Agitation in dementia: Concept clarification

Journal of Advanced Nursing

Volumn 52, Issue 5, 2005, Pages 526-536

  Kong, Eun Hi ^a  

^a UNIVERSITY OF PENNSYLVANIA   (United States)

Author keywords

Agitation; Concept clarification; Dementia; Literature review; Nursing

Indexed keywords

AGGRESSION; ARTICLE; DEMENTIA; HEALTH PERSONNEL ATTITUDE; HUMAN; NURSING STAFF; PSYCHOLOGICAL ASPECT; QUESTIONNAIRE; RESTLESSNESS;

AGGRESSION; ATTITUDE OF HEALTH PERSONNEL; DEMENTIA; HUMANS; NURSING STAFF; PSYCHOMOTOR AGITATION; QUESTIONNAIRES;

EID: 28044446298     PISSN: 03092402     EISSN: 13652648     Source Type: Journal    
DOI: 10.1111/j.1365-2648.2005.03613.x     Document Type: Article

References (106)

1. Algase D.L., Beck C., Kolanowski A., Whall A., Berent S., Richards K. & Beattie E. (1996) Need-driven dementia-compromised behavior: an alternative view of disruptive behavior. American Journal of Alzheimer's Disease & Other Dementias 11, 10-19.
2. Allen L.A. (1999) Treating agitation without drugs. American Journal of Nursing 99, 36-41.
3. American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders: DSM-III. American Psychiatric Association, Washington.
4. American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. American Psychiatric Association, Washington.
5. Ancill R.J., Carlyle W.W., Liang R.A. & Holliday S.G. (1991) Agitation in the demented elderly: a role for benzodiazepines? International Clinical Psychopharmacology 6, 141-146.
6. Aronson M.K., Post D.C. & Guastadisegni P. (1993) Dementia, agitation, and care in the nursing home. Journal of the American Geriatrics Society 41, 507-512.
7. Asada T., Kinoshita T. & Kakuma T. (2000) Analysis of behavioral disturbances among community-dwelling elderly with Alzheimer disease. Alzheimer Disease & Associated Disorders 14, 160-167.
8. Ballard C.G., Margallo-Lana M., Fossey J., Reichelt K., Myint P., Potkins D. & O'Brien J. (2001) A 1-year follow up study of behavioral and psychological symptoms in dementia among people in care environments. Journal of Clinical Psychiatry 62, 631-636.
9. Ballard C.G., O'Brien J.T., Reichelt K. & Perry E.K. (2002) Aromatherapy as a safe and effective treatment for the management of agitation in severe dementia: The results of a double-blind, placebo-controlled trial with Melissa. Journal of Clinical Psychiatry 63, 553-558.
10. Barnes R. & Raskind M. (1980) Strategies for diagnosing and treating agitation in the aging. Geriatrics 35, 111-119.
11. Bartels S.J., Horn S.D., Smout R.J., Duras A.R., Flaherty E., Jones J.K., Monane M., Taler G.A. & Voss A.C. (2003) Agitation and depression in frail nursing home elderly patients with dementia. American Journal of Geriatric Psychiatry 11, 231-238.
12. Beck C., Frank L., Chumbler N.R., O'Sullivan P., Vogelpohl T.S., Rasin J., Walls R. & Baldwin B. (1998) Correlates of disruptive behavior in severely cognitively impaired nursing home residents. Gerontologist 38, 189-198.
13. Bedard M., Molloy D.W., Pedlar D., Lever J.A. & Stones M.J. (1997) Associations between dysfunctional behaviors, gender, and burden in spousal caregivers of cognitively impaired older adults. International Psychogeriatrics 9, 277-290.
14. Bianchetti A., Scuratti A., Zanetti O., Binetti G., Frisoni G.B., Magni E. & Trabucchi M. (1995) Predictors of mortality and institutionalization in Alzheimer disease patients 1 year after discharge from an Alzheimer dementia unit. Dementia 6, 108-112.
