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Study Suggests Aggressive Behavior Prevalent in Veterans with Dementia


Understanding aggression and other behavioral manifestations of dementia is becoming increasingly important as the number of persons with dementia increases. While prevalence rates of aggression vary from 30% to 64%, the true nature of aggression in community-dwelling persons with dementia is poorly understood. This study examined aggressive behavior in 400 community-dwelling Veterans, 60 years or older and newly diagnosed with dementia at one VAMC, who were non-aggressive at the beginning of the study. Veterans and caregivers were assessed over 24 months via home visits and telephone. Aggression was defined as present when a Veteran scored higher than 0 on both the frequency and disruptiveness scales for any of the 13 behaviors that represent aggression (e.g., spitting at a person, cursing/verbal aggression, hitting [including self], kicking, pushing, and biting).

Findings show that 40.9% of initially non-aggressive Veterans with dementia became aggressive within the 24-month study period, and most aggression was verbal. Verbal aggression was associated with the highest levels of disruptiveness, with 69.3% of verbally aggressive behaviors considered moderately or extremely disruptive, while 39.8% of physically aggressive behaviors and 12.5% of sexually aggressive behaviors were considered moderately or extremely disruptive. Results also show that most caregivers were women (94%), and there were no significant differences found in aggressive vs. non-aggressive Veterans with dementia in terms of demographics. This knowledge, and a better understanding of aggression’s underlying cause, may potentially provide better treatment to individuals with dementia at a lower cost.

McNeese T, Snow A, Rehm L, Massman P, Davila J, Walder A, Morgan R, and Kunik M. Type, frequency, and disruptiveness of aggressive behavior in persons with dementia. Alzheimer’s Care Today October/December 2009;10(4):204-211.

This study was funded by HSR&D. Dr. Kunik is part of HSR&D’s Houston Center for Quality of Care and Utilization Studies.

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What are HSR&D Publication Briefs?

HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.