Physical aggression in dementia patients and its relationship to depression

Objective: The goal of this study was to determine the frequency of physica lly aggressive behavior in community-residing patients with dementia and it s relationship to depression. Method: A consecutive series of 541 patients with DSM-IV-defined dementia underwent comprehensive neuropsychiatric evalu ation and were rated on the Cornell Scale for Depression in Dementia, the M ini-Mental State, the Psychogeriatric Dependency Rating Scale, and the Gene ral Medical Health Rating. Results: Physically aggressive behavior was exhi bited by 79 patients in the 2 weeks before evaluation. Aggressive behavior was closely associated with moderate to severe depression, male gender, and greater impairment in activities of daily living, even after adjustment fo r delusions, hallucinations, sleep disturbance, and severity of cognitive i mpairment. After adjustment for depression, gender, and impairment in activ ities of daily living, there was no association between physically aggressi ve behavior and the presence of either delusions or hallucinations. Conclus ions: A substantial minority of patients with dementia exhibit physically a ggressive behavior, and this aggression is strongly linked with the presenc e of depressive symptoms. It is possible that the identification and treatm ent of depression in dementia may be a means of preventing and managing phy sically aggressive behavior.