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Review

Tailoring the therapeutic interventions for behavioral and psychological symptoms of dementia

, ORCID Icon, ORCID Icon, , ORCID Icon, , ORCID Icon, , ORCID Icon & ORCID Icon show all
Pages 707-720 | Received 28 Apr 2022, Accepted 09 Aug 2022, Published online: 18 Aug 2022

References

  • Gerlach LB, Kales HC. Managing behavioral and psychological symptoms of dementia. Psychiatr Clin North Am. 2018;41(1):127–139.
  • Kales HC, Gitlin LN, Lyketsos CG. Assessment and management of behavioral and psychological symptoms of dementia. BMJ. 2015;350(mar02 7):h369.
  • Zhao QF, Tan L, Wang HF, et al. The prevalence of neuropsychiatric symptoms in Alzheimer’s disease: systematic review and meta-analysis. J Affect Disord. 2016;190:264–271.
  • Magierski R, Sobow T, Schwertner E, et al. Pharmacotherapy of behavioral and psychological symptoms of dementia: state of the art and future progress. Front Pharmacol. 2020;11:1168.
  • Lim SC. Managing behavioral and psychological symptoms of dementia - from a geriatrician’s perspective. J Aging Geriatr Psychiatry. 2018;21:1–7.
  • Leung DKY, Wong KKY, Spector A, et al. Exploring dementia family carers’ self-initiated strategies in managing behavioral and psychological symptoms in dementia: a qualitative study. BMJ Open. 2021;11(8):e048761.
  • Finkel SI, Costa E Silva J, Cohen G, et al. Behavioral and psychological signs and symptoms of dementia: a consensus statement on current knowledge and implications for research and treatment. Int Psychogeriatr. 1996;8(Suppl 3):497–500.
  • Burley CV, Casey AN, Chenoweth L, et al. Reconceptualizing behavioral and psychological symptoms of dementia: views of people living with dementia and families/care partners. Front Psychiatry. 2021;12:710703.
  • Cloak N, Khalili YA. Behavioral and psychological symptoms in dementia. Treasure Island (FL): StatPearls Publishing; 2022.
  • Finkel SI. Behavioral and psychologic symptoms of dementia. Clin Geriatr Med. 2003 Nov;19(4):799–824.
  • Scassellati C, Ciani M, Maj C, et al. Behavioral and psychological symptoms of dementia (BPSD): clinical characterization and genetic correlates in an Italian Alzheimer’s disease cohort. J Pers Med. 2020;10(3):90.
  • Kolanowski A, Boltz M, Galik E, et al. Determinants of behavioral and psychological symptoms of dementia: a scoping review of the evidence. Nurs Outlook. 2017;65(5):515–529.
  • Feast A, Orrell M, Charlesworth G, et al. Behavioral and psychological symptoms in dementia and the challenges for family carers: systematic review. Br J Psychiatry. 2016;208(5):429–434.
  • Kim B, Noh GO, Kim K. Behavioral and psychological symptoms of dementia in patients with Alzheimer’s disease and family caregiver burden: a path analysis. BMC Geriatr. 2021;21(1):160.
  • Tible OP, Riese F, Savaskan E, et al. Best practice in the management of behavioral and psychological symptoms of dementia. Ther Adv Neurol Disord. 2017;10(8):297–309.
  • Van der Linde RM, Dening T, Stephan BC, et al. Longitudinal course of behavioral and psychological symptoms of dementia: systematic review. Br J Psychiatry. 2016;209(5):366–377.
  • Rabins PV, Schwartz S, Black BS, et al. Predictors of progression to severe Alzheimer’s disease in an incidence sample. Alzheimers Dement. 2013;9(2):204–207.
  • Wancata J, Windhaber J, Krautgartner M, et al. The consequences of non-cognitive symptoms of dementia in medical hospital departments. Int J Psychiatry Med. 2003;33(3):257–271.
