Agitated behavior in persons with dementia: the relationship between type of behavior, its frequency, and its disruptiveness.
OBJECTIVE
To examine the relationship between type, frequency, and level of disruptiveness of physically aggressive agitated behaviors, physically non-aggressive agitated behaviors, verbally aggressive agitated behaviors, and verbally non-aggressive agitated behaviors in persons with dementia.


METHODS
The study was conducted in 11 nursing homes in Maryland, one of which housed two participating buildings. Participants were 191 older nursing home residents with dementia. Cohen-Mansfield Agitation Inventory (CMAI) data provided information on frequency and level of disruptiveness of the different types of agitated behavior.


RESULTS
The highest overall frequencies were reported for verbal non-aggressive behaviors and the highest average disruptiveness was for verbal aggression. Frequency and disruptiveness of behaviors were highly correlated. Disruptiveness was highly correlated across shifts for all syndromes; a difference in magnitude of disruptiveness between shifts was only evident for physically non-aggressive behaviors (such as pacing), which were more disruptive on the day shift than on the evening shift. When controlling for frequency of behavior, physically aggressive behaviors were the most disruptive across both shifts.


CONCLUSIONS
In understanding the impact of agitated behaviors, it is important to take into account both the type of behavior and its frequency. Overall disruptiveness of a type of behavior is different from disruptiveness when the frequency of the behavior is controlled.
Cohen-Mansfield
Jiska
J
Research Institute on Aging of CES Life Communities, Hebrew Home of Greater Washington, 6121 Montrose Road, Rockville, MD 20852, United States. cohen-mansfield@hebrew-home.org
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression / Q000502:physiology / Q000523:psychology; D000544:Alzheimer Disease / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D003072:Cognition Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D003704:Dementia / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D015140:Dementia, Vascular / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D008134:Long-Term Care; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology; D008875:Middle Aged; D009483:Neuropsychological Tests; D009735:Nursing Homes / Q000706:statistics & numerical data; D015995:Prevalence; D011595:Psychomotor Agitation / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D012720:Severity of Illness Index; D014705:Verbal Behavior / Q000502:physiology