Evaluation and management of aggressive behavior in the elderly demented patient

Aggression is common in elderly patients with dementia and often leads to placement of these patients in long-term care facilities. Unfortunately, identification and evaluation of aggression is sometimes hindered by disagreement as to how aggression is distinguished from agitation. Aggression in elderly patients with dementia is best understood as a product of the interaction of neurobiological, cognitive, and environmental factors. Such a complex etiology calls for an approach to treatment that considers pharmacologic therapy as well as environmental manipulation; however, further research is needed to clarify the causes of aggression in elderly patients with dementia and thus allow the refinement of approaches to treatment.