Exploring Modifiable Factors Influencing Agitation in Alzheimer's Disease: A Comprehensive Assessment

This study aimed to comprehensively assess the impact of caregiver, environmental, and individual factors on agitation symptoms in patients with Alzheimer's disease (AD) and identify key modifiable factors.

From October 2022 to June 2023, 220 participants (110 patients with AD and their caregivers) were recruited from the Shanghai Mental Health Center. Patients with AD completed demographic, lifestyle, medical history, and neuropsychological tests, such as the Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS). The caregivers completed the Neuropsychiatric Inventory, environmental factor questionnaire, and emotional state assessments (Hamilton Depression and Anxiety Scales). Agitation severity was assessed using the Cohen-Mansfield Agitation Inventory (CMAI). Group differences and relationships between potential factors and agitation were also analyzed.

Among the 110 patients with AD, 56.36% exhibited agitation. The agitation group had more male patients (p = 0.012) and female caregivers (p = 0.003), lacked courtyard/garden views (p = 0.007), and had lower MMSE (p = 0.005) and GDS (p = 0.012) scores. After adjusting for variables, access to rooms with courtyard/garden views (OR = 0.256, p = 0.042), male caregivers (OR = 0.246, p = 0.005), and higher MMSE scores (OR = 0.194, p = 0.007) were protective factors against agitation. Male caregivers' presence was associated with a lower incidence of agitation.

Improving living environments, promoting male caregivers, enhancing caregiver support, and early cognitive intervention may reduce agitation in AD patients.