B = Behaviour

The International Psychogeriatric Association (IPA) convened a Consensus group, consisting of some 60 experts in the field, from 16 countries, to produce a statement on the definition of behavioural and psychological symptoms of dementia. The group reached consensus that: "The term behavioural disturbances should be replaced by the term behavioural and psychological symptoms of dementia (BPSD) defined as: Symptoms of disturbed perception, thought content, mood or behaviour that frequently occur in patients with dementia."

The IPA provides a simple grouping of BPSD and the definitions used are included below.

Behavioural symptoms

Usually identified on the basis of observation of the patient including:

  • Physical aggression
  • Screaming
  • Restlessness
  • Agitation
  • Wandering
  • Culturally inappropriate behaviours
  • Sexual disinhibition
  • Hoarding
  • Constant questioning
  • Cursing and

  • Shadowing

Psychological symptoms

Usually and mainly assessed on the basis of interviews with patients and relatives; these symptoms include:

  • Anxiety
  • Depressive mood
  • Paranoia
  • Hallucinations and
  • Delusions

"A number of studies looking at the occurrence of BPSD in nursing home populations have found these symptoms occur in up to 90% of patients" (IPA, 1998).

References & recommended reading

International Psychogeriatric Association (1998) Behavioural and Psychological Symptoms of Dementia (BPSD) Educational Pack - Module 1. www.ipa-online.org

Teri, L. (1999) 'Latest advances in the assessment and management of behavioural symptoms: an international perspective'. Paper presented to a Symposium reporting the latest evidence-based practices in the care of behavioural symptoms of dementia, Melbourne.

Teri, L. (1999) 'State of the art strategies in approaching behavioural disturbance and depression in dementia'. Paper presented to a Symposium reporting the latest evidence-based practices in the care of behavioural symptoms of dementia, Melbourne.