15. Bogner J. & Corrigan J.D. (1995) Epidemiology of agitation following brain injury. NeuroRehabilitation 5, 293-297.
16. Bogner J.A., Corrigan J.D., Bode R.K. & Heinemann A.W. (2000) Rating scale analysis of the Agitated Behavior Scale. Journal of Head Trauma Rehabilitation 15, 656-669.
17. Brooke M.M., Questad K.A., Patterson D.R. & Bashak K.J. (1992) Agitation and restlessness after closed head injury: a prospective study of 100 consecutive admissions. Archives of Physical Medicine & Rehabilitation 73, 320-323.
18. Buettner L.L., Lundegren H., Lago D., Farrell P. & Smith R. (1996) Therapeutic recreation as an intervention for persons with dementia and agitation: an efficacy study. American Journal of Alzheimer's Disease 11, 4-12.
19. Buffum M.D., Miaskowski C., Sands L. & Brod M. (2001) A pilot study of the relationship between discomfort and agitation in patients with dementia. Geriatric Nursing 22, 80-85.
20. Burgio L.D., Butler F.R., Roth D.L., Hardin J.M., Hsu C.C. & Ung K. (2000) Agitation in nursing home residents: the role of gender and social context. International Psychogeriatrics 12, 495-511.
21. Camberg L., Woods P., Ooi W.L., Hurley A., Volker L., Ashley J., Odenheimer G. & McIntyre K. (1999) Evaluation of simulated presence: a personalized approach to enhance well-being in persons with Alzheimer's disease. Journal of the American Geriatrics Society 47, 446-452.
22. Chan D.C., Kasper J.D., Black B.S. & Rabins P.V. (2003) Prevalence and correlates of behavioral and psychiatric symptoms in community-dwelling elders with dementia or mild cognitive impairment: the memory and medical care study. International Journal of Geriatric Psychiatry 18, 174-182.
23. Cohen-Mansfield J. (1996) Behavioral and mood evaluations: assessment of agitation. International Psychogeriatrics 8, 233-245.
24. Cohen-Mansfield J. (2003) Agitation in the elderly: definitional and theoretical conceptualizations. In Agitation in Patients with Dementia: A Practical Guide to Diagnosis and Management. Clinical Practice Series (Hay D.P. & Klein D.T., eds), American Psychiatric Publishing, Washington, DC, USA, pp. 1-21.
25. Cohen-Mansfield J. & Billig N. (1986) Agitated behaviors in the elderly. I. A conceptual review. Journal of the American Geriatrics Society 34, 711-721.
26. Cohen-Mansfield J. & Marx M.S. (1988) Relationship between depression and agitation in nursing home residents. Comprehensive Gerontology. Section B, Behavioural, Social & Applied Sciences 2, 141-146.
27. Cohen-Mansfield J. & Werner P. (1995) Environmental influences on agitation: an integrative summary of an observational study. American Journal of Alzheimer's Care and Related Disorders and Research 10, 32-39.
28. Cohen-Mansfield J., Marx M.S. & Rosenthal A.S. (1989) A description of agitation in a nursing home. Journal of Gerontology 44, M77-M84.
29. Cohen-Mansfield J., Billig N., Lipson S., Rosenthal A.S. & Pawlson H.G. (1990) Medical correlates of agitation in nursing home residents. Gerontology 36, 150-158.
30. Cohen-Mansfield J., Marx M.S. & Werner P. (1992a) Agitation in elderly persons: an integrative report of findings in a nursing home. International Psychogeriatrics 4, 221-240.
31. Cohen-Mansfield J., Marx M.S., Werner P. & Freedman L. (1992b) Temporal patterns of agitated nursing home residents. International Psychogeriatrics 4, 197-206.
