Page 98 - HA Convention 2016 [Full Version]

HOSPITAL AUTHORITY CONVENTION 2016 Masterclasses

M1.1 Dementia Management 10:45 Room 221

The Phenomenology of Behavioural and Psychological Symptoms of Dementia
Chan LK
Kwai Chung Hospital, Hong Kong

In view of our ageing population, dementia has become one of the most common chronic mental health conditions. The
cognitive impairment in dementia is often accompanied by behavioural and psychological symptoms of dementia (BPSD).
BPSD include depression, anxiety, apathy, agitation, psychosis, aggression, sleep problems, wandering, and disinhibited
behaviours. One or more of these symptoms affect nearly all people with dementia over the course of their illness. These
symptoms are important contributing factors to early institutionalisation and increased burden to caregivers. BPSD require
costly care and are associated with poor health outcomes, including increased morbidity, mortality and prolonged hospital
stay. The causes of BPSD range from neurobiologically-related disease, caregiver factors, environmental triggers to patients’
physical status. Assessment should take into account the presenting symptoms and the underlying causes. Validated rating
scales like Neuropsychiatric Inventory can be used to gain an objective impression of the nature and severity of the problem.
A thorough understanding of patients’ life history can help understand the intention and significance of their behaviours.
Management of BPSD requires coordination of different aspects such as physical, psychological, interpersonal, social and
environmental factors. Care for dementia people with BPSD should be based on a person-centred approach.

Tuesday, 3 May

M1.2 Dementia Management 10:45 Room 221

Pharmacotherapy for Behavioural and Psychological Symptoms of Dementia
Au Yeung TW
Department of Medicine and Geriatrics, Pok Oi Hospital, Hong Kong

Pharmacotherapy for behavioural and psychological symptoms of dementia (BPSD) includes anti-dementia therapy and
extends to other psychotropic drug classes. Since BPSD is common in hospital settings, drug treatment for BPSD will be
discussed both within the context of hospital and non-hospital settings, and both for acute and long-term usage. In the
aspects of pharmacotherapy of the old aged, drug-disease and drug-drug interaction will be two of the significant sources of
adverse drug reaction. This will be illustrated by case demonstration. Lastly, the management of hospitalisation-associated
delirium in dementia, manifested as BPSD will be discussed.

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