This content is for healthcare professionals outside of the UK only.

This activity is funded by an independent medical education grant from Lundbeck. This activity is jointly provided by USF Health and touchIME in collaboration with the Gerontological Society of America (GSA).

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Alzheimer's Disease & Dementia, Neurodegenerative Diseases, Psychiatric Disorders CE/CME ACCREDITED Watch Time: 58 mins

touchMDT Multidisciplinary perspectives on management of agitation in Alzheimer’s dementia

A multidisciplinary team and a care partner discuss the prevalence, impact and management of agitation in Alzheimer’s dementia.

 Overview & Learning Objectives
Patient with agitation in Alzheimer’s dementia
  • Understanding agitation in Alzheimer’s dementia
    Geriatric Psychiatrist, Cognitive Neurologist and Care Partner
    Play Arrow Watch Video

    Watch a geriatric psychiatrist and a cognitive neurologist review the behavioural symptoms of agitation in Alzheimer’s dementia, and hear from a former care partner on how agitation impacts not only the person living with dementia but everyone around them.

    Time: 11:31
    Prof. Grossberg, Dr Atri, Dr Burman
    Play Arrow Watch Video
  • How to recognize and diagnose agitation associated with Alzheimer’s dementia
    Geriatric Psychiatrist, Cognitive Neurologist, Nurse Practitioner and Care Partner
    Play Arrow Watch Video

    Watch a geriatric psychiatrist, a cognitive neurologist and a nurse practitioner discuss the criteria for diagnosis of agitation in Alzheimer’s dementia; plus, a former care partner shares her insights on the challenges of diagnosis.

    Time: 11:58
    Prof. Grossberg, Dr Atri, Ms Scanland, Dr Burman
    Play Arrow Watch Video
  • MDT insights for managing agitation in Alzheimer’s dementia
    Geriatric Psychiatrist, Cognitive Neurologist and Nurse Practitioner
    Play Arrow Watch Video

    Watch a geriatric psychiatrist, a cognitive neurologist and a nurse practitioner discuss best practice management approaches for agitation in Alzheimer’s dementia.

    Time: 13:05
    Prof. Grossberg, Ms Scanland, Dr Atri
    Play Arrow Watch Video
  • Understanding agitation in Alzheimer’s dementia
    Advocate and Care Partner
    Play Arrow Watch Video

    Watch an advocate for individuals and families living with Alzheimer’s and other dementias interview a former Alzheimer’s dementia care partner to share personal insights of how agitation impacts not only the person living with dementia but everyone around them.

    Time: 09:37
    Ms Pettis, Dr Burman
    Play Arrow Watch Video
  • How to recognize and diagnose agitation associated with Alzheimer’s dementia
    Advocate and Care Partner
    Play Arrow Watch Video

    Watch an advocate for individuals and families living with Alzheimer’s and other dementias interview a former Alzheimer’s dementia care partner; they explore the challenges of diagnosing agitation in Alzheimer’s dementia and the importance of a patient-centric multidisciplinary care team that encompasses care partners.

    Time: 11:56
    Ms Pettis, Dr Burman
    Play Arrow Watch Video

Expert Spotlight

Prof. George T Grossberg
Saint Louis University School of Medicine, St Louis, MO, USA
Dr Alireza Atri
Banner Sun Health Research Institute, Sun City, AZ, USA
Dr Bonnie Burman
Ohio Council for Cognitive Health, New Albany, OH, USA

Prof. George T Grossberg, Dr Alireza Atri and Dr Bonnie Burman discuss the behavioural symptoms of agitation in Alzheimer’s dementia, and Dr Bonnie Burman shares her own personal experience of the impact of agitation on the patient’s quality of life and on the care partner.

Get the Audio Version

Tutorial

These icons indicate there is something to be interacted with. Click it when you see it.

Poll

What is your main challenge diagnosing agitation in Alzheimer’s dementia?

Submit your answer to see the results

Overlap with other symptoms of Alzheimer’s
   
Underreporting due to stigma or lack of awareness
   
Lack of specific diagnostic criteria
   
Challenges in the differential diagnosis
   
Geriatric Psychiatrist, Cognitive Neurologist and Care Partner
Get the Audio Version
Understanding agitation in Alzheimer’s dementia
Time: 11:31
Prof. Grossberg, Dr Atri, Dr Burman

Watch a geriatric psychiatrist and a cognitive neurologist review the behavioural symptoms of agitation in Alzheimer’s dementia, and hear from a former care partner on how agitation impacts not only the person living with dementia but everyone around them.

