Agitation is a behavioral problem that frequently occurs in patients with dementia, according to the journal "American Family Physician". Agitation is characterized by physical or verbal outbursts, pacing, emotional distress, restlessness and combativeness. It is troubling to caregivers and can be challenging to treat. Many factors can cause agitation. Treatment for agitation in dementia depends on the cause. (Reference 1)
Identify and Treat the Underlying Cause
Although agitation can result from the effects of dementia on the brain, it is also commonly caused by an underlying medical or psychiatric condition. Agitation can occur when a person with dementia is suffering from a urinary tract infection, pneumonia, anxiety, psychosis or delirium. Pain is a common and often-overlooked cause of agitation, the "American Journal of Psychiatry" explains. People with dementia may be unable to communicate their symptoms. Unnecessary suffering and worsening agitation results when pain is not treated. (Reference 3) All dementia patients who become agitated should receive a thorough exam to determine if a treatable underlying condition is the cause, according to the Alzheimer's Association. (Reference 4)
Non-Drug Interventions
Non-drug methods of treating agitation are proven to be effective in dementia when an underlying problem is not the cause, says "American Family Physician". Distracting an agitated patient is more effective than trying to reason with them. Asking yes-or-no questions can be less frustrating for a patient than those requiring more thought. Pet therapy and therapeutic dance, music, art and exercise can reduce agitation. A consistent schedule and routines reduces stress. (Reference 3) The Alzheimer's association advises checking for hunger, thirst, pain, constipation, a full bladder and fatigue. (Reference 4)
Medications
When underlying causes for agitation have been ruled out and consistently applied non-drug methods have not been effective, medication may be the next step for patients with severe symptoms. Experts recommend starting with a low dose of one medication in order to target the behavior and minimize the risk of side effects. Antipsychotic drugs increase the risk of death in dementia patients, warns the Alzheimer's association, and should only be used for severe cases of agitation characterized by ongoing, inconsolable distress and danger to self or others. Medications are most effective when combined with non-drug approaches, the Alzheimer's Association explains. (Reference 4)
References
- American Academy of Family Physicians: Behavior Disorders of Dementia: Recognition and Treatment
- American Academy of Family Physicians: Guidelines for Managing Alzheimer's Disease: Part II. Treatment
- American Journal of Psychiatry: Pain: Cause of Agitation in Elderly Individuals With Dementia
- ALZ: Alzheimer's Association: Standard Treatments
