The assessment and management of neuropsychiatric symptoms of dementia (NPS) can be challenging. Psychosis, agitation and aggression can pose serious risks to patients and others. Aggressive or sexually inappropriate behavior can have forensic consequences. Ethical dilemmas often arise when balancing safety versus freedom for impaired patients who become incapable of appreciating or respecting moral or legal boundaries. Clinicians often perceive a troublesome disconnect between evidence-based guidelines and the challenges of treating dangerous NPS. Hypertension is well known as a cause of vascular dementia, recent findings highlight the role of hypertension in the pathogenesis of Alzheimer disease as well as mild cognitive impairment. Several studies reported that hypertension and high blood pressure variability are closely associated with cognitive impairment via injury of the small cerebral arteries indicating that long-standing hypertension constitutes a risk of brain matter atrophy or white matter lesions.
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Last date updated on February, 2021