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Sundown Syndrome in Persons with Dementia: An Update

Sang Joon Son|Nina Khachiyants|David Trinkle|Kye Y. Kim
대한신경정신의학회 (Korean Neuropsychiatric Association)|2011.12|PSYCHIATRY INVESTIGATION|제8권 제4호|pp. 275-287

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참고문헌

키워드

Alzheimer’s diseaseDementia.Sundowning
주제분류정신과학

초록

“Sundowning” in demented individuals, as distinct clinical phenomena, is still open to debate in terms of clear definition, etiology, operationalized parameters, validity of clinical construct, and interventions. In general, sundown syndrome is characterized by the emergence or increment of neuropsychiatric symptoms such as agitation, confusion, anxiety, and aggressiveness in late afternoon, in the evening, or at night. Sundowning is highly prevalent among individuals with dementia. It is thought to be associated with impaired circadian rhythmicity, environmental and social factors, and impaired cognition. Neurophysiologically, it appears to be mediated by degeneration of the suprachiasmatic nucleus of the hypothalamus and decreased production of melatonin. A variety of treatment options have been found to be helpful to ameliorate the neuropsychiatric symptoms associated with this phenomenon: bright light therapy, melatonin, acetylcholinesterase inhibitors, N-methyl-d-aspartate receptor antagonists, antipsychotics, and behavioral modifications. To decrease the morbidity from this specific condition, improve patient’s well being, lessen caregiver burden, and delay institutionalization, further attention needs to be given to development of clinically operational definition of sundown syndrome and investigations on etiology, risk factors, and effective treatment options.

Abstract

“Sundowning” in demented individuals, as distinct clinical phenomena, is still open to debate in terms of clear definition, etiology, operationalized parameters, validity of clinical construct, and interventions. In general, sundown syndrome is characterized by the emergence or increment of neuropsychiatric symptoms such as agitation, confusion, anxiety, and aggressiveness in late afternoon, in the evening, or at night. Sundowning is highly prevalent among individuals with dementia. It is thought to be associated with impaired circadian rhythmicity, environmental and social factors, and impaired cognition. Neurophysiologically, it appears to be mediated by degeneration of the suprachiasmatic nucleus of the hypothalamus and decreased production of melatonin. A variety of treatment options have been found to be helpful to ameliorate the neuropsychiatric symptoms associated with this phenomenon: bright light therapy, melatonin, acetylcholinesterase inhibitors, N-methyl-d-aspartate receptor antagonists, antipsychotics, and behavioral modifications. To decrease the morbidity from this specific condition, improve patient’s well being, lessen caregiver burden, and delay institutionalization, further attention needs to be given to development of clinically operational definition of sundown syndrome and investigations on etiology, risk factors, and effective treatment options.

참고문헌 (141)

  1. Cameron DE, "Studies in senile nocturnal delirium", Psychiatr Q, 15, pp.47~53 (1941)
  2. Kim P, "Sundowning syndrome in the older patient", Clin Geriatr, 13, pp.32~36 (2005)
  3. Hess CW, "Sleep disorders and dementia", Praxis, 86, pp.1343~1349 (1997)
  4. Volicer L, "Sundowning and circadian rhythms in Alzheimer’s disease", Am J Psychiatry, 158, pp.704~711 (2001)