32. Cohen-Mansfield J., Culpepper W.J. & Werner P. (1995a) The relationship between cognitive function and agitation in senior day care participants. International Journal of Geriatric Psychiatry 10, 585-595.
33. Cohen-Mansfield J., Werner P. & Freedman L. (1995b) Sleep and agitation in agitated nursing home residents: an observational study. Sleep 18, 674-680.
34. Curl A. (1989) Agitation and the older adult. Journal of Psychosocial Nursing & Mental Health Services 27, 12-14.
35. Day R.K. (1999) Psychomotor agitation: poorly defined and badly measured. Journal of Affective Disorders 55, 89-98.
36. DeYoung S., Just G. & Harrison R. (2002) Decreasing aggressiveagitated, or disruptive behavior: participation in a behavior management unit. Journal of Gerontological Nursing 28, 22-31.
37. Diwan S. & Phillips V.L. (2001) Agitation and dementia-related problem behaviors and case management in long-term care. International Psychogeriatrics 13, 5-21.
38. Dunkin J.J. & Anderson-Hanley C. (1998) Dementia caregiver burden: a review of the literature and guidelines for assessment and intervention. Neurology 51, S53-S67.
39. Dwyer M. & Byrne G.J. (2000) Disruptive vocalization and depression in older nursing home residents. International Psychogeriatrics 12, 463-471.
40. Dyck G. (1997) Management of geriatric behavior problems. Psychiatric Clinics of North America 20, 165-180.
41. Eller S., Griffin L. & Mote C. (2003) Clinical assessment and management of agitation in residential settings. In Agitation in Patients with Dementia: A Practical Guide to Diagnosis and Management. Clinical Practice Series (Hay D.P. & Klein D.T., eds), American Psychiatric Publishing, Washington, DC, USA, pp. 81-90.
42. Everitt D.E., Fields D.R., Soumerai S.S. & Avorn J. (1991) Resident behavior and staff distress in the nursing home. Journal of the American Geriatrics Society 39, 792-798.
43. Fitzsimmons S. & Buettner L.L. (2002) Therapeutic recreation interventions for need-driven dementia-compromised behaviors in community-dwelling elders. American Journal of Alzheimer's Disease & Other Dementias 17, 367-381.
44. Fuh J.L., Mega M.S., Binetti G., Wang S.J., Magni E. & Cummings J.L. (2002) A transcultural study of agitation in dementia. Journal of Geriatric Psychiatry & Neurology 15, 171-174.
45. Geda Y.E. & Rummans T.A. (1999) Pain: cause of agitation in elderly individuals with dementia. American Journal of Psychiatry 156, 1662-1663.
46. Gehrman P.R., Martin J.L., Shochat T., Nolan S., Corey-Bloom J. & Ancoli-Israel S. (2003) Sleep-disordered breathing and agitation in institutionalized adults with Alzheimer disease. American Journal of Geriatric Psychiatry 11, 426-433.
47. Gerdner L.A. & Buckwalter K.C. (1994) A nursing challenge: assessment and management of agitation in Alzheimer's patients. Journal of Gerontological Nursing 20, 11-20.
48. Grant J.E. & Mohan S.N. (2001) Treatment of agitation and aggression in four demented patients using ECT. Journal of ECT 17, 205-209.
49. Grossman F. (1998) A review of anticonvulsants in treating agitated demented elderly patients. Pharmacotherapy 18, 600-606.
50. Haley W.E., Brown S.L. & Levine E.G. (1987) Family caregiver appraisals of patient behavioral disturbance in senile dementia. Clinical Gerontologist 6, 25-34.
51. Hall G.R. & Buckwalter K.C. (1987) Progressively lowered stress threshold: a conceptual model for care of adults with Alzheimer's disease. Archives of Psychiatric Nursing 1, 399-406.
