Dementia ,[object Object],[object Object],[object Object],[object Object],[object Object]
Frontotemporal Dementia ,[object Object],[object Object],[object Object],[object Object],[object Object]
Vascular Dementia ,[object Object],[object Object],[object Object],[object Object]
Evaluation Of Neuropsychiatric Symptoms In Demented Patients ,[object Object],[object Object],[object Object]
Evaluation Of Neuropsychiatric Symptoms In Demented Patients ,[object Object],[object Object],[object Object],[object Object],[object Object]
Behavioral Interventions ,[object Object],[object Object],[object Object],[object Object],[object Object]
Behavioral Interventions ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pharmacologic Interventions: Cholinesterase inhibitors ,[object Object],[object Object],[object Object],[object Object],[object Object]
Memantine ,[object Object],[object Object],[object Object],[object Object]
Antipsychotics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Antipsychotics ,[object Object],[object Object],[object Object],[object Object],[object Object]
Mood Stabilizers ,[object Object],[object Object],[object Object],Antidepressants ,[object Object],[object Object]
Pharmacotherapy of neuropsychiatric symptoms Risperidone + SSRIs/SNRIs Trazodone AChEIs SSRIs, SNRIs, BZDs SSRIs Risperidone, Quetiapine SSRIs Quetiapine, Risperidone First line Olanzepine+SSRIs/SNRIs Psychotic depression Zolpidem Insomnia/ sundowning Apathy Atypical antipsychotics Anxiety SNRIs Depression Olanzapine, Aripiprazole Aggression Quetiapine, Risperidone Agitation Olanzapine, Aripiprazole Psychosis Second line Symptom
Conclusion ,[object Object],[object Object],[object Object],[object Object]
Key Points ,[object Object],[object Object],[object Object],[object Object]
Key Points ,[object Object],[object Object],[object Object],[object Object],[object Object]
Key Points ,[object Object],[object Object],[object Object],[object Object],[object Object]
Key Points ,[object Object],[object Object],[object Object],[object Object]
Key Points ,[object Object],[object Object],[object Object],[object Object]

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Psychiatric Manifestations In Dementia

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  • 15. Prevalence of neuropsychiatric symptoms in MCI and AD 4 15 3 15 <1 10 20 11 1 3 MCI (n=320) Community Study % Tertiary Care Centre study % 27 14 16 Aberrant motor behaviour 38 29 27 Irritability 21 18 13 Disinhibition 51 39 27 Apathy 8 11 3 Euphoria 35 25 22 Anxiety 50 39 32 Dysphoria 34 18 30 Agitation 6 0 11 Hallucination 26 4 18 Delusion AD (n=124) MCI (n=28) AD (n=362) Symptom
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  • 36. Pharmacotherapy of neuropsychiatric symptoms Risperidone + SSRIs/SNRIs Trazodone AChEIs SSRIs, SNRIs, BZDs SSRIs Risperidone, Quetiapine SSRIs Quetiapine, Risperidone First line Olanzepine+SSRIs/SNRIs Psychotic depression Zolpidem Insomnia/ sundowning Apathy Atypical antipsychotics Anxiety SNRIs Depression Olanzapine, Aripiprazole Aggression Quetiapine, Risperidone Agitation Olanzapine, Aripiprazole Psychosis Second line Symptom
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