Changed behaviours in people with dementia

Changed behaviours, such as agitation and depression, are frequently reported in people with dementia. Clinicians and researchers have previously used the umbrella term ‘behavioural and psychological symptoms of dementia’ (BPSD) to describe these behaviours. However, recently there has been a campaign led by people who live with dementia to change the current paradigm and stop using the term BPSD.
The campaign is based on evidence that shows these behaviours are not solely attributable to dementia pathology. Changed behaviours are also likely to be due to the needs of the individual, which may be causing distress or pain.
People with dementia may find it difficult to communicate their source of pain or distress, resulting in behaviours that may appear to be unusual or out-of-character for the individual. Treating clinicians need to investigate the reasons underlying these changed behaviours sufficiently to identify ways to help the individual and their carer.
There are more than 425,000 people with dementia in Australia, and with the ageing population, this number is projected to increase to more than 1.1 million by 2056. Without treatment options to stop the progression of dementia, ensuring optimal care for these people is paramount.
Despite the current evidence and guideline recommendations for non-pharmacological approaches as first-line treatment, there is an over-reliance on medications to manage changed behaviours, without sufficient attempts to identify a reason for the behaviour.