Watch Next
Geriatric Psychiatrist, Cognitive Neurologist, Nurse Practitioner and Care Partner

How to recognize and diagnose agitation associated with Alzheimer’s dementia

Watch Now

Expert Spotlight

Prof. George T Grossberg
Saint Louis University School of Medicine, St Louis, MO, USA
Dr Atri
Banner Sun Health Research Institute, Sun City, AZ, USA
Ms Susan Scanland
Dementia Connection®, Clarks Summit, PA, USA
Dr Bonnie Burman
Ohio Council for Cognitive Health, New Albany, OH, USA

Prof. George T Grossberg, Dr Alireza Atri, Ms Susan Scanland and Dr Bonnie Burman discuss the challenges of, and criteria for, diagnosing agitation in Alzheimer’s dementia.

Get the Audio Version

Tutorial

These icons indicate there is something to be interacted with. Click it when you see it.

Poll

How confidently do you use the IPA definition of agitation in Alzheimer’s dementia?

Submit your answer to see the results

Not confident
   
A little confident
   
Moderately confident
   
Extremely confident
   
Geriatric Psychiatrist, Cognitive Neurologist, Nurse Practitioner and Care Partner
Get the Audio Version
How to recognize and diagnose agitation associated with Alzheimer’s dementia
Time: 11:58
Prof. Grossberg, Dr Atri, Ms Scanland, Dr Burman

Watch a geriatric psychiatrist, a cognitive neurologist and a nurse practitioner discuss the criteria for diagnosis of agitation in Alzheimer’s dementia; plus, a former care partner shares her insights on the challenges of diagnosis.

Watch Next
Geriatric Psychiatrist, Cognitive Neurologist and Nurse Practitioner

MDT insights for managing agitation in Alzheimer’s dementia

Watch Now

Expert Spotlight

Prof. George T Grossberg
Saint Louis University School of Medicine, St Louis, MO, USA
Ms Scanland
Dementia Connection®, Clarks Summit, PA, USA
Dr Alireza Atri
Banner Sun Health Research Institute, Sun City, AZ, USA

Watch a geriatric psychiatrist, a cognitive neurologist and a nurse practitioner discuss best practice management approaches for agitation in Alzheimer’s dementia

Get the Audio Version

Tutorial

These icons indicate there is something to be interacted with. Click it when you see it.

Poll

When do you consider pharmacologic approaches for agitation in Alzheimer’s dementia?

Submit your answer to see the results

At diagnosis
   
If non-pharmacologic approaches fail or there are safety concerns
   
In tandem with non-pharmacologic approaches
   
Geriatric Psychiatrist, Cognitive Neurologist and Nurse Practitioner
Get the Audio Version
MDT insights for managing agitation in Alzheimer’s dementia
Time: 13:05
Prof. Grossberg, Ms Scanland, Dr Atri

Watch a geriatric psychiatrist, a cognitive neurologist and a nurse practitioner discuss best practice management approaches for agitation in Alzheimer’s dementia.

Watch Next
Advocate and Care Partner

Understanding agitation in Alzheimer’s dementia

Watch Now

Expert Spotlight

Ms Jennifer Pettis
Gerontological Society of America, Washington DC, USA
Dr Bonnie Burman
Ohio Council for Cognitive Health, New Albany, OH, USA

Ms Jennifer Pettis explores Dr Bonnie Burman’s own personal experience of the impact that agitation in Alzheimer’s dementia has on patient quality of life and on the care partner.

Get the Audio Version
Advocate and Care Partner
Get the Audio Version
Understanding agitation in Alzheimer’s dementia
Time: 09:37
Ms Pettis, Dr Burman

Watch an advocate for individuals and families living with Alzheimer’s and other dementias interview a former Alzheimer’s dementia care partner to share personal insights of how agitation impacts not only the person living with dementia but everyone around them.

