The Link Between Psychosis and Aggression in Persons with Dementia: A Systematic Review

The purpose of this study was to systematically review the literature to determine whether aggression is linked to psychosis in persons with dementia. An electronic search using PubMed for articles in English focusing on psychosis and aggression or agitation in adults aged 65+ with dementia. Cross-sectional, longitudinal, and randomized controlled treatment studies examining the outcomes of aggression and psychosis were eligible for inclusion. Eighteen articles were selected for final analysis. Of the seven cross-sectional and two longitudinal studies directly examining the correlation of aggression and psychosis, most showed a positive association. Outcome data from the nine treatment studies was more mixed. Limited data link psychosis with aggression in persons with dementia. Prospectively designed studies looking at the temporal relationship of these variables are needed to make a stronger causal argument.