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Neuropsychiatric Symptoms of Cognitive Impairment and Dementia

Neuropsychiatric Symptoms in Cognitive Impairment and Dementia: A Brief Introductory OverviewThe Behavioral and Psychological Symptoms of DementiaDifferent Models of DementiaReflecting on Neurobiological PerspectivesReflecting on Psychosocial PerspectivesConcluding RemarksReferencesI Common Issues in Cognitive Impairment The Difficult Distinction Between Affective Disorders and Mild Cognitive DeteriorationCase DescriptionsIntroductionDefinitions and ConceptsClinical AspectsStandardized Assessment ToolsEpidemiological AspectsPredictive Value of Affective Symptoms for DementiaCausal Relationships Between Affective Symptoms and Cognitive ImpairmentsDepression Leads to Cognitive Impairments.Depression Leads to Dementia.Dementing Disorders Lead to Affective Symptomatology.ManagementPharmacological ManagementNon-pharmacological ManagementReferencesBehavior Symptoms in Primary Progressive Aphasia VariantsPrimary Progressive AphasiaBehavior Changes in PPA Epidemiology and FrequencyType of SymptomsBehavior Changes Across PPA VariantsThe Assessment of Behavior Symptoms in PPAImplications for Diagnosis and Management Pharmacological InterventionsNon-pharmacological InterventionsFinal RemarksReferencesThe Ability to Drive in Mild Cognitive ImpairmentIntroduction to the Driving TaskMild Cognitive ImpairmentMild Cognitive Impairment and Skills Related to DrivingMild Cognitive Impairment and the Driving TaskIdentification in a Clinical Setting of Fit and Unfit Older Adult Drivers with MCIOff-Road TestingSimulatorOn-RoadDriving CessationInterventionsConclusionReferencesGlobal Hypoactivity and ApathyDefinition of Global Hypoactivity and ApathyThe Diagnosis of Global Hypoactivity with ApathyMechanisms of Hypoactivity and ApathyPrevalence of Hypoactivity and Apathy in Main Neurological DisordersAlzheimer’s Disease, Mild Neurocognitive Disorder, Behavioral Variant Frontotemporal DegenerationAlzheimer’s Disease at the Major Neurocognitive Disorder StageMild Neurocognitive Disorders and Alzheimer’s Disease at the Pre-dementia StageApathy and Behavioral Variant Frontotemporal DegenerationAnatomical Correlates of Apathy in Alzheimer’s Disease and Frontotemporal DegenerationManagement of Apathy in Major Neurocognitive DisordersParkinson’s Disease and Dementia Associated with Parkinson’s DiseasePrevalence and Clinical CorrelatesDeterminants of Apathy in Parkinson’s DiseaseDiagnosis of Hypoactivity with Apathy in Parkinson’s DiseaseManagement of Apathy in Parkinson’s DiseaseStroke and Vascular Dementia Frequency and ComorbiditiesDeterminants of ApathyDiagnosis of Hypoactivity with Apathy in StrokeManagement of Apathy in StrokeConclusionsReferencesNeuropsychiatric Symptoms in Reversible DementiasOverview of the Problem and General DefinitionsClinical VignetteEpidemiologyClinical AspectsDiagnostic WorkupPractice RecommendationsReversible DementiasPotentially Reversible DementiasStructural Lesions and Neurosurgical ConditionsSpace-Occupying LesionsHydrocephalusTraumatic Brain InjuryDural Arteriovenous FistulaMedical and Neurological ConditionsToxic DisordersMetabolic DisordersInfectious DisordersImmunologically Mediated DisordersRenal DisordersHepatic DisordersPulmonary DisordersCardiac DisordersHematological DisordersOncologic DisordersSleep DisordersEpilepsyOther DisordersDeliriumPsychiatric DisordersReversible Comorbidity in Irreversible DementiasFinal CommentsReferencesII Main Neuropsychiatric Symptoms and Syndromes in DementiaDelirium and Dementia in Older People: A Complex LinkThe Confused Older PersonDeliriumDelirium Screening InstrumentsRecommended Delirium Screening InstrumentsOther Brief Delirium Screening InstrumentsDelirium Screening Instruments in Critically 111Delirium Screening Instruments in Dementia SubjectsLaboratory and Neuroimaging Tests for DeliriumDelirium NeurobiologyNeuroinflammatory and Aberrant Stress HypothesisNeurobiological Correlates of Delirium SymptomsClinical Considerations: The Challenge of Differentiating Delirium and Dementia in Older People?Long-Term Outcomes of DeliriumDelirium Management: Prevention and TreatmentNon-pharmacological InterventionsPharmacological TreatmentAntipsychoticsOther AgentsPharmacological ProphylaxisConclusionReferencesDepression and Anxiety in Dementia SubjectsClinical ExampleEpidemiologyRelationships Between Depression, Anxiety and DementiaDistinguishing Clinically Between Depression and DementiaOverlap Between Depression and Anxiety in DementiaTreatment Options for Depression in DementiaPharmacological TreatmentPsychosocial InterventionsTreatment Options for Anxiety in DementiaConclusionReferencesAggression, Agitation, Hyperactivity, and IrritabilityDefinition of Aggression, Agitation, Hyperactivity, and Irritability in DementiaAggressionAgitationIrritabilityHyperactivityClinical Aspects DiagnosisScales for Assessment of Aggression, Agitation, Irritability, and HyperactivityGeneral