{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T13:03:59Z","timestamp":1784639039558,"version":"3.55.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":62,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007132","name":"Otsuka Pharmaceutical Co., Ltd.","doi-asserted-by":"crossref","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/501100007132","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100007132","name":"Otsuka Pharmaceutical Co., Ltd.","doi-asserted-by":"crossref","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/501100007132","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100007132","name":"Otsuka Pharmaceutical Co., Ltd.","doi-asserted-by":"crossref","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/501100007132","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Agitation, a behavioural and psychological symptom of dementia, is under-recognized in Japan. To describe the physician\u2019s perceptions and treatment practice for agitation in Alzheimer\u2019s dementia (AAD) in Japan, we conducted a cross-sectional web-based survey in October 2024. The survey included physicians in neurology, neurosurgery, psychiatry, or general internal medicine who were registered with the survey panel; consented to participation; affiliated with hospitals or clinics; treating\u2009\u2265\u200910 people with Alzheimer\u2019s dementia (AD)\/month. Responses from 529 physicians showed that they treated an average of 35.0 people with AD per month, of whom 8.4 (24%) had AAD. When asked what \u201cagitation\u201d brought to mind, physicians most commonly selected the Japanese term for \u201cexcitability\u201d, corresponding to the \u201cagitation\/aggression\u201d item in the Neuropsychiatric Inventory (58.6%). In general internal medicine, 24.2% were unaware of agitation. Anti-dementia drugs (91.7%) were most frequently selected as new medications for AD, whereas in psychiatry, antipsychotics were most frequently selected (95.8%), and side effects were cited more often as a key consideration than in other specialties. These results suggest that perceptions and treatment practices vary by specialty, particularly reflected in common antipsychotic prescriptions with higher safety awareness among psychiatrists and limited recognition of AAD in others, especially in general internal medicine.<\/jats:p>","DOI":"10.1038\/s41598-026-51118-5","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T18:46:50Z","timestamp":1778179610000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Physicians\u2019 perceptions and treatment practices for agitation associated with Alzheimer\u2019s dementia vary by specialty in Japan"],"prefix":"10.1038","volume":"16","author":[{"given":"Shunichiro","family":"Shinagawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Onuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"51118_CR1","unstructured":"Ninomiya, T. Ninchisho oyobi keido ninchi shogai no yubyoritsu chosa narabi ni shorai suikei ni kansuru kenkyu hokokusho (in Japanese). (2023). https:\/\/www.eph.med.kyushu-u.ac.jp\/jpsc\/uploads\/resmaterials\/0000000111.pdf?1715072186"},{"key":"51118_CR2","doi-asserted-by":"publisher","first-page":"e70235","DOI":"10.1002\/alz.70235","volume":"21","author":"Alzheimer\u2019s Association","year":"2025","unstructured":"Alzheimer\u2019s Association. 2025 Alzheimer\u2019s Disease Facts and Figures. Alzheimers Dement. 21, e70235; 10.1002\/alz.70235 (2025).","journal-title":"Alzheimers Dement."},{"key":"51118_CR3","unstructured":"International Psychogeriatric Association. The IPA complete guides to behavioral and psychological symptoms of dementia. (2010). https:\/\/www.ipa-online.org\/resources\/publications\/guides-to-bpsd"},{"key":"51118_CR4","doi-asserted-by":"publisher","first-page":"14138","DOI":"10.1038\/s41598-022-18470-8","volume":"12","author":"K Pinyopornpanish","year":"2022","unstructured":"Pinyopornpanish, K. et al. Impact of behavioral and psychological symptoms of Alzheimer\u2019s disease on caregiver outcomes. Sci. Rep. 12, 14138 (2022).","journal-title":"Sci. Rep."},{"key":"51118_CR5","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1016\/j.jamda.2012.09.027","volume":"14","author":"G Selbaek","year":"2013","unstructured":"Selbaek, G., Engedal, K. & Bergh, S. The prevalence and course of neuropsychiatric symptoms in nursing home patients with dementia: a systematic review. J. Am. Med. Dir. Assoc. 14, 161\u2013169 (2013).","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"51118_CR6","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1002\/gps.5030","volume":"34","author":"R Halpern","year":"2019","unstructured":"Halpern, R. et al. Using electronic health records to estimate the prevalence of agitation in Alzheimer disease\/dementia. Int. J. Geriatr. Psychiatry. 