Chapter 10 - Agitation in patients with dementia

Summary

This chapter discusses cortical dementias that include Alzheimer's disease, fronto-temporal dementia and dementia with Lewy bodies, subcortical dementias that include Parkinson's disease and Huntington's disease, and mixed dementias that include vascular dementia. Deficits characteristic of both cortical and subcortical dementias, depending on the location and extent of cerebrovascular lesions, may occur. Numerous neuropsychiatric sequelae are associated with traumatic brain injury (TBI), making it difficult to identify a well-defined syndrome. Thorough psychiatric and medical histories are critical in diagnosing patients who present with agitation and cognitive changes. Laboratory and neuroimaging studies are of variable utility in evaluating for reversible causes of altered mental status. A number of medications have been studied for their effects on dementia-related agitation. The most common categories include antipsychotics, antiepileptic medications, antidepressants, and cognitive enhancers. Controlled studies on pharmacologic treatment for agitation in Huntington's disease are rare.