Scale Assessing Aggression, Agitation, Hyperactivity, and IrritabilitySpecific Scales Assessing Aggression, Agitation, Hyperactivity, or IrritabilityResearch on Agitation, Aggression, Irritability, and HyperactivityEpidemiology of Agitation, Aggression, Irritability, and Hyperactivity in Patients with DementiaPrevalence and Longitudinal Trajectory According to Setting and Disease StagePrevalence and Longitudinal Trajectory According to Diagnosis and Cognitive ProfileCauses of Agitation, Aggression, Irritability, and HyperactivityBiological Mechanisms in the Development of Agitation, Aggression, Irritability, and HyperactivityImaging FindingsNeurotransmittersCerebrospinal FluidGeneticsConclusionImpact of Agitation, Aggression, Irritability, and HyperactivityManagement of Agitation, Aggression, Irritability, and HyperactivityGeneral Approach to the Diagnosis and Management of Agitation, Aggression, Irritability, and HyperactivityClinical Examples of Diagnosis and Management of Agitation, Aggression, Irritability, and HyperactivityGuidelines on Management of Agitation, Aggression, Irritability, and HyperactivityNon-pharmacological TreatmentInterventions Aimed at the Patient with DementiaInterventions Aimed at the CarersInterventions Aimed at the EnvironmentPharmacological TreatmentA Practical Guide to Pharmacological TreatmentPharmacological Treatment: EvidenceAnti-dementia MedicationAntipsychoticsAntidepressantsAnticonvulsants and Mood StabilizersOther MedicationsConclusionReferencesPsychosis in DementiaOverview and General DefinitionsDiagnosisHow to Diagnose PiD According to DSM-V or ICD-10Differential DiagnosisClinical CharacteristicsSymptom CourseEpidemiologyPsychosis and Dementia SeverityAetiologyBiological FactorsPsychosocial and Environmental FactorsTreatmentPsychosocial and Environmental Treatment ApproachesMedical TreatmentAntipsychotic DrugsAntidepressant DrugsAntidementia DrugsOther Drug AlternativesReferencesInappropriate Sexual Behaviors in DementiaOverviewDefinition and EpidemiologyInappropriate Sexual Behaviors in Different Types of DementiaAssessment of Inappropriate Sexual Behavior in DementiaClinical ManagementNon-pharmacological ApproachPharmacological ApproachFinal CommentReferencesInsomnia in Dementia: A Practical ApproachEpidemiologyDefining the IssueAssessment of Insomnia in DementiaSleep Scales in DementiaClinical ManagementNon-pharmacological TreatmentPharmacological TreatmentGeneral ConsiderationsBenzodiazepinesAntidepressants with Sedative EffectAntipsychoticsOther CompoundsFinal CommentReferencesFrontotemporal DementiaNeuropsychiatric Symptoms in FTDBehavioral Symptoms of the bvFTD Criteria of FTDCEarly Behavioral Disinhibition, Loss of Self-ControlEarly Apathy or InertiaEarly Loss of Sympathy or EmpathyEarly Perseverative, Stereotyped, or Compulsive Ritualistic BehaviorHyperorality and Dietary ChangesOther Neuropsychiatric Symptoms in FTD Mood ChangesPsychosisBehavioral Changes in the Language Variant of FTDProgression of Neuropsychiatric Symptoms in FTDPsychiatric Disorders Preceding FTDLinks Between bvFTD and SchizophreniaSubtypes of Neuropsychiatric Symptoms Suggestive of Certain Brain Location, Pathology, or Gene Mutation in FTDManagement of Neuropsychiatric Symptoms in FTD Pharmacological TreatmentsSerotonergic AgentsAntipsychoticsCholinesterase InhibitorsOther TreatmentsNon-pharmacological Management StrategiesConclusionsReferencesIII Non-pharmacological ApproachesCognitive and Psychological Interventions in Neurocognitive DisordersCognitive InterventionsPsychological InterventionsBehavior-Oriented ApproachesEmotion-Oriented ApproachesSensory Stimulation-Oriented ApproachesOther Psychosocial InterventionsCognitive and Psychological Interventions in Mild Stages of Neurocognitive DisordersML: A Case of Neurocognitive Disorder due to Parkinson’s DiseaseGoals and MotivationInterventionOverviewReferencesFamily Issues in Behavioral and Psychological Symptoms of Dementia: Unraveling Circular Pathways?The Experience of Caregiving and BPSDThe Negative Aspects of Caregiving, as Related to BPSDThe Positive Aspects of Caregiving Despite the BPSD: A More Comprehensive View of the Experience of Providing CareFamily Determinants of BPSDThe “Appalling Dangers” of Family LifeIs There a Place for Expressed Emotion in Our Understanding of BPSD in Families?The Most Powerful Resource? Coming to Terms with the Whole ScenePersonality Vulnerability and Protective Factors in Dementia- Related StressThe Quality of the Relationship Between Persons with Dementia and Their Family CaregiversTo What Extent Are Secondary Caregivers Important?A Word on Transcultural IssuesThe Family as the First Resource to Look ForSelected ReadingsReferencesToward a Family-Sensitive Practice in DementiaIntroduction: Jose and MariaFamily InterventionsCaregiver-Focused InterventionsFamily and Systemic TherapyPractical Approaches: Reflections for CliniciansSelected ReadingsReferences
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