Analysis of the characteristics of agitated behavior and its influencing factors in patients with cognition disorders

Abstract

Objective To explore the clinical characteristics of agitated behavior in patients with cognition disorders and screen the related influencing factors based on need⁃driven dementia⁃compromised behavior (NDB) in dementia. Methods A total of 402 patients with cognition disorders admitted to Xuanwu Hospital, Capital Medical University from January 2021 to June 2022 were selected. Mini⁃Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to evaluate overall cognitive function. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Barthel Index (BI) was used to evaluate abilities of daily living. Cohen⁃Mansfield Agitation Inventory (CMAI) was used to evaluate agitated behavior. Univariate and multivariate Logistic regression analyses were used to analyse the influencing factors of agitated behavior in patients with cognition disorders. Results The incidence of agitated behavior in 402 patients was 59.70% (240/402), while mild cognitive impairment (MCI) was 59.38% (19/32) and dementia was 59.73% (221/370), including physical aggressive behavior 23.33% (56/240), physical non⁃aggressive behavior 37.92% (91/240), verbal aggressive behavior 13.75% (33/240) and verbal non ⁃ aggressive behavior 83.33% (200/240). Logistic regression analysis showed that divorce or widower (OR=4.529, 95%CI:1.416-14.483; P=0.011), hallucination (OR=10.483, 95%CI:4.272-25.722; P=0.001), delusion (OR=2.287, 95%CI:1.140-6.591; P=0.002), the living environment was unstable (OR=1.665, 95%CI:1.024-2.708; P=0.040), communication difficulties between caregivers and patients (OR=1.817, 95%CI:1.047-3.154; P=0.034), sleep disorders (OR=2.344, 95%CI:1.142-4.810; P=0.020) were risk factors for agitated behavior in patients with cognition disorders; hearing impairment was a protective factor (OR=⁃1.086, 95%CI:0.132-0.864; P=0.024). Conclusions The incidence of agitated behavior is higher in patients with cognition disorders, and the incidence of agitated behavior is more likely in patients with cognition disorders who are divorced or widowed, hallucinations, delusions, unstable living environment, communication difficulties between caregivers and patients, and sleep disorders.

doi：10.3969/j.issn.1672⁃6731.2023.04.007