Causes of aggressive behavior in patients with dementia.

Kunik ME, Snow AL, Davila JA, Steele AB, Balasubramanyam V, Doody RS, Schulz PE, Kalavar JS, Morgan RO. Causes of aggressive behavior in patients with dementia. The Journal of clinical psychiatry. 2010 Sep 1; 71(9):1145-52.

Related HSR&D Project(s)

• IIR 01-159 – Causes and Consequences of Aggressive Behavior in Demented Patients

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Abstract:

OBJECTIVE: To examine factors predicting development of aggression. METHOD: Community-dwelling patients over 60 years of age in a Veterans Affairs Medical Center who had a documented ICD-9-CM code for dementia within 12 months of screening and no other dementia codes recorded for 2 preceding years but no aggressive behavior during the 12 months preceding study initiation were assessed every 4 months for 24 months for aggression, depression, pain, patient/caregiver relationship quality (mutuality), involvement in pleasant events, and caregiver burden. The study was conducted from September 5, 2003, to June 10, 2005. RESULTS: Of 215 patients, 89 (41%) developed aggression. In individual models, high baseline mutuality decreased risk of aggression; high burden and pain increased risk. Increases in depression and pain and declines in total mutuality also increased risk. In a full model and step-wise model, high levels of baseline caregiver burden, worst pain, and decline in mutuality over time increased risk of aggression. CONCLUSIONS: Many dementia patients become aggressive. Higher levels of worst pain, caregiver burden, and declining mutuality over time increase risk of aggression.