Identifying and Managing Agitation in Alzheimer Dementia

An estimated 6.5 million people aged 65 years or older in the United States are currently living with Alzheimer disease. By the year 2060, that number could increase to nearly 14 million.1

Alzheimer disease is the most common form of dementia and is associated with accelerated disease progression, disproportionate reductions in function and well-being, higher mortality, caregiver burden and potential burnout, and costs. Symptoms of agitation in Alzheimer dementia (AAD) include increased motor activity, restlessness, aggressiveness, and emotional distress.

W. Clay Jackson, MD, DipTh, Assistant Professor of Clinical Psychiatry and Family Medicine at the University of Tennessee College of Medicine in Arlington, Tennessee, and Leslie L. Citrome, MD, MPH, Clinical Professor in the Department of Psychiatry and Behavioral Sciences at New York Medical College in Suffern, New York, discuss AAD in their session, “Agitation in Alzheimer’s Dementia: Progress for an Age-Old Problem” at the 2022 Practical Updates in Primary Care Virtual Series.

Drs Jackson and Citrome begin their session by identifying AAD, including its precipitating factors, symptoms, and potential pathophysiological mechanisms. They then move to reviewing some of the current and emerging treatments associated with AAD and their potential for enhanced therapeutic benefits. Finally, they detail implementing management strategies for this patient population, including how to involve both patients and their care partners in treatment decisions.

Currently, there are no treatments specifically approved by the FDA for behavioral disturbances associated with dementia, and the data on pharmacotherapy shows limited effectiveness to date. However, Drs Jackson and Citrome offer potential pharmaceutical treatment approaches, including antidepressants, antipsychotics, anxiolytics, and mood stabilizers.

“The selection of any medication should be based on clinical experience, circumstance, and physician judgment,” Drs Jackson and Citrome note in their presentation. “The overall approach is ‘start low and go slow’ and consider potential drug interactions.”

For more meeting coverage, visit the Practical Updates in Primary Care newsroom.

For more information about PUPC 2022 Virtual Series and to register for upcoming sessions, visit https://practicalupdates.consultant360.com.

—Anthony Calabro