[Recommendations for the diagnostic and therapy of behavioural and psychological symptoms of dementia (BPSD)].

The «Recommendations for the Diagnosis and Treatment of Behavioral and Psychological Symptoms of Dementia (BPSD)» were developed in parallel with the Swiss National Dementia Strategy 2014-2019 under the auspices of the Swiss Society for Geriatric Psychiatry and Psychotherapy (SGAP) and mark the beginning of a series of recommendations for geriatric psychiatric disorders. They depict the evidence-based state of knowledge about diagnostics and therapy, based on the clinical experience of the experts, and are designed for interprofessional and interdisciplinary use. The non-pharmacological intervention options and pharmacotherapy are discussed in detail.

[Recommendations for the prevention, diagnosis, and therapy of addiction in the elderly].

In old age, the chronic use of substances such as alcohol and sedatives, and more recently opioids, is a major public health and personal problem. Despite this, relatively little attention has been paid to the disorders associated with the use of these substances. These recommendations have been formulated by the Swiss Society for Elderly Psychiatry and Psychotherapy (SPPA) in collaboration with the Swiss Nurses' Association (SNA) and the Swiss Society for Addiction Medicine (SSAM).

[Recommendations for the Diagnosis and Therapy of Psychotic Disorders in the Elderly].

Recommendations for the Diagnosis and Therapy of Psychotic Disorders in the Elderly Psychotic disorders in the elderly cover a wide range of causes and manifestations. They often occur as part of a depression, dementia, substance abuse or delirium. While psychosis can occur with a first manifestation in advanced age, many patients with chronic psychotic disorders reach a high age.

[Recommendations for the Prevention, Diagnostics and Therapy of Addiction Disorders in the Elderly].

Recommendations for the Prevention, Diagnostics and Therapy of Addiction Disorders in the Elderly Although the chronic consumption of alcohol and sedatives, and increasingly opioids, represents a major problem in old age with consequential damage for those affected, little attention has been paid to the substance abuse disorders in old age. The aim of the present recommendations, a collaboration work of the Swiss Society for Geriatric Psychiatry and Psychotherapy (SGAP), Swiss Nurses Association (SBK) and Swiss Society of Addiction Medicine (SSAM), is to summarize the current state of knowledge in prevention, diagnostics and therapy of substance abuse disorders in old age for an interprofessional clinical team. They are intended to help strengthen prevention and early diagnosis, and consciously emphasize psychotherapy and nursing intervention options.

The new remuneration system TARPSY in Swiss psychiatric hospitals: effects on length of stay and readmissions?

Background: In 2018, Switzerland introduced a nationwide case-based prospective remuneration system (TARPSY), with decreasing daily rates for reimbursement of inpatient care in mental health facilities. Initially, there were concerns that declining daily rates could result in early discharges and increased readmission rates.

Methods: We compared length of stay (LOS) and readmission rates for patients in adult and geriatric psychiatry treatment at four psychiatric hospitals between 2017 (the last year with the traditional remuneration system) and 2018 (the first year with TARPSY).

Quality of the caregiving relationship and quality of life in mild Alzheimer's dementia.

Background: The present study aims to investigate the quality of the dyadic relationship between mild Alzheimer patients and their caregivers. The main objective is to evaluate the consistency, agreement and validity of the German version of the Scale for Quality of the Current Relationship in Caregiving (SQCRC). The secondary objective was to examine the association of relationship quality with quality of life (QOL) in patients with mild Alzheimer's disease (AD) and their caregivers.

[Recognition of Psychiatric Symptoms in Inpatient Long-Term Care].

Recognition of Psychiatric Symptoms in Inpatient Long-Term Care As part of the Swiss national strategy on dementia, we investigated to which extent the needs assessment instruments RAI and BESA can early detect symptoms of depression, delirium, and behavioral and psychological symptoms of dementia (BPSD) in long-term care facilities. While we decided that the RAI sufficiently detected depressive symptoms, we suggest to add the two-questions-test and the geriatric depression scale to the BESA assessment. The BESA evaluation had more targeted focused assessments, allowing for better identification of delirium.

Anti--methyl-d-aspartate receptor encephalitis in an older patient presenting with a rapid onset of delusions and amnesia.

We present the case of a 77-year-old patient with a rapid onset of delusions, amnesia, agitation, insomnia and no previous psychiatric history, who was diagnosed with anti--methyl-d-aspartate receptor encephalitis. This case report highlights the importance of including autoimmune encephalitis in the differential diagnosis of older patients presenting with rapid onset psychiatric episodes.

Benzodiazepines and/or neuroleptics for the treatment of delirium in palliative care?-a critical appraisal of recent randomized controlled trials.

Delirium is a frequent condition in patients in a palliative care situation and most often associated with substantial burden or even danger for the persons concerned as well as caregivers and health-care-professionals. Despite the lack of randomized-controlled-trials (RCTs) benzodiazepines and neuroleptic agents are used extensively in palliative care for the pharmacological management of delirium. A focused review for RCTs assessing pharmacotherapy with benzodiazepines and neuroleptics for the treatment of delirium in patients treated in a palliative care or hospice setting published in 2017 was performed in PubMed.

