BPSD

IPA Task Force on BPSD: Educational Programs in Development

Behavioral (e.g. hoarding and hitting) and Psychological (e.g. delusions and depressed affect) Symptoms of Dementia (BPSD) have generally received less attention from healthcare professionals than cognitive symptoms have. Many such symptoms are still not generally recognized as being among the core symptoms of dementia even though they are a frequent cause of early institutionalization, increased costs, decreased quality of life and increased suffering by patients and families. Growing numbers of elderly people and decreasing levels of family caregiving worldwide have added urgency to the search for humane and effective ways to deal with behavioral symptoms. 

Against this background, the IPA Task Force on Behavioral Disturbances of Dementia (now the IPA Task Force on Behavioral and Psychological Symptoms of Dementia [BPSD]) was established by the IPA Board of Directors at its Cancun meeting in February 1995. At the Seventh International Congress of the IPA, the task force committee determined its mission statement to be: 

"The promotion of research, training, and dissemination of information on behavioral disturbances of dementia to healthcare professionals and caregivers".

The information that the task force disseminates includes data on the cause, diagnosis and assessment, nature and occurrence of symptoms, management, and cross-cultural and ethnic issues. The task force hopes to spread this information through a program of educational activities. The goals of the BPSD educational programs are: 

• to inform psychiatrists, neurologists, primary care physicians, related healthcare providers, and caregivers of the special symptoms of Alzheimer's disease and other dementias, as they have been described since the 1980s;
• to inform clinicians and caregivers about the relationship between the symptoms and the course of the illness;
• to encourage physicians to view the symptoms both individually and collectively in developing a specific plan for intervention; and
• to describe what is known about treatment and management of the symptoms.

Among the educational modalities being explored are the following:

• publication in journals;
• establishment of an international speakers' bureau;
• brochures and leaflets;
• interactive technology using CD-ROM or the Internet, in which a patient can be "seen" and assessed, and approaches to therapy and therapeutic response can be discussed;
• videotapes, slides, and audio-cassettes; and
• a training manual.

The first priority of the IPA Task Force on BPSD was to hold a two-day conference to define terminology - the IPA Washington Consensus Conference. This meeting was held March 31 through April 2, 1996, in the Washington, DC area. Sixty experts from 16 countries assembled to review and discuss the topic in terms of natural history and target symptoms, to obtain operational definitions. Three breakout groups arrived at preliminary statements on terminology, with the understanding that subsequent modification of the definitions might be necessary.

Summary articles from the conference, as well as the resulting consensus statement, have been published in a special supplement issue of International Psychogeriatrics (Volume 8, Supplement 3).