Watch Next
Advocate and Care Partner

How to recognize and diagnose agitation associated with Alzheimer’s dementia

Watch Now

Expert Spotlight

Ms Jennifer Pettis
Gerontological Society of America, Washington DC, USA
Dr Burman
Ohio Council for Cognitive Health, New Albany, OH, USA

Ms Jennifer Pettis explores Dr Bonnie Burman’s own personal experience of the challenges of recognizing agitation and also helpful patient-centred management strategies.

Get the Audio Version
Advocate and Care Partner
Get the Audio Version
How to recognize and diagnose agitation associated with Alzheimer’s dementia
Time: 11:56
Ms Pettis, Dr Burman

Watch an advocate for individuals and families living with Alzheimer’s and other dementias interview a former Alzheimer’s dementia care partner; they explore the challenges of diagnosing agitation in Alzheimer’s dementia and the importance of a patient-centric multidisciplinary care team that encompasses care partners.

Watch Next
Geriatric Psychiatrist, Cognitive Neurologist and Care Partner

Understanding agitation in Alzheimer’s dementia

Watch Now
Back To Top
Overview & Learning Objectives
Overview

In this activity, a multidisciplinary team of specialists plus a former care partner share their perspectives on the impact and behavioural symptoms of agitation in Alzheimer’s dementia, including discussion on diagnosis criteria and best practice management.

This activity is jointly provided by USF Health and touchIME in collaboration with the Gerontological Society of America (GSA).

Target Audience

This activity has been designed to meet the educational needs of Alzheimer’s disease specialists, neurologists, psychiatrists, primary care physicians, specialist nurse practitioners and physician assistants involved in the management of patients with Alzheimer’s dementia.

Disclosures

USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

Faculty

Prof. George T Grossberg discloses: Consultancy fees from Acadia, Avanir, Axsome, Biogen, BioXcel, Eisai, Genentech, Karuna, Lilly, Lundbeck, Otsuka, Roche and Takeda. Safety monitoring committee fees from Anavex, EryDel, Intra-Cellular Therapies, Merck, Newron and Oligomerix. Speaker’s Bureau fees from Biogen and Eisai.

Dr Alireza Atri discloses: Advisory board/panel fees from Eisai and Novo Nordisk; Lundbeck, Merck and Roche/Genetech (all relationships terminated). Consultancy fees from Eisai and Novo Nordisk; Lundbeck, Merck, Prothena and Roche/Genetech (all relationships terminated). Grant/research support from Alzheon, Athira, Eisai and Vivoryon; Lilly (relationship terminated).

Ms Susan Scanland discloses: Advisory board/ panel and consultancy fees from Acadia, BioXcel, Eisai, Lundbeck, Otsuka and Teva. Speaker’s Bureau fees from Acadia and Teva. 

Dr Bonnie Burman has no interests/relationships or affiliations to disclose in relation to this activity.

Ms Jennifer Pettis discloses: Grant/research support from Eisai, Genentech, Lilly and Otsuka.

Content reviewer

Danielle Walker, DNP, APRN, AGNP-C has no financial interests/relationships or affiliations in relation to this activity.

Touch Medical Contributors

Christina Mackins-Crabtree has no financial interests/relationships or affiliations in relation to this activity.

USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

If you have questions regarding credit please contact cpdsupport@usf.edu 

Accreditations

Physicians

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

USF Health designates this enduring material for a maximum of 1.25 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category1 CreditTM into European CME credit (ECMEC) should contact the UEMS (www.uems.eu).

Advanced Practice Providers

Physician Assistants may claim a maximum of 1.25 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

Date of original release: 04 April 2024. Date credits expire: 04 April 2025.

If you have any questions regarding credit please contact cpdsupport@usf.edu

Learning Objectives

After watching this activity, participants should be better able to:

  • Recognize the prevalence of agitation in Alzheimer's dementia and its impact on patients and care partners
  • Summarize the early behavioural symptoms of agitation in Alzheimer’s dementia and the criteria for diagnosis
  • Discuss best practice management approaches for agitation in Alzheimer's dementia from a multidisciplinary perspective
Faculty & Disclosures
Prof. George T Grossberg

Saint Louis University School of Medicine, Saint Louis, MO, USA

Prof. George T Grossberg is the Samuel W Fordyce professor and director of geriatric psychiatry in the Department of Psychiatry at Saint Louis University School of Medicine, Missouri, USA. read more

He treats geriatric patients who suffer from a range of neurocognitive disorders, including Alzheimer’s disease. His areas of expertise include late-life depression, delirium, psychiatry in the nursing home setting and geriatric psychopharmacology. He provides outpatient evaluation and treatment, long-term care consultation/treatment and inpatient care. Prof. Grossberg approaches treatment with consideration of biological, psychological and social factors affecting the patient.