[The Physical Examination of an 'Uncooperative' Elderly Patient].

The Physical Examination of an 'Uncooperative' Elderly Patient Abstract. The physical examination of uncooperative elderly patients regularly presents physicians in the private practice, in the hospital or nursing home with great challenges. The lack of cooperation itself can be an important indication of an underlying medical problem.

Memory deficits for facial identity in patients with amnestic mild cognitive impairment (MCI).

Faces are among the most relevant social stimuli revealing an encounter's identity and actual emotional state. Deficits in facial recognition may be an early sign of cognitive decline leading to social deficits. The main objective of the present study is to investigate if individuals with amnestic mild cognitive impairment show recognition deficits in facial identity.

[Recommendations of Swiss Memory Clinics for the Diagnosis of Dementia].

The early diagnosis of subjectively perceived or externally anamnestically observed cognitive impairments is essential for proving neurodegenerative diseases or excluding treatable causes such as internal, neurological or psychiatric disorders. Only in this way is early treatment made possible. As part of the project 3.

[Recommendations of Swiss Memory Clinics for the Diagnosis of Dementia].

Recommendations of Swiss Memory Clinics for the Diagnosis of Dementia The early diagnosis of subjectively perceived or externally anamnestically observed cognitive impairments is essential for proving neurodegenerative diseases or excluding treatable causes such as internal, neurological or psychiatric disorders. Only in this way is early treatment made possible. As part of the project 3.

Treatment effects of Ginkgo biloba extract EGb 761® on the spectrum of behavioral and psychological symptoms of dementia: meta-analysis of randomized controlled trials.

Unlabelled: ABSTRACTBackground:In randomized controlled trials, Ginkgo biloba extract EGb 761® has been found to be effective in the treatment of behavioral and psychological symptoms of dementia (BPSD).

Methods: To assess the effects of EGb 761® on specific BPSD, we analyzed data from all randomized, placebo-controlled, at least 20-week, trials of EGb 761® enrolling patients with dementia (probable Alzheimer's disease (AD), probable vascular dementia or probable AD with cerebrovascular disease) who had clinically significant BPSD (Neuropsychiatric Inventory (NPI) total score at least 6). Data were pooled and joint analyses of NPI single item composite and caregiver distress scores were performed by meta-analysis with a fixed effects model.

Best practice in the management of behavioural and psychological symptoms of dementia.

Behavioural and psychological symptoms of dementia (BPSD) occur in most patients with dementia. They cause great suffering in patients and caregivers, sometimes more so than the cognitive and functional decline inherent to dementia. The clinical features of BPSD include a wide variety of affective, psychotic and behavioural symptoms and signs.

Use it or lose it! Cognitive activity as a protec-tive factor for cognitive decline associated with Alzheimer's disease.

Because of the worldwide aging of populations, Alzheimer's disease and other dementias constitute a devastating experience for patients and families as well as a major social and economic burden for both healthcare systems and society. Multiple potentially modifiable cardiovascular and lifestyle risk factors have been associated with this disease. Thus, modifying these risk factors and identifying protective factors represent important strategies to prevent and delay disease onset and to decrease the social burden.

Hippocampal shape alterations are associated with regional Aβ load in cognitively normal elderly individuals.

Aβ deposition is a driving force of Alzheimer's disease pathology and can be detected early by amyloid positron emission tomography. Identifying presymptomatic structural brain changes associated with Aβ deposition might lead to a better understanding of its consequences and provide early diagnostic information. In this respect we analyzed measures of cortical thickness and subcortical volumes along with hippocampal, thalamic and striatal shape and surface area by applying novel analysis strategies for structural magnetic resonance imaging.

[Benzodiazepine Dependency in the Elderly: How to Deal with it].

Benzodiazepine/hypnotic abuse and dependency increase with advanced age. Especially in the elderly, severe adverse events accompany the regular intake of these substances. Sedation, cognitive and psychomotor effects, falls, accidents and injuries are very frequent.

Cognitive behavioural treatment for mild Alzheimer's patients and their caregivers (CBTAC): study protocol for a randomized controlled trial.

Background: About 90 % of all persons with mild Alzheimer's disease experience neuropsychiatric symptoms, most frequently apathy, depression, anxiety and irritability. These symptoms are associated with greater morbidity, a reduced quality of life for the patient, an increased burden and depression for the caregiver, and higher costs of care and nursing home placement. Psychosocial interventions based on behaviour therapy represent the most efficacious treatment of neuropsychiatric symptoms.

[Behavioral and psychological symptoms of dementia (BPSD): how to proceed].

The prevalence of the behavioral and psychological symptoms of dementia (BPSD) is very high in dementia patients. Alterations in multiple neurotransmitter systems are involved in the pathogenesis of BPSD. These symptoms complicate the therapy and outcome.