Agitated behavior in persons with dementia: The relationship between type of behavior, its frequency, and its disruptiveness

Abstract

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. Conclusion 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.