 

Prof. George T Grossberg discloses: Consultancy fees from Acadia, Avanir, Axsome, Biogen, BioXcel, Eisai, Genentech, Karuna, Lilly, Lundbeck, Otsuka, Roche and Takeda. Safety monitoring committee fees from Anavex, EryDel, Intra-Cellular Therapies, Merck, Newron and Oligomerix. Speaker’s Bureau fees from Biogen and Eisai.
Dr Alireza Atri

Banner Sun Health Research Institute, Sun City, AZ, USA

Dr Alireza Atri is an internationally renowned cognitive neurologist, neuroscientist, clinical researcher and educator in the fields of Alzheimer’s disease (AD) and related dementias (ADRD). He is the director of the Banner Sun Health Research Institute, Sun City, AZ, and also serves on the faculty at Brigham and Women’s Hospital and Harvard Medical School, Boston, MA. read more

He specializes in diagnostics, experimental therapeutics and care of individuals with cognitive disorders and dementia, particularly individuals with early-stage impairments and early-onset AD/ADRD. His research and education focus on early detection, risk reduction, experimental therapeutics, global impact and best care practices in AD/ADRD. Dr Atri serves as co-chair of the US Alzheimer’s Association national clinical practice guidelines workgroup on the evaluation of suspected cognitive impairment and AD/ADRD, and as chair of the Alzheimer’s Disease International (ADI) medical scientific advisory panel. He has delivered over 350 invited continuing education programs/symposia/lectures on cognitive ageing and impairment, and AD/ADRD worldwide; presented over 200 papers at scientific conferences; and authored more than 70 medical and scientific papers. He is co-editor of Dementia: Comprehensive Principles and Practices, Oxford University Press, 2014.


Dr Alireza Atri discloses: Advisory board/panel fees from Eisai and Novo Nordisk; Lundbeck, Merck and Roche/Genetech (all relationships terminated). Consultancy fees from Eisai and Novo Nordisk; Lundbeck, Merck, Prothena and Roche/Genetech (all relationships terminated). Grant/research support from Alzheon, Athira, Eisai and Vivoryon; Lilly (relationship terminated).
Ms Susan Scanland

Dementia Connection®, Clarks Summit, PA, USA

With 42 years of expertise in Alzheimer’s and dementia as a gerontological nurse practitioner, Ms Susan Scanland narrowed the focus of her practice in 2000 as a consultant for long-term care (LTC) physicians and interdisciplinary staff, specializing in dementia behaviors.read more

Most recently, she spearheaded the establishment of a University of California-affiliated outpatient dementia centre in Northeastern Pennsylvania, where she adeptly diagnosed and managed mild cognitive impairment and dementia. In 1999, Ms Scanland established Dementia Connection®, a dementia education and consulting firm founded in Clarks Summit, Pennsylvania. She has delivered more than 750 seminars to nurse practitioners, physician assistants, nurses, pharmacists, physicians, LTC staff, and caregivers across 42 states and internationally.

Ms Scanland recently received the national annual award from Point of Care Network for 2023 Top US Nurse Practitioner for Alzheimer’s. Susan received the National Speakers Association’s Certified Speaking Professional (CSP) award in 2014, earned by less than 15% of professional speakers.

Since 2000, Ms Scanland has held faculty appointments in Binghamton University’s gerontological/family nurse practitioner programs and University of Scranton’s undergraduate nursing program. Ms Scanland has contributed her expertise to 25 pharmaceutical advisory boards and has published in multiple nursing, geriatric, and business journals.

Ms Susan Scanland discloses: Advisory board/ panel and consultancy fees from Acadia, BioXcel, Eisai, Lundbeck, Otsuka and Teva. Speaker’s Bureau fees from Acadia and Teva.

