OBJECTIVE: This study explored the relationship between aggressive
behavior and other neuropsychiatric symptoms in patients with Alzheimer's
disease. METHOD: Consecutively assessed outpatients with probable or
possible Alzheimer's disease (N = 75) were assessed with the Behavioral
Pathology in Alzheimer's Disease Rating Scale and the Hamilton Depression
Rating Scale. RESULTS: Twenty-five patients (33%) had verbal outbursts and
13 patients (17%) engaged in physical aggression in the month prior to
assessment. Aggressive patients and nonaggressive patients did not differ
regarding age, education, gender, level of depression, or severity of
dementia. In the entire group, dysphoria was found in 33%, delusional
ideation in 39%, and hallucinations in 16%. Aggressive behavior was more
frequent among patients with hallucinations than among those without.
Scores on hallucinations and activity disturbance predicted 12% of the
variance in total aggressive behavior. When data from patients taking
psychotropic medication were excluded from the analysis, hallucination and
delusion scores predicted 22% of the variance in the aggression score.
Physical aggression was associated with activity disturbance and
hallucinations, and verbal aggression was associated with delusional
ideation. No other clinical correlates of aggression were identified.
CONCLUSIONS: Aggressive behavior is a frequent behavioral symptom in
Alzheimer's disease. About one-fourth of the variance in aggression could
be attributed to psychosis.