52. Hart B.D. & Wells D.L. (1997) The effects of language used by caregivers on agitation in residents with dementia. Clinical Nurse Specialist 11, 20-23.
53. Haskell R.M., Frankel H.L. & Rotondo M.F. (1997) Agitation. AACN Clinical Issues 8, 335-350.
54. Howard R., Ballard C., O'Brien J. & Burns A. (2001) Guidelines for the management of agitation in dementia. International Journal of Geriatric Psychiatry 16, 714-717.
55. Hurley A.C., Volicer L., Camherg L., Ashley J., Woods P., Odenheimer G., Ooi W.L., McIntyre K. & Mahoney E. (1999) Measurement of observed agitation in patients with dementia of the Alzheimer type. Journal of Mental Health & Aging 5, 117-133.
56. Jansen G., Dassen T. & Moorer P. (1997) The perception of aggression. Scandinavian Journal of Caring Sciences 11, 51-55.
57. Kindermann S.S., Dolder C.R., Bailey A., Katz I.R. & Jeste D.V. (2002) Pharmacological treatment of psychosis and agitation in elderly patients with dementia: four decades of experience. Drugs & Aging 19, 257-276.
58. Kolanowski A.M. (1991) Restlessness in the elderly: a concept analysis. NLN Publications 15-2392, 345-353.
59. Kolanowski A.M. (1995) Disturbing behaviors in demented elders: a concept synthesis. Archives of Psychiatric Nursing 9, 188-194.
60. Kolanowski A.M., Litaker M.S. & Baumann M.A. (2002) Theory-based intervention for dimentia behavior: a within-person analysis over time. Applied Nursing Research 15, 87-96.
61. Kopecky H.J. & Yudofsky S.C. (1999) Agitation: conceptualization, measurement, and treatment. Bulletin of the Menninger Clinic 63, A31-A52.
62. Leger J., Moulias R., Robert P., Vellas B., Chapuy P., Monfort J.C., Khoshnood B., Bouee S., Rebah N. & Gerard D. (2002) Agitation and aggressiveness among the elderly population living in nursing or retirement homes in France. International Psychogeriatrics 14, 405-416.
63. Lindenmayer J.P. (2000) The pathophysiology of agitation. Journal of Clinical Psychiatry 61, 5-10.
64. Logsdon R.G., Teri L., Weiner M.F., Gibbons L.E., Raskind M., Peskind E., Grundman M., Koss E., Thomas R.G. & Thai L.J. (1999) Assessment of agitation in Alzheimer's disease: the agitated behavior in Dementia Scale. Journal of American Geriatrics Society 47, 1354-1358.
65. Lott L. & Klein D.T. (2003) Psychotherapeutic interventions. In Agitation in Patients with Dementia: A Practical Guide to Diagnosis and Management. Clinical Practice Series (Hay D.P. & Klein D.T., eds), American Psychiatric Publishing, Washington, DC, USA, pp. 103-118.
66. Marx M.S., Werner P. & Cohen-Mansfield J. (1989) Agitation and touch in the nursing home. Psychological Reports 64, 1019-1026.
67. Minthon L., Edvinsson L. & Gustafson L. (1996) Correlation between clinical characteristics and cerebrospinal fluid neuropeptide Y levels in dementia of the Alzheimer type and frontotemporal dementia. Alzheimer Disease & Associated Disorders 10, 197-203.
68. Mintzer J., Brawman-Mintzer O., Mirski D.F., Unger R., Nietert P., Meeks A. & Sampson R. (1998) Fenfluramine challenge test as a marker of serotonin activity in patients with Alzheimer's dementia and agitation. Biological Psychiatry 44, 918-921.
69. Moore M.J., Zhu C.W. & Clipp E.C. (2001) Informal costs of dementia care: estimates from the National Longitudinal Caregiver Study. Journals of Gerontology Series B-Psychological Sciences & Social Sciences 56, S219-S228.