  • Resnick B, Galik E, Kolanowski A, et al. Gender differences in presentation and management of behavioral and psychological symptoms associated with dementia among nursing home residents with moderate to severe dementia. J Women Aging. 2020;33(1):1–18.
  • Cipriani G, Lucetti C, Danti S, et al. Apathy and dementia. Nosology, assessment and management. J Nerv Ment Dis. 2014;202(10):718–724.
  • Fauth EB, Gibbons A. Which behavioral and psychological symptoms of dementia are the most problematic? Variability by prevalence, intensity, distress ratings, and associations with caregiver depressive symptoms. Int J Geriatr Psychiatry. 2014;29(3):263–271.
  • García-Alberca JM, Lara Muñoz JP, Berthier Torres M. Neuropsychiatric and behavioral symptomatology in Alzheimer disease. Actas Esp Psiquiatr. 2010;38(4):212–222.
  • Tampi RR, Williamson D, Muralee S, et al. Behavioral and psychological symptoms of dementia: part I—epidemiology, neurobiology, heritability, and evaluation. Clin Geriatr. 2011;19(5):41–46.
  • Van der Linde RM, Stephan BCM, Savva GM, et al. Systematic reviews on behavioral and psychological symptoms in the older or demented population. Alzheimers Res Ther. 2012;4(4):28.
  • Fuh JL. Study of behavioral and psychological symptoms of dementia in Taiwan. Acta Neurol Taiwan. 2006;15(3):154–160.
  • Huang S, Wang WF, Liao YC. Severity and prevalence of behavioral and psychological symptoms among patients of different dementia stages in Taiwan. Arch Clin Psychiatry. 2017;44(4):89–93.
  • Ismail Z, Smith EE, Geda Y, et al. Neuropsychiatric symptoms as early manifestations of emergent dementia: provisional diagnostic criteria for mild behavioral impairment. Alzheimers Dement. 2016;12(2):195–202.
  • Mortby ME, Ismail Z, Anstey KJ. Prevalence estimates of mild behavioral impairment in a population-based sample of pre-dementia states and cognitively healthy older adults. Int Psychogeriatr. 2018;30(2):221–232.
  • Hashimoto M, Yatabe Y, Ishikawa T, et al. Relationship between dementia severity and behavioral and psychological symptoms of dementia in dementia with lewy bodies and Alzheimer’s disease patients. Dement Geriatr Cogn Dis Extra. 2015;5(2):244–252.
  • Cerejeira J, Lagarto L, Mukaetova-Ladinska EB. Behavioral and psychological symptoms of dementia. Front Neurol. 2012;3:73.
  • Rockwell E, Choure J, Galasko D, et al. Psychopathology at initial diagnosis in dementia with Lewy bodies versus Alzheimer disease: comparison of matched groups with autopsy-confirmed diagnoses. Int J Geriatr Psychiatry. 2000;15(9):819–823.
  • Ikeda M, Brown J, Holland AJ, et al. Changes in appetite, food preference, and eating habits in frontotemporal dementia and Alzheimer’s disease. J Neurol Neurosurg Psychiatry. 2002;73(4):371–376.
  • Engelborghs S, Maertens K, Nagels G, et al. Neuropsychiatric symptoms of dementia: cross-sectional analysis from a prospective, longitudinal Belgian study. Int J Geriatr Psychiatry. 2005;20(11):1028–1037.
  • Chiu MJ, Chen TF, Yip PK, et al. Behavioral and psychologic symptoms in different types of dementia. J Formos Med Assoc. 2006;105(7):556–562.
  • Liu S, Jin Y, Shi Z, et al. The effects of behavioral and psychological symptoms on caregiver burden in frontotemporal dementia, Lewy body dementia, and Alzheimer’s disease: clinical experience in China. Aging Ment Health. 2017;21(6):651–657.
  • Mukherjee A, Biswas A, Roy A, et al. Behavioral and psychological symptoms of dementia: correlates and impact on caregiver distress. Dement Geriatr Cogn Dis Extra. 2017;7(3):354–365.
