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PBA is nothing to laugh about

August 7, 2014
by Sandra Hoban, Managing Editor
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One in 10 seniors in the Grand Rapids, Mich, area is subject to uncontrollable laughter, tears or anger caused by pseudobulbar affect (PBA), a neurologic condition, a recent study found. This condition can present a frustrating quality-of-life issue because the individual has no idea why he or she is behaving inappropriately.

Kevin T. Foley, MD, an associate professor of Michigan State University’s College of Human Medicine, presented the researchers’ findings at the Alzheimer’s Association International Conference in July. The cause of PBA is unknown. Theories focus on the bulbar nuclei, which control the muscle movement of laughing and crying, according to a Michigan Live article.

Researchers reviewed charts from all the residents of nine Michigan nursing homes (811) that were similar to the national average in size and regulatory compliance. Data were collected from 418 residents who had neurologic diagnoses. Residents with a diagnosis of psychosis were excluded from the study.

Their efforts showed that PBA often is misdiagnosed as depression or is treated with antipsychotic medications as a way to manage disruptive behavior. In the analysis, 18 percent of residents with a neurologic disorder (Alzheimer’s disease or stroke) exhibited symptoms of PBA.

The authors recommend additional study to find ways to identify people with PBA to ensure an accurate diagnosis and the reduction in use of antipsychotic drugs. Antipsychotic drugs have been linked to stroke, pneumonia and other serious conditions, they note.

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