Behavioral problems produce excess disability that can be potentially devastating in cognitively impaired patients. These behavioral symptoms can be a major cause of stress, anxiety and concern for caregivers. While
psychotropic drugs are frequently used to control these symptoms, they have the potential for significant side effects, which include sedation, disinhibition, depression, falls, incontinence,
parkinsonism and akathisias. On examination of the consequences of adverse events,
somnolence, as well as postural instability and
postural hypotension, have been noted. All patients with
Alzheimer's disease (AD) and other progressive
dementias will advance through stages of moderate-to-severe AD unless effective treatments suspend transition from mild deterioration to
dementia, or competitive mortality truncates survival. Treatment trials suggest that these patients respond to both disease-modifying (such as inhibitors of
cholinesterase and butirrylcholinesterase) and symptomatic (such as
neuroleptics) agents. Relatively few studies have been conducted in this patient population, and more information regarding the type of behavioral disturbances exhibited, how best to measure them in this disabled population and their optimum treatment are urgently needed.