An Overview of Individualized Management of Neuropsychiatric Symptoms in Dementia
Background: It is estimated that about 11% of adults 65 and older have dementia in the United States. Neuropsychiatric symptoms are common in the presentation of dementia. These symptoms often result in increased morbidity and mortality, negative patient outcomes, caregiver burden, institutionalized care, and diminished quality of life. The focus of this paper is to analyze the therapeutic effectiveness of nonpharmacologic interventions in the management of neuropsychiatric symptoms of dementia.
Methods: A literature review was conducted to critique current evidence on the use of nonpharmacologic interventions in managing neuropsychiatric symptoms in older adults with dementia. Searches were performed using PubMed, UpToDate, and Google Scholar.
Results: Pharmacotherapy should be cautiously considered in treating neuropsychiatric symptoms of dementia due to adverse effects and black box warnings. Although further studies are needed, music therapy, tailored bathing routines, bright light therapy, multisensory stimulation, and eliminating the use of elderspeak language are nonpharmacologic interventions that contain some evidence in improving quality of life in dementia. The validation technique is still an ethically controversial approach to communication. As a result of the COVID-19 pandemic, social isolation has worsened in people with dementia.
Conclusion: Dementia is a disease that requires multifactorial care in approaching management. Nonpharmacologic interventions are the first-line plan of treatment in managing neuropsychiatric symptoms of dementia and present with fewer side effects and are person-centered in implementing. Future research in developing measures for quality of life is needed to study effectiveness of nonpharmacologic therapy.