Behavioral and Psychological Symptoms of Dementia

by Christine Kennard Health Professional

Behavioral and psychological symptoms in dementia (BPSD) are inevitable. It is estimated that about 90% of people with Alzheimer’s may present with a least one of the following: wandering, agitation, verbal and physical aggression, depression, apathy, disinhibition, and/or hallucinations. In this blog I offer brief information and links about symptoms and how caregivers can help.

Behavioral changes tend to increase as diseases of dementia, including Alzheimer’s damages the brain. Brain damage affects a person’s ability to think, manage activities of daily life and interact with those around them. Let's look at the common symptoms and issues that occur:

Depression: Depression is very common in dementia. It is a complex issue and the cause can significantly depend on the stage of the disease, support, social and financial circumstances of the individual. More information about depression and dementia:

Is it depression or dementia

Apathy: Is a common symptom in dementia that describes the absence or suppression of emotion, feeling, or concern, and of motivation characterized by a lack of goal-centred activity. Apathy differs from depression in that depression affects mood as well as motivation. More about apathy and how it differs from depression in dementia.

Wandering.

Agitation: Agitation is a difficult experience for the person with dementia and for the caregiver.

Physical and Verbal Aggression: Some people with Alzheimer’s can exhibit aggressive and sometimes violent behavior. Understanding what may be happening to someone with the disease helps us cope better. We can plan strategies to help defuse situations and seek help from appropriate doctors and agencies.

Aggression in Alzheimer’s disease

Disinhibition: Damage, especially to the frontal lobes of the brain and the changes in how people react to their environment when they have dementia, can lead to disinhibited behavior. For example, a lot of inappropriate and aggressive sexual behavior seen in people with Alzheimer's tends to be both short term and in the later states of the disease. Most people with Alzheimer's disease lose sexual drive as the disease progresses. More information on Coping with disinhibited and inappropriate sexual behavior.

Delusions and Hallucinations: Hallucinations can affect any of the senses, so a person may hear, see, taste, touch or smell things that are not really there. They usually occur in the middle/moderate stage of the disease but this is sometimes dependant of the type of dementia. Hallucinations occur without external stimulation and those experiencing them believe them to be real. In Alzheimer's disease hallucinations tend to be visual.

More about hallucinations and how to help cope with delusions and hallucinations.

Christine Kennard
Meet Our Writer
Christine Kennard

Christine Kennard wrote about Alzheimer's for HealthCentral. She has many years of experience in private and public sector nursing care homes for people with dementia. She has worked in a variety of hospital, public and private health settings and specialized in community nursing. Christine is qualified in group analytic psychotherapy, is registered in general and mental health nursing and has a Masters degree.