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Taking the fight out of Alzheimer's and dementia

Taking the fight out of Alzheimer's and dementia Dementia-related aggression could be more problematic than similar behaviors in Alzheimer's because of where each disease affects the brain.

Aggressive behavior is a known issue with dementia and Alzheimer's patients. This activity presents safety risks for family, caregivers and the patients, which is why one recent study sought to examine why individuals with these conditions show aggression.

Lund University researchers determined about 33 percent of frontotemporal dementia or Alzheimer's patients exhibited this behavior toward the aforementioned groups, as well as strangers, other patients and animals. The study gathered its findings from records for 281 deceased individuals from 1967 to 2013, and these materials included patient journals and brain examinations.

In addition to the figure, the researchers produced these insights:

  • Aggressive behavior onset was earlier in frontotemporal dementia patients, possibly as a result of where each condition has origins in the brain.
  • The activity was also more frequent among the dementia group.
  • In addition to frequency, the level of aggression was higher with dementia patients.
  • Alzheimer's patients presented a greater number of violent individuals, yet they were much less aggressive toward strangers than their counterparts (2 percent versus 21 percent).

Why does aggression occur?
Past research has identified various reasons why dementia and Alzheimer's patients lash out physically. These factors have internal and external origins.

For instance, temperature discomfort can prompt aggression. Frequent caregiver changes can also act as a catalyst.

On the internal side, physiological issues could be at play. Infections are one example. Also, psychological factors can lead to aggressive behavior. Patients can exhibit violent actions because they're bored, distrust their caregivers, feel lonely, perceive family and caregivers have ignored them or feel their changing world is threatening.

"Patients can exhibit violent actions because they're bored."

Moreover, the Lund University researchers found dementia sufferers in the study group required less external stimulus:

"A person with frontotemporal dementia can use physical aggression without any provocation, whereas a person with Alzheimer's generally does this if another person approaches them too fast, for example in a nursing care situation," said Madeleine Liljegren, a Lund University doctoral student and study lead author.

At the moment, no pharmacological solutions exist to treat aggressive behaviors in these groups. However, caregivers have behavioral modification strategies they can use.

How do care providers address aggression?
Alzheimer's and dementia patients have access to a variety of treatment options to help with violent tendencies. Some options, such as psychomotor therapy, target long-term behavioral changes.

Other intervention techniques present as in-the-moment responses. One defining trait among these steps is to refrain from blaming or punishing patients. Another is de-escalation. Such actions mean avoiding caregiver-initiated physical contact, calm tones, clear explanations and giving patients space to calm themselves as needed.

Like many treatments, early intervention can lead to greater success. Liljegren noted atypical criminal or socially deviant behavior could be a sign of dementia, and she cautioned friends and family members to seek a physician's opinion sooner rather than later.

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