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. 2025 Jun;16(3):753-770.
doi: 10.1007/s41999-025-01155-6. Epub 2025 Feb 19.

Management of behavioural and psychological symptoms of dementia: a pragmatic scoping review of European guidelines and literature

Alessandra Coin  1 , Elsa Brew-Girard  2 , Ellen Tracey  3 , Vincenza Frisardi  4 , Federica Piccione  1 , Costanza Muraro  1 , Eleonora Mizzon  1 , Susan D Shenkin  5 , Pinar Soysal  6 , Tomas Welsh  7   8   9 , Hanna-Maria Roitto  10   11 ; Dementia SIG
Affiliations

Management of behavioural and psychological symptoms of dementia: a pragmatic scoping review of European guidelines and literature

Alessandra Coin et al. Eur Geriatr Med. 2025 Jun.

Abstract

Purpose: Dementia prevalence within the European Union (EU) is expected to double by 2050. Behavioural and Psychological Symptoms of Dementia (BPSD) are common, causing burden to patients and caregivers. This pragmatic scoping review aims to synthesize recommendations of European BPSD management guidelines and literature, highlighting areas of consensus and disagreement.

Methods: An electronic literature search, including Medline, PsychINFO, and CINAHL, and Internet search for grey literature were undertaken to identify published BPSD guidelines from the EU, European Economic Area (EEA) and UK, supplemented by contacting EU member countries of European Geriatric Medicine Society (EuGMS).

Results: The literature search found 11 papers describing BPSD management. Of the 32 countries of interest, 22 guidelines were sourced (five confirmed no guidelines, five did not respond). There was a general consensus between the guidelines, as all recommended comprehensive assessment and individualised approaches, with non-pharmacological therapies as first line, but there was disagreement around specific therapies. Psycho-education was most commonly recommended (15 countries). There was general agreement that pharmacological treatment should be used as an adjunct to non-pharmacological interventions, but recommendations differed between medication groups. Short-term atypical antipsychotics were most commonly recommended, especially risperidone (18 countries). 15 countries recommended acetylcholinesterase inhibitors and 12 memantine. 16 countries recommended the use of SSRIs. Recommendations for the use of sedative medications and antiepileptics varied.

Conclusions: This study provides a broad, inclusive overview of current European guidelines for the management of BPSD, demonstrating significant variability. Clinical practice in dementia care throughout Europe needs to be optimised and standardised.

Keywords: BPSD; Dementia; Guidelines; Neuropsychiatric symptoms.

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Conflict of interest statement

Declarations. Conflict of interest: The authors have no conflicts of interest to declare. Ethical approval: This article does not contain any studies with human participants or animals performed by any of the authors. Informed consent: For this type of study, formal consent is not required.

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