■臨床医のために
認知症の周辺症状（BPSD）への対応
鈴木 達也, 野呂瀬 準, 須田（二見） 章子, 鈴木 一成, 関水 憲一, 大内 基司, 猪狩 吉雅, 渡邊 健太郎, 中野 博司, 大庭 建三
日本医科大学大学院医学研究科器官機能病態内科学
日本医科大学内科学（循環器・肝臓・老年・総合病態部門）
Management of Behavioral and Psychological Symptoms of Dementia in Elderly Patients with Dementia
Tatsuya Suzuki, Jun Norose, Shoko Futami-Suda, Kazunari Suzuki, Kenichi Sekimizu, Motoshi Ouchi, Yoshimasa Igari, Kentaro Watanabe, Hiroshi Nakano and Kenzo Oba
Division of Cardiology, Hepatology, Geriatrics, and Integrated Medicine, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School
Division of Geriatric Medicine, Nippon Medical School
In recent years, elderly patients with dementia have been increasing in Japan. It is currently estimated that behavioral and psychological symptoms of dementia (BPSD) occur in approximately 80% of the elderly patients with dementia. As BPSD occur more frequently in elderly patients with dementia, the caregivers burden increases. Although non-pharmacological interventions can reduce BPSD in patients with dementia, antipsychotic medications have been used to treat severe BPSD. Physicians should be particularly careful in the use of antipsychotic medications in the elderly, which have been associated with dangerous adverse effects. Donepesil not only improves the cognitive dysfunction of Alzheimer disease patients, but may also relieve BPSD in these patients. Moreover, the effects on BPSD of yokukan-san, Kampo medicine, have been reported in elderly patients with dementia. A multicenter randomized crossover study, which we participated in, confirmed that yokukan-san is effective in the treatment of BPSD and that no rebound related deterioration occur after withdrawal of yokukan-san. The effects of yokukan-san on BPSD have been reported to influence gamma-amino-n-butyric acid and serotonin receptors.
日医大医会誌 2010; 6(3), 135-139
Key words
dementia, behavioral and psychological symptoms of dementia, elderly
Correspondence to
Tatsuya Suzuki, Department of Internal Medicine (Divisions of Cardiology, Hepatology, Geriatrics, and Integrated Medicine), Division of Geriatric Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku Tokyo 113-8603, Japan
E-mail：t-suzuki@nms.ac.jp
受付：2010年3月31日 受理：2010年4月20日 |
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