Addressing agitation, aggression with dementia
Memantine found promising for management
Agitation, aggression, and psychosis are predictably problematic in persons with progressive dementia. In fact, more than 90% of dementia patients will experience one or more of these during the course of their illness.
Such affective changes quite often are the "straw that breaks the camel's back" that result in institutionalization because of the unmanageability of such problems in the home setting. Agitation and aggression (A&A) are more commonplace than psychosis, but treatment interventions to prevent or modulate A&A are limited. In addition, the presence of A&A is predictive of a more rapid progression of dementia.
The Neuropsychiatry Inventory (NPI) is a scoring system that contains subitems addressing agitation and psychosis. Nine hundred and eight-three study subjects with moderately severe to severe Alzheimer's disease were randomized to memantine (MEM) or placebo.1 A post-hoc analysis assessed the impact among dementia patients with prevalent A&A.
MEM was associated with a statistically significant reduction in risk for A&A. This was not at the expense of functionality, since the Alzheimer Disease Cooperative Study Activities of Daily Living Inventory also showed improvements with MEM compared to placebo.
MEM is promising as a tool for management of A&A in people with advanced dementia.
Reference
1. Wilcock GK, Ballard CG, Cooper JA, et al. Memantine for agitation/aggression and psychosis in moderately severe to severe Alzheimer's disease: A pooled analysis of 3 studies. J Clin Psychiatry 2008; 69:341-348.
Agitation, aggression, and psychosis are predictably problematic in persons with progressive dementia. In fact, more than 90% of dementia patients will experience one or more of these during the course of their illness.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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