  • Majer R, Simon V, Csiba L, et al. Behavioral and psychological symptoms in neurocognitive disorders: specific patterns in dementia subtypes. Open Med (Wars). 2019;14(1):307–316.
  • Köhler CA, Magalhaes TF, Oliveira JM, et al. Neuropsychiatric disturbances in mild cognitive impairment (MCI): a systematic review of population-based studies. Curr Alzheimer Res. 2016;13(10):1066–82.39.
  • Modrego PJ, Ferrandez J. Depression in patients with mild cognitive impairment increases the risk for developing dementia of Alzheimer type: A prospective color study. Arch Neurol. 2004;61(8):1290–1293.
  • Brodaty H, Heffernan M, Draper B, et al. Neuropsychiatric symptoms in older people with and without cognitive impairment. J Alzheimers Dis. 2012;31(2):411–420.
  • Diniz BS, Butters MA, Albert SM, et al. Late-life depression and risk of vascular dementia and Alzheimer’s disease: systematic review and meta-analysis of community-based cohort studies. Br J Psychiatry. 2012;202(5):329–335.
  • Palmer K, Berger AK, Monastero R, et al. Predictors of progression from mild cognitive impairment to Alzheimer disease. Neurology. 2007;68(19):1596–1602.
  • Palmer K, Di Iulio F, Varsi AE, et al. Neuropsychiatric predictors of progression from amnestic-mild cognitive impairment to Alzheimer’s disease: the role of depression and apathy. J Alzheimers Dis. 2010;20(1):175–183.
  • Lee J, Lee KJ, Kim H. Gender differences in behavioral and psychological symptoms of patients with Alzheimer’s disease. Asian J Psychiatr. 2017;26:124–128.
  • Hsieh SW, Chen CH, Huang LC, et al. Gender differences in presentation of behavioral and psychological symptoms in Alzheimer’s disease in Taiwan. Aging Ment Health. 2020;24(8):1342–1347.
  • Mao Y, Fisher DW, Yang S, et al. Protein-protein interactions underlying the behavioral and psychological symptoms of dementia (BPSD) and Alzheimer’s disease. PLoS One. 2020;15(1):e0226021.
  • Zaudig M. Assessing behavioral symptoms of dementia of the Alzheimer type: categorical and quantitative approaches. Int Psychogeriatr. 1996;8(S2):183–200.
  • De Deyn PP, Wirshing WC. Scales to assess efficacy and safety of pharmacologic agents in the treatment of behavioral and psychological symptoms of dementia. J Clin Psychiatry. 2001;62:19–22.
  • Auer SR, Monteiro IM, Reisberg B. The empirical behavioral pathology in Alzheimer’s disease (E-BEHAVE-AD) rating scale. Intl Psychogeriatr. 1996;8(2):247–266.
  • Reisberg B, Auer SR, Monteiro IM. Behavioral pathology in Alzheimer’s disease (BEHAVE-AD) rating scale. Int Psychogeriatr. 1996;8:301–308.
  • Reisberg B, Borenstein J, Franssen E, et al. BEHAVE-AD: a Clinical Rating Scale for the Assessment of Pharmacologically Remediable Behavioral Symptomatology in Alzheimer’s Disease. In: Alzheimer’s Disease: Problems, Prospects, and Perspectives, editor. Altman HJ. 1987;pp. 1–16. Boston, MA: Springer.
  • Cummings JL, Mega M, Gray K, et al. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994;44(12):2308–2314.
  • Cummings JL. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology. 1997;48(5):S10–16.
  • Kaufer DI, Cummings JL, Ketchel P. Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. J Neuropsychiatry Clin Neurosci. 2000;12(2):233–239.
  • Wood S, Cummings JL, Hsu MA, et al. The use of the Neuropsychiatric Inventory in nursing home residents: characterization and measurement. Am J Geriatr Psychiatry. 2000;8(1):75–83.
