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

One hundred seven community-dwelling elderly patients with Alzheimer disease were enrolled in a study to evaluate the characteristics specific to the patients' and caregivers' situations that are associated with behavioral disturbances and to examine how these disturbances are related to caregiving stress. The frequencies of the disturbance were assessed by using the Troublesome Behavior Scale according to its three categories, agitation, hyperactivity, and miscellaneous. The patients' characteristics found to contribute most to their own behavioral disturbances were visual and speech function, activities of daily living, years of education, cognitive function, and sex, whereas the caregivers' characteristics contributing to these disturbances were duration of caregiving, age of caregiver, and relationship to the patient. In addition, a mutual relation among the three categories was found. Among the three categories, agitation was most strongly related to the caregivers' psychologic health status rated by use of the General Health Questionnaire. 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 characteristics and situational circumstances of both the patient and caregiver, influencing, in turn, the caregivers' psychologic health status.