Prevalence and pharmacological management of behavioural and psychologicalsymptoms amongst dementia sufferers living in care environments

Background. Behavioural and psychological symptoms in dementia (BPSD) are a common reason for placement in long term carl and are often associated wit h indiscriminate prescription of psychotropic medication. Aims. To determine the prevalence of BPSD in care environments, their relat ionship with severity of dementia and the pattern of psychotropic medicatio n. Methods. Two hundred and thirty-one elderly residents (39% living: in socia l care facilities and 61% in nursing home care) were assessed using a range of standardised psychiatric schedules. Additional information about the re sidents and medication was obtained from professional carers. Results. Overall 90% of residents had dementia, 79% of whom had clinically significant BPSD with 58% receiving psychotropic medication. There was no d ifference in the prevalence of BPSD between social and nursing care. Depres sion was most common in people with mild dementia, whilst delusions arose m ost frequently in those with moderate dementia and aberrant motor behaviour had a high prevalence in people with severe dementia. Conclusion. BPSD are common in elderly people with dementia living in care environments. More rigorous guidelines are needed pertaining to the prescri ption and monitoring of medication and the need to disseminate skills regar ding psychosocial management approaches to care staff. Copyright (C) 2001 J ohn Wiley & Sons, Ltd.