  5. Rindlisbacher P, "An investigation of the sundowning syndrome", Int J Geriatr Psychiatry, 7, pp.15~23 (1992)
  6. Prinz PN, "Aging and Sleep Disorders, in Sleep Disorders: Diagnosis and Treatment" (1978), John Wiley and Sons
  7. Sadock BJ, "Signs and Symptoms in Psychiatry, in Kaplan & Sadock’s Comprehensive Textbook of Psychiatry" (2000), Lippincott Williams & Willkins
  8. Bliwise DL, "What is sundowning", J Am Geriatr Soc, 42, pp.1009~1011 (1994)
  9. Bliwise DL, "Development of an agitated behavior rating scale for discrete temporal observations", J Nurs Meas, 1, pp.115~124 (1993)
  10. Martin J, "Circadian rhythms of agitation in institutionalized patients with Alzheimer’s disease", Chronobiol Int, 17, pp.405~418 (2000)
  11. Cohen-Mansfield J, "Does sundowning occur in residents of an Alzheimer’s unit", Int J Geriatr Psychiatry, 35, pp.101~108 (1989)
  12. Bliwise DL, "Sundowning and rate of decline in mental function in Alzheimer’s disease", Dementia, 3, pp.335~341 (1992)
  13. Evans LK, "Sundown syndrome in institutionalized elderly", J Am Geriatr Soc, 35, pp.101~108 (1987)
  14. Cohen-Mansfield J, "Temporal patterns of agitated nursing home residents", Int Psychogeriatr, 4, pp.197~206 (1992)
  15. Burgio LD, "Studying disruptive vocalization and contextual factors in the nursing home: computer-assisted real-time observation", J Gerontol, 49, pp.P230~P239 (1994)
  16. O’Leary PA, "Behavioral assessment in Alzheimer’s disease: use of a 24-hr log", Psychol Aging, 8, pp.139~143 (1993)
  17. Sloane PD, "Environmental correlates of resident agitation in Alzheimer’s disease special care units", J Am Geriatr Soc, 46, pp.862~869 (1998)
  18. Kutner NG, "Observed Agitation and the Phenomenon of “Sundowning” among SCU Residents, in Research and Practice in Alzheimer’s Disease", pp.151~161 (2000), Springer
  19. Little JT, "Sundown syndrome in severely demented patients with probable Alzheimer’s disease", J Geriatr Psychiatry Neurol, 8, pp.103~106 (1995)
  20. Satlin A, "Circadian locomotor activity and core-body temperature rhythms in Alzheimer’s disease", Neurobiol Aging, 16, pp.765~771 (1995)
  21. "Statistics about Alzheimer’s disease" (2006)[URL]
  22. Duckett S, "Managing the sundowning patient", J Rehabil, 1, pp.24~28 (1993)
  23. U.S. Congress, Office of Technology Assessment, "Special Care Units for People With Alzheimer’s and Other Dementias: Consumer Education, Research, Regulatory, and Reimbursement Issues" (1992), Government Printing Office
  24. Devanand DP, "Behavioral syndromes in Alzheimer’s disease", Int Psychogeriatr, 4(2), pp.161~184 (1992)
  25. Scarmeas N, "Hadjigeorgiou G, Dubois B, et al. Disruptive behavior as a predictor in Alzheimer disease", Arch Neurol, 64, pp.1755~1761 (2007)
  26. Gallagher-Thompson D, "The relations among caregiver stress, “sundowning” symptoms, and cognitive decline in Alzheimer’s disease", J Am Geriatr Soc, 40, pp.807~810 (1992)
  27. Ancoli-Israel S, "Increased light exposure consolidates sleep and strengthens circadian rhythms in severe Alzheimer’s disease patients", Behav Sleep Med, 1, pp.22~36 (2003)
  28. Morley JE, "Nocturnal agitation: Sleep Disorders and Insomnia in the Elderly", Facts Res Gerontology, 7, pp.103~116 (1993)
  29. "What is sundowning? Answer to question “Sundowning: late day confusion”"[URL]
  30. Bliwise DL, "Disruptive nocturnal behavior in Parkinson’s disease and Alzheimer’s disease", J Geriatr Psychiatry Neurol, 8, pp.107~110 (1995)
