Some identifiable symptoms of agitation due to Alzheimer’s include:

• Increased physical aggression such as hitting, grabbing, shoving, kicking, biting, scratching, throwing objects, destroying property, and/or resisting²
• Increased verbal aggression such as shouting, yelling, screaming and/or using profanity³
• Excessive motor activity such as pacing, rocking, gesturing, pointing fingers⁴, restlessness, and/or performing repeating mannerisms⁵
• Increased emotional distress such as rapid changes in mood, irritability, and outbursts⁶ including crying⁷
• Wandering⁸
• Sleeplessness⁹

Agitation and other behavioral symptoms due to Alzheimer’s are extremely common, affecting up to 90% of patients11. The emotional impact of agitation can be difficult to manage for patients and negatively affect both quality of life and disease progression. 12

Behavioral symptoms due to agitation can contribute to the financial burden of care and maintaining employment. Studies have shown these financial losses can amount to more than $7,000 annually, compared to $2,600 for patients not experiencing agitation13.

As agitation worsens and care becomes more difficult, many families may choose to move the patient to a long-term care facility14. This disruption to routine and loss of daily contact with loved ones can be particularly hard on patients, causing them added stress and anxiety.

The estimated annual healthcare cost for agitated patients is over $20,000 – more than double the cost of non-agitated patients 17.

Due to high costs of professional care, responsibilities often fall on the patient’s loved ones. As a result, caregivers for patients with agitation often sacrifice time otherwise spent working, potentially indirectly costing up to $5,000 annually in lost wages, nearly double the cost of care for patients without agitation 18. This increased need for care often results in a future loss of income for caregivers who are forced to sacrifice potential employment opportunities and career advancement19.

The challenges add up to financial and psychological difficulties that make it more difficult for caregivers to provide the necessary support for their loved ones. Studies show 30%-40% of family caregivers report experiencing symptoms of depression, compared to 5%-17% of non-caregivers of similar ages 20.

Identifying the causes of agitation is vital to providing the best care possible. Symptoms can be triggered by a variety of causes including:

• Insomnia
• Sudden changes in routines or locations
• Loud noises
• Pressure from others to complete traditionally simple tasks that have become more difficult due to Alzheimer’s
• Feeling lonely or detached from loved ones
• Physical symptoms including diminished vision, hearing loss, and hunger or thirst¹⁰

There are many ways to intervene, manage, and treat a patient exhibiting signs of agitation. When responding to agitation, it’s important to continuously document behavior and the frequency of disruptions to better help healthcare providers make informed decisions.

Two evidence-based areas for response are pharmacological interventions (medication administered by a healthcare professional) and non-pharmacological interventions (medication-free tactics)21 22.

Non-pharmacological treatments include:

• Be Proactive: A good strategy is to stop symptoms stemming from agitation before they start. This can be accomplished by creating a calm, familiar environment for the patient and reducing the risk of potential triggers, such as loud noises²³.
• Listen: If verbal symptoms of agitation occur, it is important to remain calm and listen to the patient’s concerns. Do your best to reassure them they are safe and provide as much comfort and support as you can²⁴. If the patient is agitated but non-verbal, more work should be done to understand the possible cause.
• Collaborate with a Healthcare Team: Contact their healthcare provider to determine next steps and possible options. Share information about the patient’s behavioral symptoms and the frequency of these behaviors.
• Take Care of Yourself: Caregivers often sacrifice their own wellbeing for that of the patient, which has costs. To provide the best care possible, it is important for caregivers to take breaks, get good sleep, and make sure physical needs are met.

Pharmacological interventions may include:

• There are currently no medications to cure Alzheimer’s disease; however, there are several medications that have been FDA-approved to address Alzheimer’s underlying biology and other drugs that treat the symptoms of the disease²⁵. These pharmacological interventions are administered in conversation with a healthcare provider.

For more information about Alzheimer’s-related dementia, visit BrainGuide’s resource page Living with Alzheimer’s Disease.