Development and treatment of aggression in individuals with dementia

Gilmore, Meghan; Stebbins, Lisa; Arguelles-Borge, Soledad; Trinidad, Brizel; Golden, Charles J.

doi:10.1016/j.avb.2020.101415

Cited by 5 publications

(2 citation statements)

References 80 publications

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“…Moreover, it is not possible to assert that the Rasch analysis alone in the DBDS sub-items accurately reflects the degree of difficulty of BPSD in Alzheimer's disease. The appearance of symptoms may be undeniable to vary depending on different situations since BPSD is a symptom that occurs based on biological, psychosocial, and environmental factors [37]. However, the difficulty of the DBDS sub-items in patients with Alzheimer's disease that we have shown in the present study is an important finding because it gives a new perspective that has not been shown previously.…”

Section: Discussionmentioning

confidence: 43%

Difficulty and Change of Sub-items of the Dementia Behavior Disturbance Scale in Patients with Alzheimer-type Dementia

Watanabe

Kawaguchi

Matsuoka³

et al. 2023

Asian J OT

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Objectives: It is difficult to predict behavioral disturbances in patients with Alzheimer's dementia because the order of appearance of behaviors is not clear. This study aimed to clarify the difficulty of the Dementia Behavior Disturbance Scale (DBDS) sub-items in patients with Alzheimer's disease and to compare changes in behavioral disorders after 6 months. Methods: The participants were inpatients with Alzheimer-type dementia hospitalized in participating hospitals for more than a year. They were assessed with the DBDS, the Mini-Mental State Examination (MMSE), and the Functional Independence Measure (FIM) twice: at the initial assessment and after 6 months. Rasch analysis for the sub-items of the DBDS determined the difficulty of behavioral disturbances. Results: The participants were 44 inpatients. There was no significant difference in the DBDS, MMSE, and FIM between the initial assessment and that after 6 months. Even though many participants increased or decreased for each assessment scale, there was no major change in the order of item difficulty of DBDS between the initial assessment and after 6 months. Conclusions:The systematic indication of the difficulty of behavioral disturbances in the DBDS is a new finding. It is possible to rank the difficulty of sub-items of the DBDS and infer behavioral disturbances that are likely to appear in the future. This is useful for clinical decision-making in dementia rehabilitation and care because it indicates the predictability of signs of dementia and behavioral disturbances that suggest the need for dementia intervention.

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Section: Discussionmentioning

confidence: 43%

Difficulty and Change of Sub-items of the Dementia Behavior Disturbance Scale in Patients with Alzheimer-type Dementia

Watanabe

Kawaguchi

Matsuoka³

et al. 2023

Asian J OT

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“…Specifically, increased staffing ratios and environmental designs which optimize visibility in the facility may help to reduce aggressive interactions [5, 16, 22, 24, 26, 27]. Tailored management, including both pharmacological and nonpharmacological approaches, is recommended for aggression management in dementia [18, 66]. Given the particular challenges in assessment and management of older offenders with dementia, there should also be consideration of specialized geriatric forensic psychiatry services [5, 16, 22, 24, 26, 27].…”

Section: Discussionmentioning

confidence: 99%

Homicide and Dementia: A Systematic Review

Sundakov-Krumins

Lubbe

Wand

2022

Dement Geriatr Cogn Disord

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Background: Homicide by older offenders is rare and devastating. It likely occurs due to a complex interaction of personal, social, and environmental factors. Dementia is a progressive neurological condition which may amplify behavioural disturbances such as aggression. This systematic review aims to evaluate the factors associated with homicide committed by people with dementia in order to inform clinical practice. Summary: MEDLINE, PsychINFO, Embase, and PubMed databases were searched in accordance with PRISMA guidelines for empirical studies examining the characteristics and circumstances of people with dementia who committed homicides. Data on factors associated with the homicide were extracted and the quality of each study rated using standardized criteria. A total of 499 papers were screened and thirteen studies met the inclusion criteria. Study design included case reports (seven studies), case series (four studies), and two retrospective cohort studies, indicative of low levels of evidence. Sample sizes were 1–70. Study findings were predominantly descriptive. Quality ratings ranged from 50 to 100%. Factors associated with disinhibition such as dysexecutive syndrome, alcohol use, and delirium may predispose to severe impulsive aggression. Psychosis and personality pathology appeared to influence targeted assaults resulting in homicide by people with dementia. Victim vulnerability was also a key element. Key Messages: The current evidence examining risk factors for homicide committed by people with dementia is limited. However, there are common characteristics reported in these descriptive studies including psychiatric factors and cognitive states causing disinhibition. Recommendations for clinical practice include early assessment of older people with dementia and changed behaviours to allow management of comorbidities and reversible risk factors, alongside education, and advice to carers (who may be targets of aggression). Specialized geriatric forensic psychiatry services and care settings should be developed.

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Geriatric Psychiatry

Price

2022

Malpractice and Liability in Psychiatry

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Development and treatment of aggression in individuals with dementia

Cited by 5 publications

References 80 publications

Difficulty and Change of Sub-items of the Dementia Behavior Disturbance Scale in Patients with Alzheimer-type Dementia

Difficulty and Change of Sub-items of the Dementia Behavior Disturbance Scale in Patients with Alzheimer-type Dementia

Homicide and Dementia: A Systematic Review

Geriatric Psychiatry

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