  31. Grace JB, "A comparison of sleep profiles in patients with dementia with Lewy bodies and Alzheimer’s disease", Int J Geriatr Psychiatry, 15, pp.1028~1033 (2000)
  32. Harper DG, "Differential circadian rhythm disturbances in men with Alzheimer’s disease and frontotemporal degeneration", Arch Gen Psychiatry, 58, pp.353~360 (2001)
  33. Bliwise DL, "Greater daytime sleepiness in subcortical stroke relative to Parkinson’s disease and Alzheimer’s disease", J Geriatr Psychiatry Neurol, 15, pp.61~67 (2002)
  34. Feinberg I, "Sleep electroencephalographic and eye-movement patterns in patients with chronic brain syndrome", J Psychiatr Res, 39, pp.11~26 (1965)
  35. Yesavage JA, "Ancoli-Israel", Annu Rev Med, 57, pp.499~511 (2006)
  36. Swaab DF, "The suprachiasmatic nucleus of the human brain in relation to sex, age and senile dementia", Brain Res, 342, pp.37~44 (1985)
  37. Van Gelder RN, "Blue light and the circadian clock", Br J Ophthalmol, 88, pp.1353~ (2004)
  38. Wu YH, "The human pineal gland and melatonin in aging and Alzheimer’s disease", J Pineal Res, 38, pp.145~152 (2005)
  39. Stopa EG, "Pathologic evaluation of the human suprachiasmatic nucleus in severe dementia", J Neuropathol Exp Neurol, 58, pp.29~39 (1999)
  40. Huitrón-Reséndiz S, "Age-independent and age-related deficits in visuospatial learning, sleep-wake states, thermoregulation and motor activity in PDAPP mice", Brain Res, 928, pp.126~137 (2002)
  41. Huitrón-Reséndiz S, "Sleep-wake states in transgenic mouse models overexpressing the human beta-amyloid precursor protein", Am J Alzheimers Dis Other Demen, 20, pp.87~90 (2005)
  42. Vloeberghs E, "Altered circadian locomotor activity in APP23 mice: a model for BPSD disturbances", Eur J Neurosci, 20, pp.2757~2766 (2004)
  43. Liu RY, "Decreased melatonin levels in postmortem cerebrospinal fluid in relation to aging, Alzheimer’s disease, and apolipoprotein E-epsilon 4", 4 genotype, 1999, pp.84, 323~327
  44. Reiter RJ, "Melatonin reduces oxidant damage and promotes mitochondrial respiration: Implications for aging", Ann N Y Acad Sci, 959, pp.238~250 (2002)
  45. Wu YH, "Molecular changes underlying reduced pineal melatonin levels in Alzheimer’s disease: alterations in preclinical and clinical stages", J Clin Endocrinol Metab, 88, pp.5898~5906 (2003)
  46. Cardinali DP, "The use of melatonin in Alzheimer’s disease", Neuro Endocrinol Lett, 23(1), pp.20~23 (2002)
  47. de Jonghe A, "Effectiveness of melatonin treatment on circadian rhythm disturbances in dementia. Are there implications for delirium? A systematic review", Int J Geriatr Psychiatry, 25, pp.1201~1208 (2010)
  48. Cohen-Mansfield J, "Melatonin for treatment of sundowning in elderly persons with dementia-a preliminary study", Arch Gerontol Geriatr, 31, pp.65~76 (2000)
  49. Klaffke S, "Sundowning and circadian rhythm disorders in dementia", Acta Neurol Belg, 106, pp.168~175 (2006)
  50. Foley DJ, "Sleep complaints among elderly persons: an epidemiologic study of three communities", Sleep, 18, pp.425~432 (1995)
  51. Jelicic M, "Subjective sleep problems in later life as predictors of cognitive decline. Report from the Maastricht Ageing Study (MAAS)", Int J Geriatr Psychiatry, 17, pp.73~77 (2002)
  52. Tractenberg RE, "The sleep disorders inventory: an instrument for studies of sleep disturbance in persons with Alzheimer’s disease", J Sleep Res, 12, pp.331~337 (2003)
  53. Cacabelos R, "APOE-related frequency of cognitive and noncognitive symptoms in dementia", Methods Find Exp Clin Pharmacol, 18, pp.693~706 (1996)
