Understanding BPSD: Managing Behavioral Symptoms in Dementia Patients
In this episode of Psychiatry Boot Camp, Dr. George Grossberg—renowned geriatric psychiatrist and Henry and Amelia Nasrallah Endowed Professor at Saint Louis University School of Medicine—takes us on a clinical and compassionate journey into Behavioral and Psychological Symptoms of Dementia (BPSD), also known as Neuropsychiatric Symptoms of Dementia.
With decades of leadership in geriatric psychiatry, Dr. Grossberg unpacks the most common behavioral disturbances in dementia, including:
Apathy
Depression
Agitation
Delusions and psychosis
Aggressive behaviors
These symptoms significantly impact quality of life—not just for patients but for families and care teams. This episode offers both evidence-based frameworks and human-centered insights for managing this complex syndrome.
🔍 What You'll Learn in This Episode:
🔸 Understanding BPSD:
Gain clarity on what behavioral and psychological symptoms truly are and why nearly all dementia patients experience at least one BPSD over the course of their illness.
🔸 Neurobiology & Pathophysiology:
Learn how the progression of dementia affects the brain's structure and chemistry—contributing to aggression, paranoia, apathy, and other behavioral shifts.
🔸 Nonpharmacological Interventions:
Dr. Grossberg emphasizes the value of personalized, non-drug interventions as first-line treatment, including validation therapy, music therapy, behavioral redirection, and environmental adaptations.
🔸 Pharmacological Treatments:
When medications become necessary, this episode explains the risks and benefits of atypical antipsychotics, mood stabilizers, antidepressants, and cholinesterase inhibitors in treating agitation, psychosis, and depression in dementia.
🔸 Ethical & Clinical Decision-Making:
We discuss how to weigh safety concerns, quality of life, and autonomy in decision-making—especially when pharmacologic options are limited or come with black box warnings.
📚 References from the Episode:
Progress in Pharmacologic Management of Neuropsychiatric Syndromes
Cummings 2024 – PubMed
Neuropsychiatric Symptoms of Dementia
Tampi 2022 – PubMed
Management of BPSD Algorithm
Chen & Osser 2021 – PubMed
Atypical Antipsychotics in Alzheimer’s
Ballard 2006 – PMC
Efficacy and Adverse Effects of Antipsychotics in Dementia
Schneider 2006 – PubMed
Sequential Drug Algorithm for Agitation in Dementia
Davies 2018 – PMC
👨⚕️ About the Guest:
Dr. George Grossberg is a leading figure in geriatric psychiatry, having served as President of both the American Association for Geriatric Psychiatry and the International Psychogeriatric Association. His dedication to person-centered dementia care makes this episode a must-watch for all healthcare professionals working with older adults.
🎧 Perfect For:
✔️ Psychiatry residents
✔️ Primary care & geriatric providers
✔️ Consultation-liaison psychiatrists
✔️ Neurology teams
✔️ Caregivers and dementia advocates
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#BPSD #DementiaCare #GeriatricPsychiatry #Neuropsychiatry #PsychiatryBootCamp #BehavioralSymptoms #Alzheimers #Caregiving #DementiaAwareness #GeriatricMedicine #MentalHealth #PsychEducation #CognitiveDisorders #NeurodegenerativeDisorders
