What Do We Know About Behavioral Crises in Dementia? A Systematic Review

Area of Science:

• Gerontology
• Neuroscience
• Psychiatry

Background:

• Behavioral crises in dementia are common, often necessitating professional intervention and increasing hospitalization risk.
• Factors contributing to these crises remain poorly understood, highlighting a gap in current knowledge.

Purpose of the Study:

• To identify and analyze factors associated with behavioral crises in individuals with dementia.
• To inform the development of targeted interventions for dementia care.

Main Methods:

• A comprehensive literature search was conducted across multiple databases (MEDLINE, CINAHL, PsycINFO, EMBASE, AMED).
• Eligibility screening by two researchers and narrative synthesis were employed to analyze findings from 18 distinct studies.

Main Results:

• Aggression and agitation were the most frequent behaviors during crises, alongside delusions, wandering, and hallucinations.
• Crises predominantly occurred in severe dementia stages, affecting individuals in home and long-term care settings, often leading to psychiatric admissions.
• Inconsistent assessment and management of agitation/aggression were noted.

Conclusions:

• Interventions should address aggression and agitation, targeting both family and care home settings.
• Future research must focus on preventative factors and effective care models to mitigate dementia-related behavioral crises.