  54. Bliwise DL, "Sleep disorders in Alzheimer’s disease and other dementias", Clin Cornerstone, 6(1A), pp.S16~S28 (2004)
  55. Wake Patterns and Sleep Disorders in Alzheimer’s Disease, in Handbook of Sleep Disorders, "Sleep", pp.1990, Vitiello MV
  56. Bliwise DL, "Sleep and “sundowning” in nursing home patients with dementia", Psychiatry Res, 48, pp.277~292 (1993)
  57. Martin JL, "Nighttime oxygen desaturation and symptoms of sleep- disordered breathing in long-stay nursing home residents", J Gerontol A Biol Sci Med Sci, 60, pp.104~108 (2005)
  58. Horiguchi J, "Nocturnal eating", drinking syndrome and neuroleptic-induced restless legs syndrome, 1999, pp.14, 33~36
  59. Cohen-Mansfield J, "Sleep and agitation in agitated nursing home residents: an observational study", Sleep, 18, pp.674~680 (1995)
  60. Descriptions and Management, in Modern Perspectives in the Psychiatry of Old Age, "Confusional States", pp.1975, Kral VA
  61. Jacobson S, "Clinical Manual of Geriatric Psychopharmacology", pp.580~586 (2007), American Psychiatric Publishing, Inc
  62. Mace N, "The 36 Hour Day", pp.234~235 (2006), Grand Central Publishing
  63. Bachman D, "“Sundowning” and other temporary associated agitation states in dementia patients", Annu Rev Med, 57, pp.499~511 (2006)
  64. Pollak CP, "Sleep problems in the community elderly as predictors of death and nursing home placement", J Community Health, 15, pp.123~135 (1990)
  65. Pollak CP, "Sleep problems and institutionalization of the elderly", J Geriatr Psychiatry Neurol, 4, pp.204~210 (1991)
  66. Lee JH, "Twenty-four-hour rhythms of sleep-wake cycle and temperature in Alzheimer’s disease", J Neuropsychiatry Clin Neurosci, 16, pp.192~198 (2004)
  67. Margiotta A, "Clinical characteristics and risk factors of delirium in demented and not demented elderly medical inpatients", J Nutr Health Aging, 10, pp.535~539 (2006)
  68. Lipowski Z, "Delirium: Acute brain failure in man" (1980), Charles C Thomas
  69. Lipowski ZJ, "Transient cognitive disorders (delirium, acute confusional states) in the elderly", Am J Psychiatry, 140, pp.1426~1436 (1983)
  70. Exum ME, "Sundown syndrome: is it reflected in the use of PRN medications for nursing home residents", Gerontologist, 33, pp.756~761 (1993)
  71. Rabheru K, "Take a S-M-A-R-T Approach: Unpredictable course of dementia symptoms can be managed", Can Fam Physician, 49, pp.389~ (2003)
  72. "Putting the P.I.E.C.E.S. together. Tillsonburg (ON): P.I.E.C.E.S"[URL]
  73. Campbell SS, "Exposure to light in healthy elderly subjects and Alzheimer’s patients", Physiol Behav, 42, pp.141~144 (1988)
  74. McGonigal-Kenney ML, "Non-pharmacologic Management of Agitated Behaviors in Persons with Alzheimer Disease and Other Chronic Dementing Illnesses" (2004), University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core, National Guideline Clearinghouse
  75. Satlin A, "Bright light treatment of behavioral and sleep disturbances in patients with Alzheimer’s disease", Am J Psychiatry, 149, pp.1028~1032 (1992)
  76. Mishima K, "Morning bright light therapy for sleep and behavior disorders in elderly patients with dementia", Acta Psychiatr Scand, 89, pp.1~7 (1994)
  77. Van Someren EJ, "Circadian rest-activity rhythm disturbances in Alzhei-mer’s disease", Biol Psychiatry, 40, pp.259~270 (1996)
  78. Murphy PJ, "Enhanced performance in elderly subjects following bright light treatment of sleep maintenance insomnia", J Sleep Res, 5, pp.165~172 (1996)
  79. Haffmans PM, "Bright light therapy and melatonin in motor restless behavior in dementia: a placebo-controlled study", Int J Geriatr Psychiatry, 16, pp.106~110 (2001)
