Treating psychiatric disorders in the nursing home: A focus on Alzheimer's disease

Seventy percent to 90% of all nursing home residents have one or more DSM-IV diagnosable psychiatric disorders with the dementias, largely Alzheimer's disease (AD) and its secondary behavioral disturbances. The presence of agitation/aggressivity, psychosis, or mood disturbance in the context of AD is the number one reason for psychiatric consultation in the nursing home. Nearly 80% of AD patients will develop agitation, 40% will experience depression, and 33% will manifest psychotic symptoms. This article will focus on evaluation and management of these disturbances.