For example, in an extensive nursing home study, Cohen-Mansfield and collaborators found that a large number of patients with verbal aggression had undiagnosed hip fractures.9

Furthermore, an evaluation of the correlation between behaviors such as verbal aggression and environmental factors shows that the quality of the patient’s social environment is inversely proportional to the presence of verbal aggression. This suggests that an improvement in social interactions can have a therapeutic effect on verbal aggression. Indeed, a study by the same group of researchers shows intervention based on increasing social interaction to be better than a control intervention in the treatment of verbal Inhibitors,research,lifescience,medical aggression.8 Based on the aforementioned example, we believe that behavioral Inhibitors,research,lifescience,medical and environmental interventions should play a key role in the management of BPSD, thereby challenging clinicians and researchers to develop new and creative interventions.21 Conclusion Although the etiology of BPSD remains unknown, available evidence suggests that a combination of behaviorspecific biological and environmental factors may be partially responsible for

the onset of BPSD. Diagnosis The diagnosis of BPSD is based on direct clinical history, direct observation, psychiatric and physical examinations, and reports by care providers. In addition, laboratory tests are Inhibitors,research,lifescience,medical used to evaluate the presence of medical conditions that can trigger or exacerbate the clinical presentation of BPSD. The clinical characteristics of BPSD are syndrome-specific. Inhibitors,research,lifescience,medical The following is a brief description of some of the most, commonly observed syndromes. Psychosis

The symptoms of psychosis are defined by the presence of hallucinations and delusions lasting for one or more months. The onset of psychotic symptoms must occur after the onset of the dementia in order to fit this diagnosis. The main differential diagnosis Inhibitors,research,lifescience,medical is with late-onset schizophrenia; however, symptom presentation of BPSD psychosis is substantially different from schizophrenia. Symptoms such as misidentification of caregivers and visual hallucinations are common no in BPSD psychosis and are rare in patients with schizophrenia. In contrast, patients with selleck chemical schizophrenia usuallypresent Schneiderian first-rank symptoms, bizarre complex delusions, and active suicidal ideation. These symptoms are rarely observed in BPSD psychosis. Disease progression is also reported to be substantially different in BPSD psychosis. Psychosis in schizophrenia rarely shows remission, and the need for antipsychotic treatment is prolonged; psychosis in BPSD has a shorter duration and therefore requires shorter periods of treatment. Circadian rhythm (sleep-wake) disturbance in dementia Circadian rhythm disturbances among BPSD patients, termed sleep-wake rhythm disturbances for the purposed of this paper, make caregiving extremely difficult and are among the most, important reasons for institutionalization.