Treatment of Dementia due to Cerebrovascular Disease with Behaviour Changes in Vascular Cognitive Impairment
Clinical scenario
This protocol addresses patients with vascular cognitive impairment (VCI) who present with behaviour changes — such as agitation, aggression, or other disruptive or distressing behaviours — in the context of dementia due to cerebrovascular disease. Identifying these behaviour changes requires structured assessment, including interviews with the patient, family members, and members of the wider care team.
Specific situation
The focus is on individuals where behaviour changes are causing clinically significant distress or disruption — to the patient, their caregivers, or those around them — requiring active clinical consideration beyond routine monitoring.
Treatment approach (partial)
Management involves a combined strategy in which pharmacological intervention is considered alongside — not instead of — non-pharmacological approaches, with specialist input playing a key role. The full regimen, sequencing, and criteria for escalation are detailed in the structured protocol.
Full algorithm, options, and thresholds available via the link below →
References
- Individuals with known or suspected VCI should be screened for behaviour changes that may cause distress or disruption, including through interviews with the individual, family members and members of their healthcare team.
- Pharmacological intervention may be considered if the individual, their family or other caregivers are severely distressed, or there is an immediate risk of harm to the individual with VCI or others (i.e., very severe symptoms).
- If pharmacological management is used, this should complement, not replace, non-pharmacological approaches.
- Pharmacological strategies for behavioural management can have potential harm. Involvement of specialists in adult behaviour management should be considered.
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