34, 420\u2013431 (2019).","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"51118_CR7","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1017\/S1041610222001041","volume":"36","author":"M Sano","year":"2024","unstructured":"Sano, M. et al. Agitation in cognitive disorders: Progress in the International Psychogeriatric Association consensus clinical and research definition. Int. Psychogeriatr. 36, 238\u2013250 (2024).","journal-title":"Int. Psychogeriatr."},{"key":"51118_CR8","doi-asserted-by":"publisher","first-page":"89","DOI":"10.3233\/JAD-210105","volume":"83","author":"E Jones","year":"2021","unstructured":"Jones, E. et al. Agitation in Dementia: Real-World Impact and Burden on Patients and the Healthcare System. J. Alzheimers Dis. 83, 89\u2013101 (2021).","journal-title":"J. Alzheimers Dis."},{"key":"51118_CR9","doi-asserted-by":"publisher","first-page":"663","DOI":"10.3233\/JAD-215670","volume":"88","author":"J Schein","year":"2022","unstructured":"Schein, J. et al. The Impact of Agitation in Dementia on Caregivers: A Real-World Survey. J. Alzheimers Dis. 88, 663\u2013677 (2022).","journal-title":"J. Alzheimers Dis."},{"key":"51118_CR10","unstructured":"Research Group for the Development of Clinical Guidelines on New Anti-A\u03b2 Antibody Drugs for Alzheimer\u2019s Disease and Psychotropic Medications for BPSD. (2024 Health and Labour Sciences Research Grant). Guideline for the use of psychotropic medications to manage BPSD for primary care physicians and dementia support doctors. 3rd ed. (in Japanese). (2025). https:\/\/dementia-japan.org\/wp-content\/uploads\/2025\/06\/guideline.pdf"},{"key":"51118_CR11","unstructured":"Ministry of Health. Labour and Welfare. Survey on Appropriate Use of Psychotropic Drugs by Primary Care Physicians for Dementia Patients (in Japanese). (2021). https:\/\/mhlw-grants.niph.go.jp\/project\/25227"},{"key":"51118_CR12","unstructured":"Otsuka Pharmaceutical Co., Ltd. Otsuka Obtains Additional Indication for Rexulti\u00ae in Japan as an Adjunctive Treatment for Agitation Associated with Dementia due to Alzheimer\u2019s Disease. https:\/\/www.otsuka.co.jp\/en\/company\/newsreleases\/2024\/20240924_2.html (2024)."},{"key":"51118_CR13","doi-asserted-by":"publisher","first-page":"1687","DOI":"10.1002\/alz.12335","volume":"17","author":"A De Mauleon","year":"2021","unstructured":"De Mauleon, A. et al. Agitation in Alzheimer\u2019s disease: Novel outcome measures reflecting the International Psychogeriatric Association (IPA) agitation criteria. Alzheimers Dement. 17, 1687\u20131697 (2021).","journal-title":"Alzheimers Dement."},{"key":"51118_CR14","unstructured":"Ikeda, M. et al. Agitation in Japan: an overview and the Japanese definition. (in Japanese). Dementia Japan. in the press (2026)."},{"key":"51118_CR15","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.2174\/1567205013666160502123129","volume":"13","author":"CA Kohler","year":"2016","unstructured":"Kohler, C. A. et al. Neuropsychiatric Disturbances in Mild Cognitive Impairment (MCI): A Systematic Review of Population-Based Studies. Curr. Alzheimer Res. 13, 1066\u20131082 (2016).","journal-title":"Curr. Alzheimer Res."},{"key":"51118_CR16","first-page":"3","volume":"1","author":"H Yamaguchi","year":"2017","unstructured":"Yamaguchi, H. et al. Trends of BPSD, evaluated with NPI, in outpatients of the Medical Center for Dementia. (in Japanese). Tokyo J. Dement. Care Res. 1, 3\u201310 (2017).","journal-title":"Tokyo J. Dement. 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Pharmacoepidemiol"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-51118-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-51118-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-51118-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T12:32:41Z","timestamp":1784637161000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-51118-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,7]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["51118"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-51118-5","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,7]]},"assertion":[{"value":"16 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 July 2026","order":6,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":7,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The original online version of this Article was revised: The original version of this Article contained an error in the layout of Table 2, where \u2018BPSD\u2019 was omitted from first column in the top row. The original Article has been corrected.","order":8,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Author S.S. has received speaking and lecture fees from Otsuka Pharmaceutical, Kowa, Sumitomo Pharma, Eisai, Takeda Pharmaceutical, MSD, Lundbeck, Eli Lilly Japan, and Viatris Pharmaceutical. He has also served advisory roles for Eisai, Otsuka Pharmaceutical, Eli Lilly Japan, and Ono Pharmaceutical. Authors K.O. and K.S. are employees of Otsuka Pharmaceutical Co., Ltd.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"21081"}}