Dr Bonnie Burman

Ohio Council for Cognitive Health, New Albany, OH, USA

Dr Bonnie Burman, ScD, is the president of the Ohio Council for Cognitive Health, a growing network of individuals, organizations and providers throughout Ohio dedicated to not only changing—but truly transforming—care and even life itself for those living with Alzheimer’s disease and other dementias, their care partners and their communities. The Council’s goal is to ensure that those impacted by cognitive impairment continue to live with meaning, purpose and joy. read more

Previously, Dr Burman served as the Director of the Ohio Department of Aging from 2011 until her retirement in 2016. As Director, she helped lead Ohio’s strong efforts to transform health care and long-term services and support for our elders. In this role she advocated for and implemented new, responsive and cost-effective approaches that emphasized high quality, person-centered care.

Before joining Governor Kasich’s cabinet, Dr Burman served as the executive director of the Pioneer Network from 2007 to 2011. Her efforts there focused on public policy change at the highest government levels. Working with a wide range of stakeholders at the national, state and local level the Pioneer Network developed cost effective, consumer-directed long-term care programs, policies and financing through regulatory enforcement, payment reform, and workforce enhancements. In addition, she demonstrated the market viability of consumer-directed care and choice by de-mystifying the costs of person-centered care, while articulating the linkages between this care and cost-effective policies and financing.

Dr Bonnie Burman has no interests/relationships or affiliations to disclose in relation to this activity.
Ms Jennifer Pettis

Gerontological Society of America, Washington DC, USA

Jennifer Pettis has a diverse work experience in the healthcare field. Jennifer is currently the Director of Strategic Alliances at The Gerontological Society of America (GSA). Prior to this, she worked as a subject matter expert/consultant at Chase Consulting Group, LLC. Jennifer also served as an adjunct faculty at State University of New York Empire State College. read more

Jennifer has had significant involvement with Nurses Improving Care for Healthsystem Elders (NICHE), where she held the position of associate director of the long-term care program. Jennifer has also worked as a nurse researcher/associate at Abt Associates.

Jennifer has been actively involved in education and training. Jennifer served as a casual lecturer at the University of Albany School of Public Health Center for Public Health Continuing Education, where she taught Minimum Data Set (MDS) education. Additionally, she has been a Gold STAMP Coach, assisting regional collaboratives in implementing the Gold STAMP Pressure Ulcer Project.

Jennifer’s experience also includes working as an independent contractor for the Centers for Medicare & Medicaid Services (CMS) nursing home division, where she provided technical expertise on the maintenance of the MDS 3.0 and resolved RAI-related inquiries. Jennifer has also served as the director of program development at Harmony Healthcare International and as a senior policy analyst/consultant at New York Association of Homes and Services for the Aging (NYAHSA).

Throughout her career, Jennifer has demonstrated her expertise in various aspects of healthcare, including resident assessment coordination, policy analysis, and program development. Jennifer holds a Master of Science degree in nursing and is a certified nurse executive (CNE). Jennifer Pettis, MS, RN, CNE, completed a degree at SUNY Empire State College. 

Ms Jennifer Pettis discloses: Grant/research support from Eisai, Genentech, Lilly and Otsuka.
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This activity is funded by:

An independent medical education grant from Lundbeck.
This activity is jointly provided by USF Health and touchIME in collaboration with the Gerontological Society of America (GSA).

The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgement of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

This content is intended for healthcare professionals.

Date of original release: 04 April 2024. Date credits expire: 04 April 2025

This content is intended for healthcare professionals outside of the UK only. Please confirm that you are a healthcare professional.

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Question 1/5
How prevalent are behavioural and psychological symptoms, including agitation, in people living with dementia?
 Correct

Behavioural and psychological symptoms of dementia include agitation and aggression, and are common among people living with dementia. Reports suggest up to 80% of patients with dementia present with behavioural and psychological symptoms of dementia at some stage of their illness. 

 

Reference

Davies SJ, et al. J Psychopharmacol. 2018;32:509–23.

Question 2/5
A care partner is concerned about the behaviours their loved one with Alzheimer’s dementia has recently been exhibiting. Which of the following sets of behaviours would most lead you to believe that they may have AAD?

