Impact of Dementia-Related Psychosis on Patients and Caregivers: The Treatment Imperative
When you treat patients with dementia-related psychosis, do you evaluate the burden on carers, too? If they feel discomfort, fear, or depression, how would you help them? Learn from an expert in this brief CME activity.
Behavioral and psychological symptoms are common in patients with dementia. Especially troublesome are the delusions and hallucinations of dementia-related psychosis (DRP) due to their negative impact on both patients and their carers and family members. This report reviews the impact of DRP on patients and carers, assessment tools, and coping strategies and techniques to help care partners manage DRP.
From the Series: Dementia-Related Psychosis: Recognition and Treatment
To cite: Aarsland D. Impact of dementia-related psychosis on patients and caregivers: the treatment imperative. J Clin Psychiatry. 2020;81(6):AD19038BR2C.
To share: https://doi.org/10.4088/JCP.AD19038BR2C
© Copyright 2020 Physicians Postgraduate Press, Inc.
Neurologists, psychiatrists, nurse practitioners, and physician assistants
Discuss the impact of psychosis on patients with dementia with them (if possible) and their caregivers
Supported by an educational grant from ACADIA Pharmaceuticals Inc.
After completing this educational activity, you should be able to:
- Discuss the impact of psychosis on patients with dementia with them (if possible) and their caregivers
Release, Review, and Expiration Dates
This brief report activity was published in October 2020 and is eligible for AMA PRA Category 1 Credit™ through October 31, 2022. The latest review of this material was September 2020.
Statement of Need and Purpose
Hallucinations and delusions are key behaviors contributing to behavioral crises in patients with dementia, and a lack of consistency in assessment of behaviors has been found. Clinicians may lack awareness of the incidence of psychotic symptoms in different forms of dementia, as dementia pathology has been incorrectly diagnosed on the basis of the presence or absence of psychosis. Some patients may not be able to describe their psychotic symptoms, requiring caregiver input to aid clinicians in recognition. Rating scales can be implemented to aid identification. Clinicians need education about assessing patients with dementia for hallucinations and delusions and about the incidence of psychotic symptoms in different forms of dementia. In addition, many patients with dementia-related psychosis (DRP) receive antipsychotics and are on treatment for over a year, although guidelines recommend tapering after 4 months. Clinicians need education to implement guideline-concordant care that is tailored to the individual patient, incorporating current information on the risks and benefits of nonpharmacologic and pharmacologic interventions for DRP. This activity was designed to meet the needs of participants in CME activities provided by the CME Institute of Physicians Postgraduate Press, Inc., who have requested information on DRP.
Disclosure of Off-Label Usage
Dr Aarsland has determined that, to the best of his knowledge, no investigational information about pharmaceutical agents or device therapies that is outside US Food and Drug Administration–approved labeling has been presented in this activity.
The faculty members agreed to provide a balanced and evidence-based presentation and discussed the topics and CME objectives during the planning sessions. The faculty’s submitted content was validated by CME Institute staff, and the activity was evaluated for accuracy, use of evidence, and fair balance by the Chair and a peer reviewer who is without conflict of interest.
This activity is derived from the teleconference series “Current Management Approaches for Insomnia,” which was held in May and June 2020 and supported by an educational grant from ACADIA Pharmaceuticals Inc. The opinions expressed herein are those of the faculty and do not necessarily reflect the opinions of the CME provider and publisher or the commercial supporter.
Dag Aarsland, MD, PhD
National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation and Institute of Psychiatry, Psychology & Neuroscience at King's College London, UK
The faculty for this CME activity and the CME Institute staff were asked to complete a statement regarding all relevant personal and financial relationships between themselves or their spouse/partner and any commercial interest. The Accreditation Council for Continuing Medical Education (ACCME) defines a commercial interest as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME defines relevant financial relationships as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. The CME Institute has resolved any conflicts of interest that were identified. No member of the CME Institute staff reported any relevant personal financial relationships.
Dr Aarsland has received research support and/or honoraria from AstraZeneca, Lundbeck, Novartis, Biogen, and GE Health and served as a paid consultant for Lundbeck, Eisai, Heptares, and Mentis Cura. The Chair for this activity, Clive Ballard, MBChB, MMedSci, MRCPsych, MD, is a consultant for and has received honoraria from Acadia, Roche, Lundbeck, Exevia, AARP, Synexus, and Novo Nordisk; has received grant/research support from Synexus, Novo Nordisk; and is a member of the speakers/advisory boards for Acadia, Roche, AARP, Synexus, and Novo Nordisk.
The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.
To obtain credit for this activity, study the material and complete the CME Posttest and Evaluation.
MOC Approval Statement
Through the American Board of Medical Specialties (“ABMS”) ongoing commitment to increase access to practice relevant Continuing Certification Activities through the ABMS Continuing Certification Directory, Impact of Dementia-Related Psychosis on Patients and Caregivers: The Treatment Imperative has met the requirements as a MOC Part II CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:
MOC Part II CME Activity
Psychiatry and Neurology
- 0.50 AMA PRA Category 1 Credit™
- 0.50 Participation