Introduction     Diagnosis of Mild Cognitive Impairment and Alzheimer's Disease Karen L. Bell, M.D.     Treatment Strategies for Dementia and Mild Cognitive Impairment Mary Sano, Ph.D.     Treatment of Depression, Agitation, and Psychosis in Dementia Davangere P. Devanand, M.D.     Common Symptoms       Data on Symptoms       Data on Treatment       Choosing a Drug       Assessing Depression       Treatment of Depression     Recognition of Vascular Dementia, Dementia with Lewy Bodies, and Frontotemporal Dementia Lawrence S. Honig, M.D., Ph.D.     Neuropsychology of Mild Cognitive Impairment, Alzheimer's Disease, Dementia with Lewy Bodies, and Frontotemporal Dementia Penne Sims, Ph.D.     Neuroimaging in Dementia Scott A. Small, M.D.     Genetics of Neurodegenerative Disease: Alzheimer's Disease, Frontotemporal Dementia Jennifer Williamson-Catania, M.S.     Legal and Ethical Issues for Patients with Dementia Daniel G. Fish, Esq.     Posttest         Accreditation     Reference List     Acknowledgements		Treatment of Depression, Agitation, and Psychosis in Dementia Davangere P. Devanand, M.D. Common Symptoms   In Alzheimer's disease, the common psychopathological syndromes that patients develop are agitation, aggression, delusions, hallucinations, depression, insomnia, and anxiety. There are many symptoms that patients have which do not exactly fit these criteria and which have not been thoroughly studied. Among these symptoms, agitation is by far the most common, more so than depression or anxiety. When this field began to investigate these issues, this was a bit surprising. Even among outpatients, agitation is fairly common, and quite common in nursing homes. Physical aggression is less common, especially in milder stages, but it tends to be more common in nursing homes. Although we worry a lot about sexual disinhibition and potential for suicide, these are quite rare in Alzheimer's patients. Prevalence of delusions ranges widely because isolated symptoms are frequent. The most common delusional symptoms for a patient are thinking someone is stealing his or her things or that a spouse or someone else has come into the house and stolen something, when in fact the items may just be misplaced. We still do not have a consensus on whether to classify this as a full-blown delusion, as we see in schizophrenia, so for now we are counting it as a delusional symptom. Full-blown psychosis with classic delusions and hallucinations of the auditory type are quite rare. The common symptoms of delusions include thinking someone is stealing things and misidentification, such as when a patient feels that the living place is not their home. In these cases, typically a family member will drive the patient around and then return home so the patient can recognize his or her home. This sequence can be quite problematic for the caregiver.     PREVIOUS | NEXT