  • De Medeiros K, Robert P, Gauthier S, et al. The Neuropsychiatric Inventory-Clinician rating scale (NPI-C): reliability and validity of a revised assessment of neuropsychiatric symptoms in dementia. Int Psychogeriatr. 2010;22(6):984–994.
  • Cohen-Mansfield J, Marx M, Rosenthal A. A description of agitation in a nursing home. J Gerontol. 1989;44(3):M77–M84.
  • Kupeli N, Vickerstaff V, White N, et al. Psychometric evaluation of the Cohen-Mansfield Agitation Inventory in an acute general hospital setting. Int J Geriatr Psychiatry. 2018;33(1):e158–e165.
  • Bessey LJ, Walaszek A. Management of behavioral and psychological symptoms of dementia. Curr Psychiatry Rep. 2019;21(8):66.
  • Prior J, Abraham R, Nicholas H, et al. Are premorbid abnormal personality traits associated with behavioral and psychological symptoms in dementia? Int J Geriatr Psychiatry. 2016;31(9):1050–1055.
  • Zilkens RR, Bruce DG, Duke J, et al. Severe psychiatric disorders in mid-life and risk of dementia in late-life (age 65–84 years): a population based case-control study. Curr Alzheimer Res. 2014;11(7):681–693.
  • Ambrogio F, Martella LA, Odetti P, et al., Behavioral disturbances in dementia and beyond: time for a new conceptual frame. Int J Mol Sci. 2019;20(15):3647.
  • Kazui H, Yoshiyama K, Kanemoto H, et al. Differences of behavioral and psychological symptoms of dementia in disease severity in four major dementias. PLoS One. 2016;11(8):e0161092.
  • Minger SL, Esiri MM, McDonald B, et al. Cholinergic deficits contribute to behavioral disturbance in patients with dementia. Neurology. 2000;55(10):1460–1467.
  • Engelborghs S, Vloeberghs E, Le Bastard N, et al. The dopaminergic neurotransmitter system is associated with aggression and agitation in frontotemporal dementia. Neurochem Int. 2008;52(6):1052–1060.
  • Herrmann N, Lanctôt KL, Khan LR. The role of norepinephrine in the behavioral and psychological symptoms of dementia. J Neuropsychiatry Clin Neurosci. 2004;16(3):261–276.
  • Flirski M, Sobow T, Kloszewska I. Behavioral genetics of Alzheimer´s disease: a comprehensive review. Arch Med Sci. 2011;7(2):195–210.
  • Ballard CG, Gauthier S, Cummings JL, et al. Management of agitation and aggression associated with Alzheimer disease. Nat Rev Neurol. 2009;5(5):245–255.
  • Clare L, Wilson BA, Carter G, et al. Depression and anxiety in memory clinic attenders and their carers: implications for evaluating the effectiveness of cognitive rehabilitation interventions. Int J Geriatr Psychiatry. 2002;17(10):962–967.
  • De Vugt ME, Nicolson NA, Aalten P, et al. Behavioral problems in dementia patients and salivary cortisol patterns in caregivers. J Neuropsychiatry Clin Neurosci. 2005;17(2):201–207.
  • Smith M, Hall GR, Gerdner L, et al. Application of the progressively lowered stress threshold model across the continuum of care. Nurs Clin North Am. 2006;41(1):57–81.
  • Zuidema SU, de Jonghe JF, Verhey FR, et al. Environmental correlates of neuropsychiatric symptoms in nursing home patients with dementia. Int J Geriatr Psychiatry. 2010;25(1):14–22.
  • Kunik ME, Snow AL, Davila JA, et al. Consequences of aggressive behavior in patients with dementia. J Neuropsychiatry Clin Neurosci. 2010;22(1):40–47.
  • Clyburn LD, Stones MJ, Hadjistavropoulos T, et al. Predicting caregiver burden and depression in Alzheimer’s disease. J Gerontol B Psychol Sci Soc Sci. 2000;55(1):S2–13.
  • Brown SL, Smith DM, Schulz R, et al. Caregiving behavior is associated with decreased mortality risk. Psychol Sci. 2009;20(4):488‐494.