AAD, agitation in Alzheimer’s dementia.
 Correct

Dementia affects people in different ways and changes in the behaviour or emotional state of someone living with dementia are common.1 Agitated behaviours may include: pacing, rocking, gesturing, pointing fingers, restlessness, performing repetitive mannerisms, yelling, speaking in an excessively loud voice, using profanity, screaming, shouting, grabbing, shoving, pushing, resisting, hitting others, kicking objects or people, scratching, biting, throwing objects, hitting self, slamming doors, tearing things and destroying property.2

References

Dementia Australia. Available at: www.dementia.org.au/about-dementia-and-memory-loss/about-dementia/behaviour/behaviour-changes (accessed 5 March 2024).

Cummings J, et al. Int Psychogeriatr. 2015;27:7–17.

Question 3/5
The IPA definition of agitation in cognitive disorders states that the person must exhibit ≥1 behaviour grouped under excessive motor activity, verbal aggression or physical aggression that has been persistent or frequently recurrent for a minimum of how many weeks?

IPA, International Psychogeriatric Association.
 Correct

The IPA formed an Agitation Definition Work Group to develop a provisional consensus definition of agitation in patients with cognitive disorders. Agitation was defined broadly as: (1) occurring in patients with a cognitive impairment or dementia syndrome; (2) exhibiting ≥1 behaviour consistent with excessive motor activity, verbal aggression or physical aggression, that has been persistent or frequently recurrent for a minimum of 2 weeks and represents a dramatic change from the patient’s usual behaviour; (3) exhibiting behaviours that are severe, associated with excess distress or produce excess disability, beyond that due to cognitive impairment and including significant impairment in interpersonal relationships, aspects of social functioning and/or the ability to perform or participate in activities of daily living; and (4) behaviours not solely attributable to another disorder (psychiatric, medical or substance-related).

Abbreviation

IPA, International Psychogeriatric Association.

Reference

Cummings J, et al. Int Psychogeriatr. 2015;27:7–17.

Question 4/5
Your 80-year-old female patient with Alzhemier’s dementia is showing signs of agitation. She has recently started pacing and wringing her hands, but does not appear to be aggressive. Working with the care partner, they tell you that the patient used to be a music teacher, has five grandchildren and loved to travel. To help manage the agitation, what would you consider for this patient?
 Correct

Nonpharmacologic practices for managing agitation in adults with cognitive impairment are person-centred, and are considered before pharmacologic approaches for the treatment of agitation in Alzheimer’s dementia.1,2 Family caregivers and paid care providers can implement evidence-based nonpharmacologic practices in home or residential care settings.1 Nonpharmacologic treatment includes sensory practices (aromatherapy, massage, multi-sensory stimulation, bright light therapy), psychosocial practices (validation therapy, reminiscence therapy, music therapy, pet therapy, meaningful activities), and structured care protocols (bathing, mouth care).1 Most practices are acceptable, have no harmful effects and require minimal to moderate investment.1

References

  1. Scales K, et al. Gerontologist. 2018;58(Suppl. 1):S88–102.
  2. Gerontological Society of America. Insights and Implications in Gerontology. August 2023. Available at: https://bit.ly/3HbJQyE (accessed 5 March 2024).
Question 5/5
Your 88-year-old male patient is showing signs of worsening AAD, despite the use of evidence-based non-pharmacologic approaches for the past 6 months. What approved pharmacologic treatment do you suggest?

AAD, agitation in Alzheimer’s dementia.
 Correct

In May 2023, brexpiprazole was approved by the FDA for the treatment of AAD.1 As of March 2024, it is still the only FDA-approved treatment for AAD. If there is no improvement or worsening of AAD after implementation of evidence-based nonpharmacologic approaches, it is recommended to then consider pharmacologic approaches.2 

Abbreviations

AAD, Agitation in Alzheimer’s dementia; FDA, US Food and Drug Administration. 

References

  1. FDA news release. Available at: www.fda.gov/news-events/press-announcements/fda-approves-first-drug-treat-agitation-symptoms-associated-dementia-due-alzheimers-disease (accessed 5 March 2024).
  2. Gerontological Society of America. Insights and Implications in Gerontology. August 2023. Available at: https://bit.ly/3HbJQyE (accessed 5 March 2024).
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