Abstract
Answer A. Behavioural management
Behavioural problems can be difficult to manage with dementia patients. Agitation and aggression put the patient and the people around them at risk. Reversible causes should be looked for initially and non-pharmacological treatment is advised. This may include education of families and carers on de-escalating situations and adhering to an appropriate sleeping cycle. This should be the primary management. Memantine is not recommended for vascular dementia and anti-psychotics like olanzapine and risperidone can increase risk of cardiovascular disease and are not ideal. A very low dose of lorazepam with close monitoring can be used to treat patients for agitation and aggression when behavioural management fails.
InnovAiT article: Vascular cognitive impairment and vascular dementia. DOI: 10.1177/1755738018760649.