How does dementia affect a patient psychologically?

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An explanation of some of the ways in which dementia patients are psychologically affected by the progression of the condition

Question

How does dementia affect a patient psychologically?

Answer

Dementia significantly impacts patients psychologically, manifesting in a range of behavioural and psychological symptoms. These symptoms, collectively known as Behavioural and Psychological Symptoms of Dementia (BPSD), are prevalent in up to 90% of dementia patients and include depression, anxiety, agitation, aggression, delusions, and hallucinations (Kwon and Lee, 2021; Aarsland, 2020; Werner, 2022; Aarsland, 2020).

Key Psychological Effects of Dementia

Depression and Anxiety: These are common in dementia patients, with prevalence rates often exceeding 20% (Kwon and Lee, 2021; Kim, Noh and Kim, 2021). Anxiety and depression can exacerbate cognitive decline and increase caregiver burden (Aarsland, 2020; Kim, Noh and Kim, 2021).

Psychosis: Delusions and hallucinations are significant components of dementia-related psychosis, particularly in advanced stages. These symptoms can lead to increased caregiver stress and are more common in certain types of dementia, such as Lewy body dementia (Aarsland, 2020; Aarsland, 2020).

Agitation and Aggression: These behaviours are prevalent and can complicate care, leading to increased use of psychotropic medications and higher caregiver distress (Anantapong et al., 2025; Sidenkova, 2021).

Apathy and Irritability: Apathy is one of the most common symptoms, affecting up to 32% of patients, and is associated with decreased engagement in daily activities (Kwon and Lee, 2021; Kim, Noh and Kim, 2021).

Sleep and Eating Disorders: These are also prevalent, contributing to the overall psychological burden on patients and complicating care management (Kwon and Lee, 2021; Anantapong et al., 2025).

Impact on Caregivers

The psychological symptoms of dementia not only affect patients but also significantly impact caregivers, increasing their emotional and physical burden. The severity of BPSD is closely linked to caregiver distress, highlighting the need for supportive interventions (Kim, Noh and Kim, 2021; Werner, 2022; Sidenkova, 2021).

Dementia profoundly affects patients psychologically, with symptoms like depression, anxiety, psychosis, and agitation being common. These symptoms not only deteriorate the quality of life for patients but also place a significant burden on caregivers. Understanding and managing these symptoms are crucial for improving care and support for both patients and their families.

References

Kwon, C., & Lee, B., 2021. Prevalence of Behavioural and Psychological Symptoms of Dementia in Community-Dwelling Dementia Patients: A Systematic Review. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.741059

Aarsland, D., 2020. Epidemiology and Pathophysiology of Dementia-Related Psychosis.. The Journal of clinical psychiatry, 81 5. https://doi.org/10.4088/JCP.AD19038BR1C

Kim, B., Noh, G., & Kim, K., 2021. Behavioural and psychological symptoms of dementia in patients with Alzheimer’s disease and family caregiver burden: a path analysis. BMC Geriatrics, 21. https://doi.org/10.1186/s12877-021-02109-w

Werner, P., 2022. Like beauty and contact lenses, the meaning of dementia behavioural changes is in the eyes of the beholder. International Psychogeriatrics, 35, pp. 59 – 61. https://doi.org/10.1017/S104161022200120X

Aarsland, D., 2020. Impact of Dementia-Related Psychosis on Patients and Caregivers: The Treatment Imperative.. The Journal of clinical psychiatry, 81 6. https://doi.org/10.4088/jcp.ad19038br2c

Anantapong, K., Jiraphan, A., Aunjitsakul, W., Sathaporn, K., Werachattawan, N., Teetharatkul, T., Wiwattanaworaset, P., Davies, N., & Sampson, E., 2025. Behavioural and psychological symptoms of people with dementia in acute hospital settings: a systematic review and meta-analysis. Age and Ageing, 54. https://doi.org/10.1093/ageing/afaf013

Sidenkova, A., 2021. 549 – Psychosocial factors in the formation of non-cognitive symptoms of dementia. International Psychogeriatrics, 33, pp. 91 – 91. https://doi.org/10.1017/S1041610221002441

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