The Behavioral Psychology of Alzheimer's Disease: Neuropathology, Manifestations, and Non-Pharmacological Management
DOI:
https://doi.org/10.64229/bsbpn936Keywords:
Alzheimer's Disease, Behavioral and Psychological Symptoms of Dementia (BPSD), Neuropsychology, Non-pharmacological Interventions, Person-centered Care, Caregiver BurdenAbstract
Alzheimer's disease (AD) is a progressive neurodegenerative disorder classically defined by its cognitive deficits in memory, language, and executive function. However, the behavioral and psychological symptoms of dementia (BPSD) are nearly universal, often more distressing to patients and caregivers than cognitive decline, and a primary driver of institutionalization. This article provides a comprehensive review of AD from a behavioral psychology perspective. We first delineate the core neuropathological hallmarks of AD-amyloid-beta plaques and neurofibrillary tangles-and link their distribution to the disruption of large-scale neural networks, thereby providing a biological basis for behavioral symptomatology. We then present a detailed analysis of the most prevalent BPSD, including apathy, agitation, aggression, depression, anxiety, psychosis, and disturbances of sleep and appetite. These behaviors are conceptualized not as random symptoms of a damaged brain, but as meaningful expressions of unmet needs, compromised cognitive resources, and maladaptive interactions between the individual and their environment. The article critically evaluates the principal behavioral assessment tools used in both clinical and research settings. A central thesis is that non-pharmacological interventions, grounded in behavioral principles, should be the first-line management strategy for BPSD. We review the empirical support for person-centered care, the Antecedent-Behavior-Consequence (ABC) model, cognitive stimulation therapy, music and reminiscence therapy, and structured caregiver training. While pharmacological options exist, their limitations and risks are highlighted. The conclusion synthesizes the evidence, advocating for a multimodal, individualized, and compassionate approach that prioritizes behavioral understanding and intervention to improve the quality of life for both individuals living with AD and their caregivers.
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