  • Kasuya RT, Polgar-Bailey P, Takeuchi R. Caregiver burden and burnout. A guide for primary care physicians. Postgrad Med. 2000;108(7):119–123.
  • Campbell P, Wright J, Oyebode J, et al. Determinants of burden in those who care for someone with dementia. Int J Geriatr Psychiatry. 2008;23(10):1078–1085.
  • Volicer L. Caregiver burden in dementia care: prevalence and health effects. Curr Psychos Ther Reports. 2005;3:20‐25.
  • Vellone E, Piras G, Sansoni J. Stress, anxiety, and depression among caregivers of patients with Alzheimer’s disease. Ann Ig. 2002;14(3):223‐232.
  • Vitaliano PP, Zhang J, Scanlan JM. Is caregiving hazardous to one’s physical health? A meta‐analysis. Psychol Bull. 2003;129(6):946‐972.
  • Lou Q, Liu S, Huo YR, et al. Comprehensive analysis of patient and caregiver predictors for caregiver burden, anxiety and depression in Alzheimer’s disease. J Clin Nurs. 2015;24(17–18):2668‐2678.
  • Isik AT, Soysal P, Solmi M, et al., Bidirectional relationship between caregiver burden and neuropsychiatric symptoms in patients with Alzheimer’s disease: a narrative review. Int J Geriatr Psychiatry. 2019;34(9):1326–1334.
  • Baiyewu O, Smith-Gamble V, Akinbiyi A, et al. Behavioral and caregiver reaction of dementia as measured by the neuropsychiatric inventory in Nigerian community residents. Int Psychogeriatr. 2003;15(4):399–409.
  • Von Känel R, Mills PJ, Mausbach BT, et al. Effect of Alzheimer caregiving on circulating levels of C‐reactive protein and other biomarkers relevant to cardiovascular disease risk: a longitudinal study. Gerontology. 2012;58(4):354‐365.
  • Steinberg M, Hess K, Corcoran C, et al. Vascular risk factors and neuropsychiatric symptoms in Alzheimer’s disease: the Cache County Study. Int J Geriatr Psychiatry. 2014;29(2):153–159.
  • Bruce DG, Paterson A. Barriers to community support for the dementia carer: a qualitative study. Int J Geriatr Psychiatry. 2000;15(5):451–457.
  • Davidsdottir SR, Snaedal J, Karlsdottir G, et al. Validation of the Icelandic version of the Neuropsychiatric Inventory with caregiver distress (NPI-D). Nord J Psychiatry. 2012;66(1):26–32.
  • Kosberg JI, Kaufman AV, Burgio LD, et al. Family caregiving to those with dementia in rural Alabama: racial similarities and differences. J Aging Health. 2007;19(1):3–21.
  • Waite A, Bebbington P, Skelton-Robinson M, et al. Social factors and depression in carers of people with dementia. Int J Geriatr Psychiatry. 2004;19(6):582–587.
  • Riello R, Geroldi C, Zanetti O, et al. Caregiver’s distress is associated with delusions in Alzheimer’s patients. Behav Med. 2002;28(3):92‐98.
  • Connors MH, Ames D, Woodward M, et al. Psychosis and clinical outcomes in Alzheimer disease: a longitudinal study. Am J Geriatr Psychiatry. 2017;26(3):304‐313.
  • McCurry SM, Logsdon RG, Teri L, et al. Characteristics of sleep disturbance in community-dwelling Alzheimer’s disease patients. J Geriatr Psychiatry Neurol. 1999;12(2):53–59.
  • Canevelli M, Lucchini F, Garofalo C, et al. Inappropriate sexual behaviors among community‐dwelling patients with dementia. Am J Geriatr Psychiatry. 2017;25(4):365‐371.
  • Hamel M, Gold DP, Andres D, et al. Predictors and consequences of aggressive behavior by community‐based dementia patients. Gerontologist. 1990;30(2):206‐211.