  80. "Light therapy for managing sleep, behaviour, and mood disturbances in dementia. In The Cochrane Library, 2005. Issue 2. Oxford Update Soft-ware"[URL]
  81. Okawa M, "Sleep-wake disorder and phototherapy in elderly patients with dementia", Biol Psychiatry, 1, pp.837~840 (1994)
  82. Lovell BB, "Effect of bright light treatment on agitated behavior in institutionalized elderly subjects", Psychiatry Res, 57, pp.7~12 (1995)
  83. Uchida K, "Daily rhythm of serum melatonin in patients with dementia of the degenerative type", Brain Res, 717, pp.154~159 (1996)
  84. Dori D, "Chrono-neuroendocrinological aspects of physiological aging and senile dementia", Chronobiologia, 21, pp.121~126 (1994)
  85. Mishima K, "Melatonin secretion rhythm disorders in patients with senile dementia and disturbed sleep-waking", Biol Psychiatry, 45, pp.417~421 (1999)
  86. Balan S, "The relation between the clinical subtypes of delirium and the urinary level of 6-SMT", J Neuropsychiatry Clin Neurosci, 15, pp.363~366 (2003)
  87. Shigeta H, "Postoperative delirium and melatonin levels in elderly patients", Am J Surg, 182, pp.449~454 (2001)
  88. Ohashi Y, "Daily rhythm of serum melatonin levels and effect of light exposure in patients with dementia of the Alzheimer’s type", Biol Psychiatry, 45, pp.1646~1652 (1999)
  89. Olde Rikkert MG, "Melatonin in elderly patients with insomnia. A systematic review", Z Gerontol Geriatr, 34, pp.491~497 (2001)
  90. Monti JM, "A critical assessment of the melatonin effect on sleep in humans", Biol Signals Recept, 9, pp.328~339 (2000)
  91. Asayama K, "Double blind study of melatonin effects on the sleep-wake rhythm, cognitive and non-cognitive functions in Alzheimer type dementia", J Nippon Med Sch, 70, pp.334~341 (2003)
  92. Rao ML, "The influence of phototherapy on serotonin and melatonin in non-seasonal depression", Pharmacopsychiatry, 23, pp.155~158 (1990)
  93. Singer C, "A multicenter, placebo-controlled trial of melatonin for sleep dis-turbance in Alzheimer’s disease", Sleep, 26, pp.893~901 (2003)
  94. Ross JS, "Aricept-induced nightmares in Alzheimer’s disease: 2 case reports", J Am Geriatr Soc, 46, pp.119~120 (1998)
  95. Rogers SL, "Donepezil improves cognition and global function in Alzheimer’s disease: a 15 week, double-blind, placebo-controlled study. Donepezil Study Group", Arch Intern Med, 158, pp.1021~1031 (1998)
  96. Markowitz JS, "Sleep-related outcomes in persons with mild to moderate Alzheimer disease in a placebo-controlled trial of galantamine", Sleep, 26, pp.602~606 (2003)
  97. McKeith I, "Efficacy of rivastigmine in dementia with Lewy bodies: a randomised, double-blinded, placebo-controlled international study", Lancet, 356, pp.2031~2036 (2000)
  98. Jackson S, "The safety and tolerability of donepezil in patients with Alzheimer’s disease", Br J Clin Pharmacol, 58(1), pp.1~8 (2004)
  99. Mizuno S, "Effects of donepezil on Alzheimer’s disease: the relationship between cognitive function and rapid eye movement sleep", Psychiatry Clin Neurosci, 58, pp.660~665 (2004)
  100. Skjerve A, "Improvement in sundowning in dementia with Lewy bodies after treatment with donepezil", Int J Geriatr Psychiatry, 15, pp.1147~1151 (2000)
  101. Simard M, "The acetylcholinesterase inhibitors for treatment of cognitive and behavioral symptoms in dementia with Lewy bodies", J Neuropsychiatry Clin Neurosci, 16, pp.409~425 (2004)
  102. MacLean LE, "Dementia with Lewy bodies treated with rivastigmine: effects on cognition, neuropsychiatric symptoms, and sleep", Int Psychogeriatr, 13, pp.277~288 (2001)
