LONGITUDINAL CHANGES IN BEHAVIORAL-PROBLEMS IN OLD-AGE - A STUDY IN AN ADULT DAY-CARE POPULATION

Background. Four types of agitation have been identified: physically a ggressive behaviors, physically nonaggressive behaviors, verbally aggr essive behaviors, and verbally nonaggressive behaviors. These pose a m ajor challenge to caregivers and are sometimes indicators of the emoti onal state of the older person. Longitudinal changes in these four sub types of agitated behaviors were examined. Methods. One hundred and fo ur community-dwelling participants of five senior day care centers (me an age = 79) were followed up for 2 years. Their agitation was assesse d, as was their cognitive functioning, affect, and medical functioning . Results. Although physically nonaggressive, physically aggressive, a nd verbally aggressive behaviors increased significantly over 2 years, verbally nonaggressive behaviors did not show significant changes ove r time. These patterns can be partially explained by the relationship between the different types of agitation and cognitive functioning. In creases in physically nonaggressive behaviors from start to end of the 2 years were predicted by greater cognitive impairment at baseline an d by receiving a smaller number of medications at baseline. Increases in verbally aggressive behaviors and in physically aggressive behavior s during the study period correlated significantly with a greater decl ine in cognitive functioning and increased depression at baseline. In addition, increases in physical aggression were correlated with greate r cognitive impairment at baseline. Conclusions. The course of change for each type of agitation was unique. The relationships between inapp ropriate behaviors, cognitive functioning, physical health, and depres sion over time are complex and vary by type of agitation.