Dementia and agitation in nursing home residents: How are they related?

Abstract

The link between agitated behaviors and cognitive functioning in 408 nursing home residents was examined. Results showed that cognitively impaired residents manifested aggressive behaviors (e.g., cursing, hitting) and physically nonaggressive behaviors (e.g., pacing). The highest levels of physically nonaggressive behaviors were manifested by those residents who presented intermediate levels of impairment in their performance of activities of daily living. Cognitively intact residents exhibited verbally agitated behaviors (e.g., complaining). These findings have important implications for caregivers of agitated nursing home residents.

Longitudinal Changes in Behavioral Problems in Old Age: A Study in an Adult Day Care Population

“…Previous research in the nursing home and day care populations showed a much clearer relationship of increase in agitation with cognitive decline for physically nonaggressive behaviors as well as for aggressive behaviors in comparison with verbal nonaggressive behaviors (8,11). We therefore examined the time course of each syndrome for three levels of cognitive impairment based on the baseline score of the BCRS: cognitively intact; BCRS 1-2 (n = 27); moderate impairment; 3-5 (n = 43); and severe impairment; 6-7 (n = 34); These are presented in Figures 2-5.…”

Efficacy and safety of risperidone oral solution in agitation associated with dementia in the elderly

“…Patients with cognitive impairment are more prone to aggressive behavior and wandering than those with milder impairment, who show more verbal agitated behaviors. However, this is observed mainly in institutions 23 . A recent nine year prospective study on the relationship between cognition and BPSD in a community sample of demented patients failed to show such tendencies.…”

Foot Massage and Physiological Stress in People with Dementia: A Randomized Controlled Trial

“…This is reflected in the reductions on physiological stress measures seen in the QP group. Losses in social functioning associated with dementia can result in the person with dementia feeling alone and furthermore, when living in a LTC facility, their connection with others may be influenced by the environment, limited staffing and visitors, [2][3][4] as well as by the stigmatization of their disease. 27 Social connections are important 28 and can improve psychological well-being.…”

“…Predisposing factors are related to internal features such as personality and functional and cognitive impairment, and external features including characteristics of the environment. 2 The anxiety associated with unfamiliar surroundings, the disorientation and mental confusion, and the social isolation that accompanies dementia can often create increased stress for people living in long-term care (LTC) settings. 3 Such a response is thought to affect the autonomic nervous system and result in emotional and physical symptoms of distress, 4 and as a result the individual can experience a stress response.…”