  • Preuss UW, Wong JWM, Koller G. Treatment of behavioral and psychological symptoms of dementia: a systematic review. Psychiatr Pol. 2016;50(4):679–715.
  • De Oliveira AM, Radanovic M, Cotting Homem de Mello P, et al. Nonpharmacological interventions to reduce behavioral and psychological symptoms of dementia: a systematic review. Biomed Res Int. 2015;2015:218980.
  • Lowery D, Cerga-Pashoja A, Iliffe S, et al. The effect of exercise on behavioral and psychological symptoms of dementia: the EVIDEM-E randomized controlled clinical trial. Int J Geriatr Psychiatry. 2014;29(8):819–827.
  • Abraha I, Rimland JM, Trotta FM, et al. Systematic review of systematic reviews of non-pharmacological interventions to treat behavioral disturbances in older patients with dementia. The SENATOR-OnTop series. BMJ Open. 2017;7(3):e012759.
  • Scales K, Zimmerman S, Miller SJ. Evidence-based nonpharmacological practices to address behavioral and psychological symptoms of dementia. Gerontologist. 2018;58(suppl_1):S88–S102.
  • Mascherona I, Ferretti M, Soldini E, et al. Essential oil therapy for the short-term treatment of behavioral and psychological symptoms of dementia: a monocentric randomized pilot study. Aging Clin Exp Res. 2021;33(8):2251–2259.
  • Press-Sandler O, Freud T, Volkov I, et al. Aromatherapy for the treatment of patients with behavioral and psychological symptoms of dementia: a descriptive analysis of RCTs. J Altern Complement Med. 2016;22(6):422–428.
  • Raglio A, Bellelli G, Traficante D, et al. Efficacy of music therapy in the treatment of behavioral and psychiatric symptoms of dementia. Alzheimer Dis Assoc Disord. 2008;22(2):158–162.
  • Ueda T, Suzukamo Y, Sato M, et al. Effects of music therapy on behavioral and psychological symptoms of dementia: a systematic review and meta-analysis. Aging Res Rev. 2013;12(2):628–641.
  • Olazarán J, Reisberg B, Clare L, et al. Nonpharmacological therapies in Alzheimer’s disease: a systematic review of efficacy. Dement Geriatr Cogn Disord. 2010;30(2):161–178.
  • Dyer SM, Harrison SL, Laver K, et al. An overview of systematic reviews of pharmacological and non-pharmacological interventions for the treatment of behavioral and psychological symptoms of dementia. Int Psychogeriatr. 2018 Mar;30(3):295–309.
  • Zhou T, Wang J, Xin C, et al. Effect of memantine combined with citalopram on cognition of BPSD and moderate Alzheimer’s disease: a clinical trial. Exp Ther Med. 2019;17(3):1625–1630.
  • Carotenuto A, Rea R, Traini E, et al. The effect of the association between donepezil and choline alphoscerate on behavioral disturbances in Alzheimer’s disease: interim results of the ASCOMALVA trial. J Alzheimers Dis. 2017;56(2):805–815.
  • Chen R, Chan PT, Chu H, et al. Treatment effects between monotherapy of donepezil versus combination with memantine for Alzheimer's disease: a meta-analysis. PLoS One. 2017;12(8):e0183586.
  • Savaskan E, Mueller H, Hoerr R, et al. Treatment effects of Ginkgo biloba extract EGb 761® on the spectrum of behavioral and psychological symptoms of dementia: meta-analysis of randomized controlled trials. Int Psychogeriatr. 2018;30(3):285–293.
  • Ohno Y, Kunisawa N, Shimizu S. Antipsychotic treatment of behavioral and psychological symptoms of dementia (BPSD): management of extrapyramidal side effects. Front Pharmacol. 2019;10:1045.
  • Wolinsky D, Drake K, Bostwick J. Diagnosis and management of neuropsychiatric symptoms in Alzheimer´s disease. Curr Psychiatry Rep. 2018;20(12):117.
