Assessment and management of dementia in the nursing home

Well over half of the nursing home residents in the United States suffer from dementia, and the absolute number of those affected is expected to increase dramatically. Dementia is a clinical syndrome for which physicians assess patients carefully to search for reversible etiologies and other factors which worsen cognitive function. Behavioral and affective symptoms are common and may be understood as having organic, environmental, psychological, and interpersonal components. Patients with dementia may benefit from judicious use of psychotropics but are often highly vulnerable to adverse effects. Specialized treatment units are showing early promise.