Agitation in alzheimer's disease: a decision tree for healthcare providers

Abstract Agitation in Alzheimer's Disease (AAD) impacts nearly 80% of persons with Alzheimer's Disease and is a cause of significant distress for patients and family/professional caregivers.Clinicians need guidance relative to assessment as well as non-pharmacologic and pharmacologic treatment approaches to AAD. To this end, the Gerontological Society of America (GSA) convened a group of experts representing Geriatric Psychiatry, Gerontological Nursing, Geriatric Medicine, and Long-Term Care to develop a "Decision Tree for Healthcare Providers" in the evaluation and management of AAD. The "Decision Tree" is a practical, user-friendly template for clinicians which provides a step-by-step approach to differential diagnosis of AAD, including conditions such as delirium, pain/discomfort, environmental and psycho-social stressors. The "Decision Tree" also walks the clinician through a range of non-pharmacologic treatment options such as music therapy; activities therapy, environmental modification and de-prescribing. The "Decision Tree" highlights rational use of pharmacotherapies as well as their hazards in this vulnerable population.