" Well, the term BPSD, behavioral and psychological symptoms of dementia is something that is created by physicians to describe signs and symptoms of illness and that’s typically the way physicians work because they need to differentiate different kinds of illnesses from one another so that they can devise the treatments that are appropriate to each. But there are what they very often refer to as symptoms of dementia can also be thought of from the perspective of a person who is diagnosed as behavioral and psychological signs of distress or basic personal signs of distress — if people are upset. For example, if suddenly you couldn’t tie your shoelaces anymore or sign your name after you spent a lifetime doing it, you might be upset about that or even depressed about it. So that’s not really a symptom of dementia as much as it is a very appropriate reaction to a loss that matters to you. And so if a person is depressed or saddened or gets angry about not being able to do something that he or she always was able to do, that’s really not a sign of disease as much as it is a symptom of being able to figure out that I ought to be able to do this, I can’t do it, I have always been proud of my ability to do that and now I can’t and that really upsets me. And how people express their feelings of being upset can vary, some people can become depressed, some people could scream, so these kinds of reactions are very often perfectly appropriate and the irony of all this of course is that if a person has incurred those kinds of losses and they don’t react at all, then from a medical point of view, they are described as unaware of their deficits. So in a crazy sort of way, you can’t win from that point of view. Either you are showing signs of disease or you are showing a different kind of sign of disease in that you are not aware that you have a problem. "
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