University of South Florida, Tampa, FL, USA.
Clin Geriatr Med. 2018 Nov;34(4):637-651. doi: 10.1016/j.cger.2018.06.009. Epub 2018 Aug 24.
Behavioral problems decrease quality of life of people with dementia and their care providers. Three main consequences of dementia are functional impairment and in some cases also mood disorders and psychosis. These consequences, alone or in combination, result in 3 main behavioral problems: apathy, agitation, and rejection of care/aggression. Nonpharmacologic management strategies include meaningful activities and individualized comfort care, for example, Namaste Care. If needed, pharmacologic management should concentrate on treatment of main dementia consequences, especially depression, instead of treating secondary symptoms, for example, insomnia. Use of antipsychotics should be minimized but antipsychotics may be necessary for augmentation of antidepressants.
行为问题会降低痴呆症患者及其照护者的生活质量。痴呆症的三个主要后果是功能障碍，在某些情况下还会出现情绪障碍和精神病。这些后果单独或组合在一起会导致三个主要的行为问题：冷漠、激越和拒绝照顾/攻击。非药物管理策略包括有意义的活动和个性化的舒适护理，例如 Namaste 护理。如果需要，药物管理应集中治疗主要的痴呆症后果，特别是抑郁症，而不是治疗次要症状，例如失眠。应尽量减少使用抗精神病药物，但抗精神病药物可能有必要增强抗抑郁药的疗效。
