Although the cognitive impairments in dementia are the defining aspect, the non-cognitive changes such as behavioural disturbance and personality change are very common and may cause great distress to the patient and the carer. This article reviews the definition, prevalence and nature of behavioural disturbance in dementia. In addition, we review assessment scales and published reports of psychological, physical and psychosocial management strategies. Finally, we present the results of a successful randomized controlled trial of an individualized intervention package for behavioural manifestations of dementia. We conclude that this approach can help alleviate some of the distressing symptoms of dementia.