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Association of Depression with Agitation in Elderly Nursing Home Residents

Luda Borin, MD

Allen Raskin, PhD

Department of Psychiatry, University of Maryland School of Medicine

Ann L. Gruber-Baldini, PhD

Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland

A. Srikumar Menon, MD, PhD

Mental Health Service Line, Veterans Affairs Maryland Health Care Center, Baltimore, Maryland

Bruce Kaup, MD

Mental Health Service Line, Veterans Affairs Maryland Health Care Center, Baltimore, Maryland

David Loreck, MD

Mental Health Service Line, Veterans Affairs Maryland Health Care Center, Baltimore, Maryland

Paul E. Ruskin, MD

Veterans Affairs Capitol Network Research Education and Clinical Center, Baltimore, Maryland

Sheryl Zimmerman, PhD

School of Social Work, University of North Carolina, Chapel Hill, North Carolina

Jay Magaziner, PhD

Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland

Agitation is a serious problem for elderly individuals with dementia. It is often the major reason for admission to a restrictive environment such as a nursing home or hospital. The objectives of the current study were to (1) identify the components of agitation embedded in the Psychogeriatric Dependency Rating Scale (PGDRS) and (2) find race, gender, depression, and cognitive deficits associated with the factors extracted from the PGDRS in demographic variables and clinical variables. The study sample comprised 2285 subjects who were admitted to 59 nursing homes across Maryland. The factor analysis of the PGDRS confirmed that agitation is made up of a number of different elements ranging from physical and/or verbal aggression to wandering. Correlates of these elements varied, as did possible treatments. For example, physical and/or verbal aggression often accompanied severe depression, suggesting that treating the depression may alleviate this problem. However, wandering and psychotic behavior may be less amenable to existing treatments as these behaviors were associated with severe cognitive impairment. (J Geriatr Psychiatry Neurol 2003; 16:4-7).

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