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• W2038403985 abstract "Negli ultimi anni è stata dedicata una sempre maggiore attenzione alla disabilità mentale nei soggetti affetti da demenza in ragione della sua elevata prevalenza, del suo impatto su prognosi e riabilitazione, dello stress che induce nel paziente e nel caregiver e, non per ultimo, dell’incremento dei costi sociali che essa comporta. Oltre al deficit cognitivo, i fattori all’origine della disabilità mentale in questi pazienti sono costituiti dalla costellazione dei cosiddetti sintomi comportamentali e psichici, meglio noti con l’acronimo di BPSD, derivato dalla letteratura anglosassone. Nella presente revisione critica, vengono pertanto analizzati i più recenti sviluppi relativi ai BPSD, considerando, innanzitutto il loro profilo nosografico, la loro espressione clinica in ciascuna delle tre principali forme di demenza degenerativa (malattia di Alzheimer, demenza a corpi di Lewy, degenerazione fronto-temporale) e la loro utilità nell’ambito della diagnostica differenziale delle demenze. Particolare attenzione viene anche dedicata ai possibili meccanismi fisiopatogenetici dei BPSD in ambito neurobiologico, genetico e neurochimico, e, soprattutto, ai recenti contributi forniti dalle metodiche di neuroimmagine anatomica e funzionale. Vengono poi passati in rassegna i correlati psicologici e sociali dei BPSD così come le principali scale di valutazione neuropsichiatriche. In relazione al trattamento, la presente rassegna si focalizza soprattutto sulle problematiche e gli interrogativi bioetici sollevati dalla terapia dei BPSD in quanto assai recentemente questi hanno cominciato a trovare, anche in Italia, una prima proposta di risposta condivisa, grazie allo sforzo congiunto operato dalle principali società scientifiche nazionali coinvolte nella loro gestione. In recent years the high prevalence of mental disability in patients suffering from dementia has brought greater attention to aspects such as its impact on prognosis and rehabilitation, the levels of stress induced on the patients and the caregivers and the increased social costs it entails. In addition to cognitive deficits, other and more important factors are associated to mental disability in these patients, a constellation of the so-called behavioural and psychological symptoms of dementia (BPSD). In this review, the latest developments in BPSD treatment are analyzed considering their nosographic profile, their clinical expression and their usefulness in the differential diagnosis amongst the three main types of degenerative dementias (Alzheimer's disease, dementia with Lewy bodies, fronto-temporal degeneration). The neurobiological, genetic and neurochemical mechanisms supposed to be at the heart of the pathogenesis of BPSD as well as the most recent contributions provided by the anatomical and functional neuroimaging techniques are discussed. Their psychological and social correlates are reviewed as well as the main tools and scales used in clinical assessment. Finally we discuss the bioethical issues at the root of BPSD treatment. Recently in Italy there has been an initial proposal for a shared approach by the national scientific societies involved in the clinical management of these symptoms." @default.
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• W2038403985 date "2009-12-01" @default.
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• W2038403985 title "La disabilità mentale nella malattia di Alzheimer e nelle altre demenze degenerative" @default.
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• W2038403985 doi "https://doi.org/10.1016/j.quip.2009.11.003" @default.
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