  • Lanctôt KL, Herrmann N, Rothenburg L, et al. Behavioral correlates of GABAergic disruption in Alzheimer’s disease. Int Psychogeriatr. 2007;19(1):151–158.
  • Lin CH, Lane HY. The role of N-methyl-D-aspartate receptor neurotransmission and precision medicine in behavioral and psychological symptoms of dementia. Front Pharmacol. 2019;10:540.
  • Garcia-Alloza M, Tsang SW, Gil-Bea FJ, et al. Involvement of the GABAergic system in depressive symptoms of Alzheimer’s disease. Neurobiol Aging. 2006;27(8):1110–1117.
  • Lin CH, Yang HT, Chen PK, et al. Precision medicine of sodium benzoate for the treatment of behavioral and psychological symptoms of dementia (BPSD). Neuropsychiatr Dis Treat. 2020;16:509–518.
  • Lin CH, Chen PK, Wang SH, et al. Effect of sodium benzoate on cognitive function among patients with behavioral and psychological symptoms of dementia: secondary analysis of a randomized clinical trial. JAMA Network Open. 2021;4(4):e216156.
  • Nowrangi MA, Lyketsos CG, Rosenberg PB. Principles and management of neuropsychiatric symptoms in Alzheimer’s dementia. Alzheimers Res Ther. 2015;7(1):1–10.
  • Rapp MA, Schnaider-Beeri M, Grossman HT, et al. Increased hippocampal plaques and tangles in patients with Alzheimer disease with a lifetime history of major depression. Arch Gen Psychiatry. 2006;63(2):161–167.
  • Rapp MA, Schnaider-Beeri M, Purohit DP, et al. Increased neurofibrillary tangles in patients with Alzheimer's disease with comorbid depression. Am J Geriatr Psychiatry. 2008;16(2):168–174.
  • Korczyn AD, Halperin I. Depression and dementia. J Neurol Sci. 2009;283(1–2):139–142.
  • Lanari A, Amenta F, Silvestrelli G, et al. Neurotransmitter deficits in behavioral and psychological symptoms of Alzheimer’s disease. Mech Aging Dev. 2006;127(2):158–165.
  • Zubenko GS, Moossy J, Martinez AJ, et al. Neuropathologic and neurochemical correlates of psychosis in primary dementia. Arch Neurol. 1991;48(6):619–624.
  • Bergener M, Finkel SI. Treating Alzheimer´s and other dementias: clinical application of recent research advances. New York (NY): Springer; 1995. Chapter 6, Biochemical, Neuropathological, and Clinical Correlations of Neurofibrillary Degeneration in Alzheimer’s Disease; p. 57–80.
  • Förstl H, Burns A, Levy R, et al. Neuropathological correlates of psychotic phenomena in confirmed Alzheimer’s disease. Br J Psychiatry. 1994;165(1):53–59.
  • Farber NB, Rubin EH, Newcomer JW, et al. Increased neocortical neurofibrillary tangle density in subjects with Alzheimer disease and psychosis. Arch Gen Psychiatry. 2000;57(12):1165–1173.
  • Sweet RA, Panchalingam K, Pettegrew JW, et al. Psychosis in Alzheimer disease: postmortem magnetic resonance spectroscopy evidence of excess neuronal and membrane phospholipid pathology. Neurobiol Aging. 2002;23(4):547–553.
  • Pinto T, Lanctôt KL, Herrmann N. Revisiting the cholinergic hypothesis of behavioral and psychological symptoms in dementia of the Alzheimer’s type. Aging Res Rev. 2011;10(4):404–412.
  • Ismail Z, Nguyen MQ, Fischer CE, et al. Neurobiology of delusions in Alzheimer’s disease. Curr Psychiatry Rep. 2011;13(3):211–218.
  • Tsang SW, Francis PT, Esiri MM, et al. Loss of [3 H]4-DAMP binding to muscarinic receptors in the orbitofrontal cortex of Alzheimer’s disease patients with psychosis. Psychopharmacology (Berl). 2008;198(2):251–259.