  103. Reading PJ, "Rivastigmine in the treatment of parkinsonian psychosis and cognitive impairment: preliminary findings from an open label trial", Mov Disord, 16, pp.1171~1174 (2001)
  104. Stahl SM, "Examination of nighttime sleep-related problems during double-blind, placebo-controll-ed trials of galantamine in patients with Alzheimer’s disease", Curr Med Res Opin, 20, pp.517~524 (2004)
  105. Herrmann N, "Galantamine treatment of problematic behavior in Alzheimer disease: post-hoc analysis of pooled data from three large trials", Am J Geriatr Psychiatry, 13, pp.527~534 (2005)
  106. Figiel G, "A systematic review of the effectiveness of rivastigmine for the treatment of behavioral disturbances in dementia and other neurological disorders", Curr Med Res Opin, 24, pp.157~166 (2008)
  107. Cummings JL, "Effects of rivastigmine treatment on the neuro-psychiatric and behavioral disturbances of nursing home residents with moderate to severe probable Alzheimer’s disease: a 26-week, multicenter, open-label study", Am J Geriatr Pharmacother, 3, pp.137~148 (2005)
  108. Gauthier S, "EXACT: rivastigmine improves the high prevalence of attention deficits and mood and behaviour symptoms in Alzheimer’s disease", Int J Clin Pract, 61, pp.886~895 (2007)
  109. Cummings JL, "Effects of donepezil on neuropsychiatric symptoms in patients with dementia and severe behavioral disorders", Am J Geriatr Psychiatry, 14, pp.605~612 (2006)
  110. Barak Y, "Donepezil for the treatment of behavioral disturbances in Alzheimer’s disease: a 6-month open trial", Arch Gerontol Geriatr, 33, pp.237~241 (2001)
  111. Paleacu D, "Donepezil for the treatment of behavioral symptoms in patients with Alzheimer’s disease", Clin Neuropharmacol, 25, pp.313~317 (2002)
  112. Wilcock GK, "Memantine for agitation", aggression and psychosis in moderately severe to severe Alzheimer’s disease: a pooled analysis of 3 studies, 2008, pp.69, 341~348
  113. "Topics in Geriatrics: Part 2: Update on managing problem behaviors in Alzheimer’s disease"[URL]
  114. Stoppe G, "Sleep disturbances in the demented elderly: treatment in ambulatory care", Sleep, 18, pp.844~848 (1995)
  115. Tariot PN, "Pharmacological Treatment of Severe Dementia, in Alzheimer’s Disease and Related Disorders Research", pp.653~661 (2003), Ana Asian Int Acad Aging
  116. Ruths S, "Effect of antipsychotic withdrawal on behavior and sleep", wake activity in nursing home residents with dementia: a randomized placebo-controlled, dou-ble-blinded study. The Bergen District Nursing Home Study, 2004, pp.52, 1737~1743
  117. Meguro K, "Risperidone is effective for wandering and disturbed sleep", wake patterns in Alzheimer’s disease, 2004, pp.17, 61~67
  118. Falsetti AE, "Risperidone for control of agitation in dementia patients", Am J Health Syst Pharm, 57, pp.862~870 (2000)
  119. Suh GH, "A rando-mized, double-blind, crossover comparison of risperidone and haloperidol in Korean dementia patients with behavioral disturbances", Am J Geriatr Psychiatry, 12, pp.509~516 (2004)
  120. Katz I, "The efficacy and safety of risperidone in the treatment of psychosis in Alzheimer’s disease and mixed dementia: a meta-analysis of 4 placebo-controlled clinical trials", Int J Geriatr Psychiatry, 22, pp.475~484 (2007)
  121. Street JS, "Olanzapine treatment of psychotic and behavioral symptoms in patients with Alzheimer disease in nursing care facilities: a double-blind, randomized, plaacebo-controlled trial. The HGEU Study Group", Arch Gen Psychiatry, 57, pp.968~976 (2000)
