Fabrizia D'Antonio, Lucio Tremolizzo, Marta Zuffi, Simone Pomati, Elisabetta Farina, Sindem BPSD Study Group, Margherita Alberoni, Serena Amici, Arighi Andrea, Francesca Baglio, Federica Barocco, Amalia Cecilia Bruni, Giuseppe Bruno, Annachiara Cagnin, Elena Calabrese, Antonio Callari, Marco Canevelli, Rosanna Colao, Matteo Cotta Ramusino, Eduardo Cumbo, Chiara Cupidi, Alfredo Costa, Sabrina Curcio, Chiara Cutaia, Carlo de Lena, Mario Tommaso dell'Osa, Babette Dijk, Francesco Di Lorenzo, Maria Grazia, Di Maggio, Andrea Francescani, Francesca Frangipane, Valeria Isella, Claudio Ivaldi, Sebastiano Lorusso, Antonina Luca, Giuseppe Magnani, Luigi Giovanni Manfredi, Michele Maniscalco, Lorenzo Marchese, Michela Marcon, Alessandra Marcone, Maria Giuseppina Mascia, Antonio Milia, Concetta Mina, Cristina Moglia, Flavio Mariano Nobili, Giulia Perini, Patrizia Perrone, Giuseppina Pilia, Federico Pozzi, Gianfranco Puccio, Francesca Saibene, Ermanno Matteo Soave, Elena Sinforiani, Micaela Sepe Monti, Michelangelo Stanzani Maserati, Andrea Stracciari, Gloria Tognoni, Marco Vista
Abstract
Behavioral and psychological symptoms of dementia (BPSD) have a high prevalence, and their presence is associated with a severe impact in terms of social costs. However, dedicated clinical tools or biomarkers to detect these symptoms are lacking. Thus, BPSD management in clinical settings is challenging. The aim of this study was to investigate the perception and the treatment strategies for BPSD in Italian centers working in the dementia field.
A multicenter, national survey was developed by BPSD Study Group of the Italian Neurological Society for Dementia (SINDEM). The survey consisted of a semi-structured questionnaire that was e-mailed to SINDEM members, dementia centers part of the national network of memory clinics (Centers for Cognitive Deterioration and Dementia [CDCD]), and clinicians working in dementia care settings. The questions were focused on (1) perceived global frequency and relevance of BPSD; (2) tools used to assess BPSD; (3) pharmacological treatment for psychosis, apathy, agitation, aggression, depression, anxiety, sleep, and nutrition disturbances; (4) non-pharmacological treatments; (5) drugs side effects.
One-hundred and thirty-six clinicians participated in this study. Seventy-nine participants worked in a CDCD and 57 in other settings. The perceived frequency of BPSD was 74%. BPSD are detected by means of a clinical assessment for 96.3% or a caregiver interview for 97%. For psychosis treatment the first choice was atypical antipsychotics (83.3%), followed by typical antipsychotic (8.9%) and antidepressants (4.8%). For agitation, atypical antipsychotics were the first-choice treatment in 64% of cases and antidepressants in 16.1%. For aggression, the most used drugs were atypical antipsychotics (82.9%). For anxiety, 55.2% use antidepressants, 17.9% use atypical antipsychotics, and 16.9% use benzodiazepines. Interestingly, most of the centers apply non-pharmacological treatments for BPSD. Some differences emerged comparing the responses from CDCD and other care settings.
The survey results revealed many differences in BPSD perception, treatment options, and observed side effect according to the clinical setting. This variability can be explained by the absence of clear guidelines, by differences in patients' characteristics, and by clinical practice based on subjective experience. These results suggest that producing guidelines for the pharmacological treatment of BPSD is a major need.
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 April 2022.
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