Abstract
Alzheimer’s disease and vascular dementia are estimated to be the most common causes of dementia, although mixed dementia could represent the most prevalent form of dementia in older adults aged more than 80 years. Behavioral disturbances are common in the natural history of dementia. However, so far, there is a paucity of studies that investigated the causal association between behavioral psychological symptoms of dementia and dementia sub-types, due to the high heterogeneity of methodology, study design and type of clinical assessment. To understand the scant evidence on such a relevant clinical issue, it could be hypothesized that a new shifting paradigm could result in a better identification of the relationship between behavioral disturbances and dementia. This narrative review provides an update of evidence on the behavioral patterns associated with different dementia sub-types and offers a potential future perspective as common ground for the development of new translational studies in the field of behavioral disturbances in dementia and the appropriateness of psychoactive treatments.
Highlights
Dementia is expected to affect approximately 42.3 million people worldwide by 2020 [1] and Alzheimer’ s disease (AD) is estimated to be the first cause of dementia whereas vascular dementia (VaD) is estimated to be the second most common type, with at least 20% of all cases of dementia [2]
In line with that and from a neuropathological standpoint, Jellinger et al [3,4] reported that autopsies on oldest old patients aged more than 85 years confirmed the high prevalence of mixed brain neurodegenerative conditions, including mixed dementia (MixD), synucleinopa-thy, TDP-43 protein accumulation, and astrogliopathy.In a wider conceptual framework, vascular cognitive impairment (VCI) could be considered the first clinical manifestation of VaD, as proposed by Sachdev [5] in 1999, and it includes a series of cognitive deficits of vascular origin
The results showed that VaD patients had increased blunted affect, depression, emotional withdrawal, motor retardation, decreased motivation, anxiety and somatic concerns
Summary
Dementia is expected to affect approximately 42.3 million people worldwide by 2020 [1] and Alzheimer’ s disease (AD) is estimated to be the first cause of dementia whereas vascular dementia (VaD) is estimated to be the second most common type, with at least 20% of all cases of dementia [2]. Growing evidence indicates that BPSD are common in patients with dementia across the natural history of the disease, representing a wide spectrum of non-cognitive symptoms Their presence is considered a predictor of poorer clinical outcomes [11], including multimorbidity, disability, poorer quality of life, higher caregivers’ burden [12,13], and institutionalization [14]. Patients with VaD may early experience depression, that is generally characterized by a higher clinical burden of symptoms, with reduced antidepressant response In line with these notions, it could be conceived that specific BPSD patterns could be associated with different dementia sub-types on the basis of a common neuroanatomic background, the multifactorial origin of behavioral disturbances makes this putative association a real challenge
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
