Treatment of non-cognitive symptoms in dementia

Non-cognitive symptoms are common in dementia. Emotional disturbances such as depression, anxiety and irritability-aggressiveness dominate. Depression is seen in about one third of demented persons. There are findings indicating that degenerative changes in the brain can cause depressive changes. Depression in elderly and in dementia differs from that in younger ages but no diagnostic criteria have yet been evaluated. Anxiety is a common symptom in depression suggesting a depressive-anxiety disorder. Specific serotonin re-uptake inhibitors (SSRI) are efficient in the treatment of both depression and anxiety while tricyclic antidepressants have side effects including cognitive reduction. Irritability and aggressiveness respond to the treatment with SSRI drugs. Such drugs as benzodiazepines and antipsychotics, especially those with anticholinergic effects, can reduce cognitive function in elderly and demented persons but the knowledge, this side effect is insufficient. Antipsychotics without anticholinergic effects should be used for the treatment of psychotic symptoms in demented persons.