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.