Natural history of aggressive behaviour in dementia

Keene, Judith; Hope, Tony; Fairburn, Christopher G.; Jacoby, Robin; Gedling, Kathy; Ware, Christopher J. G.

doi:10.1002/(sici)1099-1166(199907)14:7<541::aid-gps961>3.0.co;2-p

Cited by 82 publications

(86 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Disregarding residents' preferences, lack of respect, or loss of the right to make decisions seem to be additional aspects that provoke aggressive behavior. This proposition is corroborated by other authors who maintain that the interpersonal style adopted by a caregiver may trigger aggressive incidents [40,41].…”

Section: Discussionsupporting

confidence: 78%

Aggressive Behavior of Nursing Home Residents Toward Caregivers: A Systematic Literature Review

Zeller¹,

Hahn²,

Needham³

et al. 2009

Geriatric Nursing

View full text Add to dashboard Cite

(Geriatr Nurs 2009;30:174-187) Aggressive behavior of residents continues to challenge and burden caregivers working in nursing homes [1,2]. Working in a nursing home or long-term care facility is associated with a high risk of experiencing aggression [3].Studies show that aggressive behavior is more likely to occur among older people with cognitive impairment than among those with no cognitive impairment [2,4,5] although cognitively intact residents also threaten or assault the caregivers [6]. Irrespective of whether demented residents can be held responsible for their aggressive behavior, many gerontological nurses find that physical or verbal attacks by an elderly person they are giving nursing care to is one of the most difficult, emotionally distressing, and potentially dangerous aspects of their work [7], often resulting in feelings of powerlessness, sadness, anger, and ineffectiveness [8].Some studies have investigated the prevalence of aggression and associated factors in nursing homes, but it is probable that nursing home residents' aggressive behavior often goes underreported in both prevalence measures and nursing documentation. Possible causes for underreporting are a lack of competence to cope with aggressive behavior, feelings of failure, or the assumption that aggressive behavior is a common feature in the care of the elderly, especially those with psychological disturbance [1,4,9,10]. Psychological disturbances and other illnesses in the elderly may lead to aggressive behavior irrespective of situational factors. However, because such illness processes can be influenced only indirectly by nursing

show abstract

Section: Discussionsupporting

confidence: 78%

Aggressive Behavior of Nursing Home Residents Toward Caregivers: A Systematic Literature Review

Zeller¹,

Hahn²,

Needham³

et al. 2009

Geriatric Nursing

View full text Add to dashboard Cite

show abstract

“…The psychosis factor was the sum of scores for hallucinations, persecutory ideas and inappropriate anxiety. Aggressive behaviour included physical aggression, aggressive resistance and verbal aggression [18]. Each component of the syndrome was scored from 0 (absent) to 2 (severe, the behaviour had occurred on half of the days or more in the previous 4 weeks).…”

Section: Patients and Assessment Of Behaviormentioning

confidence: 99%

Involvement of an Altered 5-HT6 Receptor Function in Behavioral Symptoms of Alzheimer's Disease

Marcos

García-Alloza

Gil-Bea

et al. 2008

JAD

View full text Add to dashboard Cite

Abstract. We studied the hypothesis that disturbances in 5-HT6 receptor function in the temporal cortex may contribute to clinical symptoms of Alzheimer's disease (AD). 5-HT6 density and 5-HT levels were significantly decreased in a cohort of AD patients prospectively assessed for cognitive/behavioral symptoms. cAMP formation after stimulation with the selective 5-HT6 receptor agonist E-6801 was significantly lower (p < 0.01) in AD (170.02 ± 27.53 pmol/mg prot.) compared to controls (823.33 ± 196.67). In addition, the ratio cAMP formation after stimulation with E-6801/5-HT6 receptor density was significantly lower (p < 0.01) in AD (6.67 ± 0.83) compared to controls (16.67 ± 3.33). Splitting these results by sex, 5-HT6 receptor activation was significantly lower (p < 0.01) in AD females compared to males (121.67 ± 30.02 vs. 231.67 ± 34.17 pmol/mg prot). 5-HT6 density and 5-HT levels were significantly correlated (p 0.01) in both controls and AD patients, although in AD, this correlation was lost in females. Psychosis factor was the best predictor of reduced 5-HT levels or adenylate cyclase activity after E-6801 stimulation, the former result being due to females. It may be suggested that psychotic symptoms may be related to a dysregulation of 5-HT6 activation by 5-HT in the temporal cortex. These results are discussed in terms of purported influence of sex and therapeutical approaches to psychosis in AD.

show abstract

“…Three different aspects of aggressive behavior were used in this analysis. These were physical aggression, aggressive resistance, and verbal aggression (Keene et al, 1999), and the highest ratings were added together to give the aggressive behavior factor. Each component of the syndrome was scored from 0 to 2.…”

Section: Patients and Assessment Of Behaviormentioning

confidence: 99%

Differential Involvement of 5-HT1B/1D and 5-HT6 Receptors in Cognitive and Non-cognitive Symptoms in Alzheimer's Disease

García-Alloza

Hirst

Chen

et al. 2003

Neuropsychopharmacol

137

View full text Add to dashboard Cite

Growing evidence suggests that a compromised serotonergic system plays an important role in the pathophysiology of Alzheimer's disease (AD). We assessed the expression of 5-HT 1B/1D and 5-HT 6 receptors and cholinacetyltransferase (ChAT) activity in post-mortem frontal and temporal cortex from AD patients who had been prospectively assessed for cognitive function using the Mini-Mental State Examination (MMSE) and behavioral changes using the Present Behavioral Examination (PBE). 5-HT 1B/1D and 5-HT 6 receptor densities were significantly reduced in both cortical areas. 5-HT 1B/1D receptor density was correlated to MMSE decline in the frontal cortex, supporting its implication in memory impairment. The best predictor for lowered 5-HT 6 receptor density in the temporal cortex was the PBE measure of overactivity. The 5-HT 6 /ChAT ratio was related to aggression both in the frontal and temporal cortex. Therefore, antagonists acting at 5-HT 6 receptors could be useful in the treatment of non-cognitive symptoms associated to AD.

show abstract

Natural history of aggressive behaviour in dementia

Cited by 82 publications

References 48 publications

Aggressive Behavior of Nursing Home Residents Toward Caregivers: A Systematic Literature Review

Aggressive Behavior of Nursing Home Residents Toward Caregivers: A Systematic Literature Review

Involvement of an Altered 5-HT6 Receptor Function in Behavioral Symptoms of Alzheimer's Disease

Differential Involvement of 5-HT1B/1D and 5-HT6 Receptors in Cognitive and Non-cognitive Symptoms in Alzheimer's Disease

Contact Info

Product

Resources

About