{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:23:47Z","timestamp":1792790627886,"version":"4.5.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T00:00:00Z","timestamp":1653436800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>High-quality clinical practice guidelines (CPGs) are important for the effective treatment of behavioral and psychological symptoms of dementia (BPSD). However, recommendations provided by different quality guidelines may lead to varied clinical practice outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the quality of available CPGs for the management of BPSD and summarize the best recommendations for treating BPSD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a systematic review of CPGs for the management of BPSD with data obtained from electronic databases and evaluated using the Appraisal of Guidelines for Research and Evaluation II instrument, consisting of six domains: \u201cScope and purpose\u201d, \u201cStakeholder involvement\u201d, \u201cRigor of development\u201d, \u201cClarity of presentation\u201d, \u201cApplicability\u201d, and \u201cEditorial independence\u201d. The criteria for high-quality guidelines were set as: the score of high-quality guidelines in the \u201cRigor of development\u201d domain should be \u226560% and as well as a score of &amp;gt;60% in at least three other domains. High-quality guidelines were selected for recommendation extraction, and the final recommendations were formed in combination with the latest meta-analysis and randomized clinical-trial results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In term of median scores in each domain for the six included CPGs, \u201cScope and purpose\u201d (87.5%) scored better than all others, whereas \u201cApplicability\u201d (46.5%) was the domain with the lowest score. Four CPGs (2015 APA, 2018 NICE, 2018 CANADA, 2020 EAN) met the criteria of high-quality guidelines and were used to extract recommendations. From these four CPGs, nine specific recommendations related to the management of BPSD were summarized, of which seven were related to pharmacological treatment and two to non-pharmacological treatment. These recommendations covered the applicability of antipsychotic drugs, medication recommendations, withdrawal times, and several suitable non-pharmacological therapies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The quality of CPGs for the management of BPSD requires improvement, especially for the \u201cApplicability\u201d domain. For psychotic-like symptoms in dementia, the use of antipsychotics should be based on the individual's risk-benefit ratio, and the use of atypical antipsychotics seems to be a better choice. Non-pharmacological treatments may be suitable for emotional symptoms and sleep disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p><jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD42020209204<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.799723","type":"journal-article","created":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T05:16:37Z","timestamp":1653455797000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":44,"title":["Clinical Practice Guidelines for the Management of Behavioral and Psychological Symptoms of Dementia: A Systematic Review With AGREE II"],"prefix":"10.3389","volume":"13","author":[{"given":"Huixuan","family":"Ma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinliang","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aihong","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiumei","family":"Zuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minmin","family":"Zhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuting","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihui","family":"Lyu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longfei","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianping","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuibai","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,25]]},"reference":[{"key":"B1","unstructured":"LondonAlzheimer's Disease InternationalWorld Alzheimer Report 2019: Attitudes to dementia2019"},{"key":"B2","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1097\/YCO.0b013e32835f414b","article-title":"Agitation and aggression in people with Alzheimer's disease","volume":"26","author":"Ballard","year":"2013","journal-title":"Curr Opin Psychiatry."},{"key":"B3","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1002\/gps.490","article-title":"The cost of behavioral and psychological symptoms of dementia (BPSD) in community dwelling Alzheimer's disease patients","volume":"17","author":"Beeri","year":"","journal-title":"Int J Geriatr Psychiatry"},{"key":"B4","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.maturitas.2013.06.002","article-title":"Coping with dementia in care homes","volume":"76","author":"Corbett","year":"2013","journal-title":"Maturitas."},{"key":"B5","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.arr.2011.07.002","article-title":"Systematic appraisal of dementia guidelines for the management of behavioural and psychological symptoms","volume":"11","author":"Azermai","year":"2012","journal-title":"Ageing Res Rev."},{"key":"B6","doi-asserted-by":"publisher","first-page":"E839","DOI":"10.1503\/cmaj.090449","article-title":"AGREE II: advancing guideline development, reporting and evaluation in health care","volume":"182","author":"Brouwers","year":"2010","journal-title":"CMAJ."},{"key":"B7","doi-asserted-by":"publisher","first-page":"257","DOI":"10.7326\/M16-2020","article-title":"The scientific basis of guideline recommendations on sugar intake: a systematic review","volume":"166","author":"Erickson","year":"2017","journal-title":"Ann Intern Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1136\/bjsports-2018-100310","article-title":"How should clinicians rehabilitate patients after ACL reconstruction? 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