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Behavioral Disturbances in Dementia
Dementia can lead to a wide variety of psychological disorders, including depression and anxiety. The symptoms of depression are apathy, isolation, social withdrawal, impaired thinking, and concentration on the negative side of life (Kitching, 2015). The symptoms can be managed both pharmacologically and non-pharmacologically. The usual pharmacological treatments include anti-depressants; however, they may contribute to the effect of poly-pharmacy (Kitching, 2015).
Additionally, medications may take longer to have an effect due to old age. Thus, pharmacological treatment should be used with caution. Non-pharmacological treatments include psychotherapy or cognitive-behavioral therapy, as well as electro-convulsive therapy, which can be used (Kitching, 2015).
Common types of anxiety disorders found in older adults include panic disorder, generalized anxiety disorder, and phobias (Balsamo et al., 2018). Common symptoms include shallow breathing, trembling, nausea, sweating, irrational and excessive worry or fear, and a racing heart (Balsamo et al., 2018).
Anxiety is better treated by combining pharmacological treatment s and therapy. For pharmacological approach, Benzodiazepines are usually used; however, they may have a negative impact on memory and should be prescribed with caution (Balsamo et al., 2018). There is also evidence that older anxiety patients can benefit from psychotherapy.
Delirium and agitated depression can occur with dementia. Delirium and dementia have similar symptoms; however, delirium is a confusion that occurs and goes away rather quickly (Laske & Stephens, 2018). However, dementia is a confusion that develops slowly, and the mental changes are mostly irreversible. When speaking of depression it is a mood disorder, and confusion is not a part of it (Laske & Stephens, 2018).
References
Balsamo, M., Cataldi, F., Carlucci, L., & Fairfield, B. (2018). Assessment of anxiety in older adults: a review of self-report measures. Clinical interventions in aging, 13, 573.
Laske, R. A., & Stephens, B. A. (2018). Confusion states: Sorting out delirium, dementia, and depression. Nursing made Incredibly Easy, 16(6), 13-16.
Kitching, D. (2015). Depression in dementia. Australian Prescriber, 38(6), 209.
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