Clinical Aspects of Behavioural and Psychological Symptoms in Vascular Dementia

Dementia is a growing problem that presents increasing challenges for health services worldwide. Vascular dementia is the 2nd most common type of dementia after Alzheimer dementia. The aim of the study is to describe the clinical aspects of behavioural and psychological symptoms in patients aged ≥ 60 years diagnosed with vascular dementia. A cross sectional study was carried out in the Psychiatric Centre at tertiary care hospital from Dec 2018 to May 2019 involving elderly (≥ 60 years) with vascular dementia. Patients with other dementia types, condition and medication that stimulate cognitive disturbances were excluded. The tools used were Hindi mini mental status examination (HMSE), Zarit Burden Interview and the 12- item Neuropsychiatric inventory (NPI). All patients presented with two or more behavioural symptoms, Irritability was the most common symptom (80 %) followed by Night-time behaviour (60 %) and Agitation/ aggression (50 %). There was a significant association between Zarit Score and Behavioural Symptoms (p = 0.023), as well as HMSE and Zarit score (p = 0.03). Caregiver burden showed significant correlation with delusion, hallucination, disinhibition, aberrant motor behaviour and night-time behaviour. Most of the patients had multiple behavioural symptoms. Irritability was the most common symptom followed by night-time behaviour and Agitation

From Evidence to Practice: Denosumab in Osteoporosis and Joint Health

Osteoporosis and osteopenia are prevalent conditions in India, particularly among postmenopausal women and the elderly,leading to increased fracture risks and morbidity. Denosumab, a monoclonal antibody, demonstrates superior efficacyover other treatments in reducing fracture risk and enhancing bone mineral density (BMD). Clinical trials highlight itseffectiveness in preventing periprosthetic bone loss, improving implant stability, and mitigating femoral head collapse invarious conditions; combination therapies involving denosumab further amplify BMD gains and reduce fracture risk. Thearticle reviews the efficacy and safety of denosumab in managing osteoporosis, joint replacement therapy, and avascularnecrosis based on a review of clinical evidence and studies. Denosumab emerges as a cornerstone therapy for osteoporosismanagement, offering multifaceted benefits in fracture prevention, joint replacement therapy, and avascular necrosis