Logo image
Back
Co-Occurrence and Predictors of Three Commonly Occurring Behavioral Symptoms in Dementia: Agitation, Aggression, and Rejection of Care
Journal article   Peer reviewed

Co-Occurrence and Predictors of Three Commonly Occurring Behavioral Symptoms in Dementia: Agitation, Aggression, and Rejection of Care

Scott Seung W Choi, Chakra Budhathoki and Laura N Gitlin
The American journal of geriatric psychiatry, v 25(5), pp 459-468
May 2017
DOI: https://doi.org/10.1016/j.jagp.2016.10.013
PMID: 27914870
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Aged Aged, 80 and over Aggression - psychology Caregivers - psychology Cognition Disorders - complications Cognition Disorders - psychology Cross-Sectional Studies Dementia - complications Dementia - psychology Female Frustration Humans Male Middle Aged Patient Acceptance of Health Care - statistics & numerical data Psychomotor Agitation - complications Psychomotor Agitation - epidemiology Randomized Controlled Trials as Topic Rejection (Psychology) United States - epidemiology
To investigate co-occurrences of agitation, aggression, and rejection of care in community-dwelling families living with dementia. Cross-sectional, secondary analysis from a randomized controlled trial testing a nonpharmacological intervention to reduce behavioral symptoms. We examined frequency of occurrence of presenting behaviors at baseline and their combination. Omnibus tests compared those exhibiting combinations of behaviors on contributory factors. Multinomial logistic regression analyses examined relationships of contributory factors to combinations of behaviors. Of 272 persons with dementia (PwDs), 41 (15%) had agitation alone (Agi), 3 (1%) had aggression alone, 5 (2%) had rejection of care alone. For behavioral combinations, 65 (24%) had agitation and aggression (Agi+Aggr), 35 (13%) had agitation and rejection (Agi+Rej), 1 (0%) had aggression and rejection, and 106 (39%) had all three behaviors (All). Four behavioral subgroups (Agi, Agi+Aggr, Agi+Rej, and All) were examined. Kruskal-Wallis tests showed that there were significant group differences in PwD cognition, functional dependence, and caregiver frustration. PwDs in Agi+Rej and All were more cognitively impaired than those in Agi and Agi+Aggr. Also, caregivers in All were more frustrated than those in Agi. In logistic regression analyses, compared with Agi, greater cognitive impairment was a significant predictor of Agi+Rej and All, but not Agi+Aggr. In contrast, greater caregiver frustration was a significant predictor of Agi+Aggr and All, but not Agi+Rej. We found that agitation, aggression, and rejection are common but distinct behaviors. Combinations of these behaviors have different relationships with contributory factors, suggesting the need for targeting treatment approaches to clusters.

Metrics

9 Record Views
25 citations in Web of Science
25 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Web of Science research areas
Geriatrics & Gerontology
Gerontology
Psychiatry
Logo image