  122. Mintzer JE, "Aripiprazole for the treatment of psychoses in institutionalized patients with Alzheimer dementia: a multicenter, randomized, double-blind, placebo-controlled assessment of three fixed doses", Am J Geriatr Psychiatry, 15, pp.918~931 (2007)
  123. Katz IR, "Comparison of risperidone and placebo for psychosis and behavioral disturbances associated with dementia: a randomized, double-blind trial. Risperidone Study Group", J Clin Psychiatry, 60, pp.107~115 (1999)
  124. Tariot PN, "Quetiapine in nursing home residents with Alzheimer’s dementia and psychosis", Present-ed at the 15th annual meeting of the American Association for Geriatric Psychiatry (2002)
  125. De Deyn P, "Ari-piprazole in dementia of Alzheimer’s type", Presented at the 16th annual meeting of American Association for Geriatric Psychiatry (2003)
  126. Maixner SM, "The efficacy, safety, and tolerability of antipsychotics in the elderly", J Clin Psychiatry, 60(8), pp.29~41 (1999)
  127. Sultzer DL, "CATIE- AD Study Group. Clinical Symptom responses to atypical antipsychotic medications in Alzheimer’s Disease: phase 1 outcomes from the CATIE-AD effectiveness trial", Am J Psychiatry, 165, pp.844~854 (2008)
  128. Standridge JB, "Pharmacotherapeutic approaches to the treatment of Alzheimer’s disease", Clin Ther, 26, pp.615~630 (2004)
  129. Parnetti L, "Therapeutic options in dementia", J Neurol, 247, pp.163~168 (2000)
  130. Knol W, "Antipsychotic drug use and risk of pneumonia in elderly peo-ple", J Am Geriatr Soc, 56, pp.661~666 (2008)
  131. Sacchetti E, "Risk of stroke with typical and atypical anti-psychotics: a retrospective cohort study including unexposed subjects", J Psychopharmacol, 22, pp.39~46 (2008)
  132. Schneider LS, "Risk of death with atypical antipsy-chotic drug treatment for dementia: meta-analysis of randomized pla-cebo-controlled trials", JAMA, 294, pp.1934~1943 (2005)
  133. Herrmann N, "Diagnosis and treatment of dementia: 6. Management of severe Alzheimer disease", CMAJ, 179, pp.1279~1287 (2008)
  134. Salzman C, "Elderly patients with dementia-related symptoms of severe agitation and aggression: consensus statement on treatment options, clinical trials methodology, and policy", J Clin Psychiatry, 69, pp.889~898 (2008)
  135. Riemersma-van der Lek RF, "Effect of bright light and melatonin on cognitive and noncognitive function in elderly residents of group care facilities: a randomized controlled trial", JAMA, 299, pp.2642~2655 (2008)
  136. Vink AC, "Music therapy for people with dementia", Cochrane Database Syst Rev, pp.CD003477~ (2006)
  137. Nguen QA, "The use of aromatherapy to treat behavioural pro-blems in dementia", Int Geriatr Psychiatry, 23, pp.337~346 (2008)
  138. Javadpour A, "An educative support group for family caregivers: impact on caregivers psychological distress and patient’s neuropsychiatry symptoms", Int J Geriatr Psychiatry, 24, pp.469~471 (2009)
  139. Milev RV, "Multisensory stimulation for elderly with dementia: a 24-week single-blind randomized controlled pilot study", Am J Alzheimers Dis Other Demen, 23, pp.372~376 (2008)
  140. Zetteler J, "Effectiveness of simulated presence therapy for individuals with dementia: a systematic review and meta-analysis", Aging Ment Health, 12, pp.779~785 (2008)
  141. Schulz R, "Introduction to the special section on Resources for Enhancing Alzheimer’s Caregiver Health (REACH)", Psychol Aging, 18, pp.357~360 (2003)

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