Nonpharmacologic treatment of behavioral disorders in dementia

Dementia symptoms are often complicated by behavioral disorders such as repetitive verbalizations, aggressive behavior, and pacing. In clinical practice, the most common responses to behavioral disorders are pharmacologic, mostly using antipsychotic medication, or ignoring the behavior. However, multiple research studies support the notion that these behavioral disorders in dementia are related to unmet needs that can be addressed by nonpharmacologic interventions. Persons with dementia present multiple unmet needs, most commonly pain and discomfort, need of social contact and support, and need of stimulation that alleviates boredom. A wide range of interventions that address these needs has been investigated, though the rigor of the investigations varied greatly depending on factors related to the behavioral disorder, setting, and resource limitations. In practice, the avenues to address the unmet needs should depend on the person's abilities and preferences. Thus, nonpharmacologic interventions that are individually tailored to the person with dementia comprise a superior response to behavioral disorders and should be at the frontline of treatment of these disorders.