Analysis of behavioral disturbances among community-dwelling elderly with Alzheimer disease

One hundred seven community-dwelling elderly patients with Alzheimer diseas e were enrolled in a study to evaluate the characteristics specific to the patients' and caregivers' situations that are associated with behavioral di sturbances and to examine how these disturbances are related to caregiving stress. The frequencies of the disturbance were assessed by using the Troub lesome Behavior Scale according to its three categories, agitation, hyperac tivity, and miscellaneous. The patients' characteristics found to contribut e most to their own behavioral disturbances were visual and speech function , activities of daily living, years of education, cognitive function, and s ex, whereas the caregivers' characteristics contributing to these disturban ces were duration of caregiving, age of caregiver, and relationship to the patient. In addition, a mutual relation among the three categories was foun d. Among the three categories, agitation was most strongly related to the c aregivers' psychologic health status rated by use of the General Health Que stionnaire. Behavioral disturbance as a whole was the only predictor of the patient's institutionalization within 2 years after baseline examination. Thus, behavioral disturbances were found to be influenced by the personal c haracteristics and situational circumstances of both the patient and caregi ver, influencing, in turn, the caregivers' psychologic health status.