Disease Burden
#burden
Burden
#symptoms
Symptoms

Agitation can worsen the impact of an already devastating and burdensome disease1

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~76
of patients with dementia due to Alzheimer’s disease will develop agitation.2
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Agitation in patients with dementia due to Alzheimer’s disease has been associated with1-4,a:

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disease-progression
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Accelerated diseases
progression3
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concomitant-therapies
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Increased use of concomitant therapies1
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functional-decline
false
Functional decline3
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hourglass
false
Earlier death1,3
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decreased-qol
false
Decreased quality of life1,2,4
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disease-progression
false
Increased risk of
hospitalization/
institutionalization2,3
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aCompared to patients without agitation.

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Agitation associated with dementia due to Alzheimer's disease can manifest in different ways5,6

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Agitated behaviors, as defined by the clinically validated Cohen-Mansfield Agitation Inventory (CMAI), comprise 29 behaviors grouped into 3 subscales and are scored by clinicians based on caregiver input.

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physically-non-aggressive
PHYSICALLY NON-AGGRESSIVE
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  • General restlessness
  • Trying to get to a different place
  • Inappropriate dress or disrobing
  • Pacing, aimless wandering
  • Handling things inappropriately
  • Performing repetitive mannerisms
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verbally-agitated
Verbally Agitated
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  • Repetitive sentences or questions
  • Complaining
  • Constant unwarranted request for attention or help
  • Negativism
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aggressive
Aggressive
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  • Cursing or verbal aggression
  • Hurting self or others
  • Pushing
  • Screaming
  • Hitting
  • Grabbing onto people
  • Throwing things
  • Biting
  • Spitting
  • Kicking
  • Tearing things/destroying property
  • Scratching
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Additional behaviors assessed by CMAI total score that often have low rates of occurrence include making physical sexual advances, intentional falling, eating/drinking inappropriate substances, hiding things, hoarding things, making verbal sexual advances, and strange noises (weird laughter or crying).5,6

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References: 1. Fillit H, Aigbogun MS, Gagnon-Sanschagrin P, et al. Impact of agitation in long-term care residents with dementia in the United States. Int J Geriatr Psychiatry. 2021;36(12):1959–1969. 2. Jones E, Aigbogun MS, Pike J, Berry M, Houle CR, Husbands J. Agitation in dementia: real-world impact and burden on patients and the healthcare system. J Alzheimers Dis. 2021;83(1):89–101. 3. Halpern R, Seare J, Tong J, Hartry A, Olaoye A, Aigbogun MS. Using electronic health records to estimate the prevalence of agitation in Alzheimer disease/dementia. Int J Geriatr Psychiatry. 2019;34(3):420–431. 4. Cloutier M, Gauthier-Loiselle M, Gagnon-Sanschagrin P, et al. Institutionalization risk and costs associated with agitation in Alzheimer's disease. Alzheimers Dement (NY). 2019;5:851-861. 5. Cohen-Mansfield J. Agitated behavior in persons with dementia: the relationship between type of behavior, its frequency, and its disruptiveness. J Psychiatr Res. 2008;43(1):64–69. 6. Rabinowitz J, Davidson M, De Deyn PP, Katz I, Brodaty H, Cohen-Mansfield J. Factor analysis of the Cohen-Mansfield Agitation Inventory in three large samples of nursing home patients with dementia and behavioral disturbance. Am J Geriatr Psychiatry. 2005;13(11):991–998.

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