70. Morse J.M. (2000) Exploring pragmatic utility: concept analysis by critically appraising the literature. In Concept Development in Nursing: Foundations, Techniques, and Applications (Rodgers B.L. & Knafl K.A., eds), Saunders, Philadelphia, pp. 333-352.
71. Morse J.M., Hupcey J.E., Mitcham C. & Lenz E.R. (1996) Concept analysis in nursing research: a critical appraisal. Scholarly Inquiry for Nursing Practice 10, 253-277.
72. Mungas D., Weiler P., Franzi C. & Henry R. (1989) Assessment of disruptive behavior associated with dementia: the disruptive behavior rating scales. Journal of Geriatric Psychiatry & Neurology 2, 196-202.
73. Neugroschl J. (2002) Agitation: how to manage behavior disturbances in the older patient with dementia. Geriatrics 57, 33-37.
74. Norris C.M. (1975) Restlessness: a nursing phenomenon in search of meaning. Nursing Outlook 23, 103-107.
75. Oxford University Press (2004) Oxford English Dictionary. Retrieved from http://www.oed.com
76. Ragneskog H., Gerdner L.A., Josefsson K. & Kihlgren M. (1998) Probable reasons for expressed agitation in persons with dementia. Clinical Nursing Research 7, 189-206.
77. Reyes R.L., Bhattacharyya A.K. & Heller D. (1981) Traumatic head injury: restlessness and agitation as prognosticators of physical and psychologic improvement in patients. Archives of Physical Medicine & Rehabilitation 62, 20-23.
78. Rodgers B.L. (1993) Concept analysis: an evolutionary view. In Concept Development in Nursing: Foundations, Techniques, and Applications (Rodgers B.L. & Knafl K.A., eds), W.B. Saunders, Philadelphia, pp. 73-92.
79. Rodriguez M.M. (2003) Hormone therapies. In Agitation in Patients with Dementia: A Practical Guide to Diagnosis and Management (Hay D.P. & Klein D.T., eds), American Psychiatric Publishing, Washington, DC, USA, pp. 209-219.
80. Roper J.M., Shapira J. & Chang B.L. (1991) Agitation in the demented patient. A framework for management. Journal of Gerontological Nursing 17, 17-21.
81. Rosen J., Mulsant B.H. & Wright B.A. (1992) Agitation in severely demented patients. Annals of Clinical Psychiatry 4, 207-215.
82. Rosen J., Burgio L., Kollar M., Cain M., Allison M., Fogleman M., Michael M. & Zubenko G.S. (1994) The Pittsburgh Agitation Scale. American Journal of Geriatric Psychiatry 2, 52-59.
83. Shevitz S. (1979) The agitated patient. Journal of Family Practice 9, 305-311.
84. Sinha D., Zemlan F.P., Nelson S., Bienenfeld D., Thienhaus O., Ramaswamy G. & Hamilton S. (1992) A new scale for assessing behavioral agitation in dementia. Psychiatry Research 41, 73-88.
85. Sloane P.D., Mitchell C.M., Preisser J.S., Phillips C., Commander C. & Burker E. (1998) Environmental correlates of resident agitation in Alzheimer's disease special care units. Journal of the American Geriatrics Society 46, 862-869.
86. Spore D.L., Horgas A.L., Smyer M.A. & Marks L.N. (1992) The relationship of antipsychotic drug use, behavior, and diagnoses among nursing home residents. Journal of Aging & Health 4, 514-535.
87. Struble L.M. & Sivertsen L. (1987) Agitation behaviors in confused elderly patients. Journal of Gerontological Nursing 13, 40-44.
88. Sultzer D.L., Mahler M.E., Mandelkern M.A., Cummings J.L., Van Gorp W.G., Hinkin C.H. & Berisford M.A. (1995) The relationship between psychiatric symptoms and regional cortical metabolism in Alzheimer's disease. Journal of Neuropsychiatry & Clinical Neurosciences 7, 476-484.
