Non-cognitive symptoms of dementia include symptoms such as delusions, hallucinations, depression, anxiety, and apathy. Up to 90% of people with dementia experience non-cognitive symptoms. These symptoms can be managed using non-pharmacological interventions and/or psychotropic medications. Non-pharmacological interventions are non-invasive interventions that do not involve medication and attempt to better manage complex needs. Some examples of non-pharmacological interventions include music therapy, physical exercise and cognitive stimulation therapy. Psychotropic medications are medications capable of affecting the mind, emotions and behaviour through an effect on the chemical makeup of the brain and nervous system. There are a number of different categories of including antipsychotics, antidepressants and hypnotics.
The Irish National Dementia Strategy (Department of Health, 2014) identifies psychotropic prescribing as a key issue. Non-cognitive symptoms of dementia: Guidance on non-pharmacological interventions for healthcare and social care practitioners was published in 2019 by the National Dementia Office to provide detailed information and guidance on the use of non-pharmacological interventions in managing non-cognitive symptoms in people with dementia. Furthermore, the National Clinical Guideline (NCG) on “Appropriate prescribing of psychotropic medication for non-cognitive symptoms in people with dementia” (hereafter referred to as NCG No. 21) was published by the Department of Health in December 2019 to guide the appropriate use of psychotropic medication for non-cognitive symptoms in a person with dementia (in any setting). This is complemented by a clinical algorithm for clinical staff and a “patient and family Information leaflet” for a person living with dementia or caring for a person with dementia, or the general public.
A project is currently underway to implement NCG No. 21 across a range of settings. More information about this project here.