title: Common psychiatric problems in cognitively impaired older patients: causes and management.
abstract: Although dementias are defined by their cognitive and functional deficits, psychiatric problems are common, contribute to patient distress and caregiver burden, and precipitate institutionalization. Successful treatment involves understanding that physiologic, psychological, and environmental factors can contribute to the development of these symptoms. By carefully assessing each of these factors, clinicians can individualize treatment and flexibly use nonpharmacologic and pharmacologic approaches tailored to patients and the context of care. Although there exist limitations to many treatment options, clinicians can still adapt current knowledge to develop a multifaceted treatment approach that improves the quality of life for patients and their caregivers.
authors.affiliation: Mental Health Service, VA Puget Sound Healthcare System, 1660 South Columbian Way, S-116, Seattle, WA 98108, USA; Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Box 356560, Seattle, WA 98108, USA. Electronic address: lucy.wang@va.gov.
authors.forename: Lucy Y
authors.initials: LY
authors.lastname: Wang
authors.affiliation: Mental Health Service, VA Puget Sound Healthcare System, 1660 South Columbian Way, S-116, Seattle, WA 98108, USA; Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Box 356560, Seattle, WA 98108, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Borisovskaya
authors.affiliation: Mental Health Service, VA Puget Sound Healthcare System, 1660 South Columbian Way, S-116, Seattle, WA 98108, USA; Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Box 356560, Seattle, WA 98108, USA.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Maxwell
authors.affiliation: Mental Health Service, VA Puget Sound Healthcare System, 1660 South Columbian Way, S-116, Seattle, WA 98108, USA; Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Box 356560, Seattle, WA 98108, USA.
authors.forename: Marcella
authors.initials: M
authors.lastname: Pascualy
mesh_terms: D000368:Aged; D060825:Cognitive Dysfunction / Q000150:complications / Q000523:psychology / Q000628:therapy; D019468:Disease Management; D006801:Humans; D011618:Psychotic Disorders / Q000209:etiology / Q000523:psychology / Q000628:therapy; D011788:Quality of Life
keywords: Agitation; Anxiety; Behavioral and psychological symptoms; Dementia; Depression; Psychosis