Behavioral Disturbances

Symptoms of behavioral disturbances in Alzheimer’s disease include agitation, depression, apathy, hallucinations, delusions, anxiety, disinhibition, irritability, wandering, pacing, appetite changes and nighttime behavioral alterations. Some, such as apathy and depression, begin early in the disease and become progressively more common with time. In the end, up to 80 percent of individuals with Alzheimer’s exhibit agitation, 70 percent have apathy, 40 percent have depression and 20 percent have evidence of psychosis with delusions and hallucinations. Non-pharmacologic approaches such as education, avoidance, and behavior-soothing activities may help as interventions, but if they fail, drug therapies are often used. The behavioral changes worsen the quality of life not only of the individual, but adversely affect the quality of life of caregivers who are struggling with agitated or depressed family members. These symptoms often contribute to the decision that a family can no longer care for someone at home, with the result of transition to a long-term care setting. In research pertaining to the treatment of behavioral and neuropsychiatric symptoms, there is promise on the horizon. Clinical trials are advancing non-pharmacologic interventions as well as improving understanding of pharmacologic treatments, leading to new and better treatments for behavioral disturbances in Alzheimer’s. From: AFA Care Quarterly, Spring, 2016, Alzheimer’s Foundation of America.