Dementia is a mental deterioration that impairs judgment, thinking and memory. It is much more common in elderly people. Dementia symptoms may appear in patients with Alzheimer's disease, vascular dementia, Lewy body dementia, Parkinson's disease, Huntington's disease and other conditions. One disturbing dementia symptom is aggression. Understanding the cause of aggression can help caregivers manage it properly, and avoid or reduce the severity of future episodes.
Depression
A study in a 1999 issue of "The American Journal of Psychiatry" explored the relationship between aggression and depression in people with a diagnosis of dementia. It found a strong association between moderate to severe depression and physically aggressive behavior.
Overstimulation
Overstimulation can lead to aggressive behavior, explains the Alzheimer's Association. Loud, unexpected noises or a chaotic environment may be more than the patient can deal with, causing him to lash out. Constant sounds coming from a TV or radio can fray the nerves of the elderly patient. Noisy, busy children or an influx of chattering adults may prove to be too stimulating.
Fear
Fear can produce an aggressive response in an elderly dementia patient. The surroundings may look unfamiliar, or a caregiver invading the dementia patient's personal space may not be recognized. The patient may not know what to expect and feel as if she is being held prisoner far away from familiar surroundings or loved ones.
Humiliation
Loss of bowel or bladder control can be humiliating for any adult, and the elderly are not exempt. Being forced to ask for food, being told what to do and forgetting one's own name are all potential realities for the person with dementia. These and other indignities can easily lead to humiliation, which can manifest as aggressive behavior.
Frustration
Task-performance abilities can drastically decline during the course of dementia. An inability to communicate one's needs and understand verbal communication can prove frustrating to the patient. Resultant aggression may be displayed against self, objects or others in the vicinity.
Pain
Physical pain and discomfort are strong stimuli for aggressive behavior. The pain may be coming from a headache, stomachache or joint pain that the patient cannot articulate; discomfort may result from being cold or sitting in wet underwear for hours.
Medication
Many of the drugs commonly taken by elderly patients have neurological or psychiatric side effects. Medications taken for mental issues, as well as drugs taken for other chronic or acute conditions, may be at the root of aggressive behavior.
References
- Alzheimer's Association: Behaviors: What Causes Dementia-Related Behavior Like Aggression, and How to Respond
- "The American Journal of Psychiatry"; Physical Aggression in Dementia Patients and Its Relationship to Depression; Constantine G. Lyketsos, M.D., M.H.S., et al.; 1999
- Alzheimer's Society: Dealing With Aggressive Behaviour