  • Ballard C, Piggott M, Johnson M, et al. Delusions associated with elevated muscarinic binding in dementia with Lewy bodies. Ann Neurol. 2000;48(6):868–876.
  • Teaktong T, Piggott MA, Mckeith IG, et al. Muscarinic M2 and M4 receptors in anterior cingulate cortex: relation to neuropsychiatric symptoms in dementia with Lewy bodies. Behav Brain Res. 2005;161(2):299–305.
  • Garcia-Alloza M, Gil-Bea FJ, Diez-Ariza M, et al. Cholinergic-serotonergic imbalance contributes to cognitive and behavioral symptoms in Alzheimer’s disease. Neuropsychologia. 2005;43(3):442–449.
  • Borroni B, Grassi M, Agosti C, et al. Genetic correlates of behavioral endophenotypes in Alzheimer disease: role of COMT, 5-HTTLPR and APOE polymorphisms. Neurobiol Aging. 2006;27(11):1595–1603.
  • Angelucci F, Bernardini S, Gravina P, et al. Delusion symptoms and response to antipsychotic treatment are associated with the 5-HT2A receptor polymorphism (102 T/C) in Alzheimer’s disease: a 3-year follow-up longitudinal study. J Alzheimers Dis. 2009;17(1):203–211.
  • Di Maria E, Bonvicini C, Bonomini C, et al. Genetic variation in the G720/G30 gene locus (DAOA) influences the occurrence of psychotic symptoms in patients with Alzheimer’s disease. J Alzheimers Dis. 2009;18(4):953–960.
  • Proitsi P, Lupton MK, Reeves SJ, et al. Association of serotonin and dopamine gene pathways with behavioral subphenotypes in dementia. Neurobiol Aging. 2012;33(4):791–803.
  • Mitchell RA, Herrmann N, Lanctôt KL. The role of dopamine in symptoms and treatment of apathy in Alzheimer’s disease. CNS Neurosci Ther. 2011;17(5):411–427.
  • Massimo L, Powers C, Moore P, et al. Neuroanatomy of apathy and disinhibition in frontotemporal lobar degeneration. Dement Geriatr Cogn Disord. 2009;27(1):96–104.
  • Rosen HJ, Allison SC, Schauer GF, et al. Neuroanatomical correlates of behavioral disorders in dementia. Brain. 2005;128(11):2612–2625.
  • Tekin S, Mega MS, Masterman DM, et al. Orbitofrontal and anterior cingulate cortex neurofibrillary tangle burden is associated with agitation in Alzheimer disease. Ann Neurol. 2001;49(3):355–361.
  • Matthews KL, Chen CP, Esiri MM, et al. Noradrenergic changes, aggressive behavior, and cognition in patients with dementia. Biol Psychiatry. 2002;51(5):407–416.
  • Yesavage JA, Friedman L, Ancoli-Israel S, et al. Development of diagnostic criteria for defining sleep disturbance in Alzheimer’s disease. J Geriatr Psychiatry Neurol. 2003;16(3):131–139.
  • Sagud M, Nikolac Perkovic M, Vuksan-Cusa B, et al. A prospective, longitudinal study of platelet serotonin and plasma brain-derived neurotrophic factor concentrations in major depression: effects of vortioxetine treatment. Psychopharmacol (Berl). 2016;233(17):3259–3267.
  • Bishop MM, Fixen DR, Linnebur SA, et al. Cognitive effects of vortioxetine in older adults: a systematic review. Ther Adv Psychopharmacol. 2021;11:20451253211026796.
  • Scuteri D, Corasaniti MT, Tonin P, et al. New trends in pharmacological control of neuropsychiatric symptoms of dementia. Curr Opin Pharmacol. 2021;61:69–76.
  • Kwon CY, Lee B. Herbal medicine for behavioral and psychological symptoms of dementia: a systematic review and meta-analysis. Front Pharmacol. 2021;12:713287.

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