89. Sweet R.A., Pollock B.G., Mulsant B.H., Rosen J., Lo K.H., Yao J.K., Henteleff R.A. & Mazumdar S. (1997) Association of plasma homovanillic acid with behavioral symptoms in patients diagnosed with dementia: a preliminary report. Biological Psychiatry 42, 1016-1023.
90. Taft L.B. (1989) Conceptual analysis of agitation in the confused elderly. Archives of Psychiatric Nursing 3, 102-107.
91. Talerico K.A., Evans L.K. & Strumpf N.E. (2002) Mental health correlates of aggression in nursing home residents with dementia. Gerontologist 42, 169-177.
92. Tariot P.N. (1999) Treatment of agitation in dementia. Journal of Clinical Psychiatry 60, 11-20.
93. Tekin S., Mega M.S., Masterman D.M., Chow T., Garakian J., Vinters H.V. & Cummings J.L. (2001) Orbitofrontal and anterior cingulate cortex neurofibrillary tangle burden is associated with agitation in Alzheimer disease. Annals of Neurology 49, 355-361.
94. Thomas D.R. (1988) Assessment and management of agitation in the elderly. Geriatrics 43, 45-53.
95. Vance D.E., Burgio L.D., Roth D.L., Stevens A.B., Fairchild J. & Yurick A. (2003) Predictors of agitation in nursing home residents. Journals of Gerontology Series B-Psychological Sciences & Social Sciences 58B, P129-P137.
96. Verma S.D., Davidoff D.A. & Kambhampati K.K. (1998) Management of the agitated elderly patient in the nursing home: the role of the atypical antipsychotics. Journal of Clinical Psychiatry 59, 50-55.
97. Victoroff J., Zarow C., Mack W.J., Hsu E. & Chui H.C. (1996) Physical aggression is associated with preservation of substantia nigra pars compacta in Alzheimer disease. Archives of Neurology 53, 428-434.
98. Volicer L. & Hurley A.C. (2003) Management of behavioral symptoms in progressive degenerative dementias. Journals of Gerontology Series A-Biological Sciences & Medical Sciences 58A, M837-M845.
99. Walker L.O. & Avant K.C. (1995) Strategies for Theory Construction in Nursing. Appleton-Century-Crofts, Norwalk, CT, USA.
100. Webster J. & Grossberg G.T. (2003) Differential diagnosis of agitation in dementia: delirium, depression, psychosis, and anxiety. In Agitation in Patients with Dementia: A Practical Guide to Diagnosis and Management. Clinical Practice Series (Hay D.P. & Klein D.T., eds), American Psychiatric Publishing, Washington, DC, USA, pp. 67-79.
101. Werner P. (2003) Nursing care adaptations, behavioral interventions, environmental changes, and sensory enhancement: conceptual, process, and outcome issues. In Agitation in Patients with Dementia: A Practical Guide to Diagnosis and Management. Clinical Practice Series (Hay D.P. & Klein D.T., eds), American Psychiatric Publishing, Washington, DC, USA, pp. 91-101.
102. Werner P., Cohen-Mansfield J., Braun J. & Marx M.S. (1989) Physical restraints and agitation in nursing home residents. Journal of the American Geriatrics Society 37, 1122-1126.
103. Wood S.A., Cummings J.L., Barclay T., Hsu M., Allahyar M. & Schnelle J.F. (1999) Assessing the impact of neuropsychiatric symptoms on distress in professional caregivers. Aging & Mental Health 3, 241-245.
104. Yudofsky S.C., Kopecky H.J., Kunik M., Silver J.M. & Endicott J. (1997) The Overt Agitation Severity Scale for the objective rating of agitation. Journal of Neuropsychiatry & Clinical Neurosciences 9, 541-548.
105. Zayas E.M. & Grossberg G.T. (1996) Treating the agitated Alzheimer patient. Journal of Clinical Psychiatry 57, 46-51.
106. Zubenko G.S. (1998) Agitation in dementia. Biological Psychiatry 43, 395-396.