Dementia with Behavioral Disturbances: Behaviors, Causes, and Types

Continue reading to learn about the types of dementia with behavioral disturbances and types without behavioral problems.

What is dementia with behavioral disturbances?

Many types of dementia can cause mood and behavioral changes. It's estimated that up to 90% of patients with dementia experience one or more dementia-related behavioral disturbances, such as:

• Verbal or physical aggression
• Incontinence
• Agitation, wandering and pacing
• Paranoia, hallucinations, and delusions
• Sexual disinhibition
• Sleep disturbances
• Changes in appetite
• Hoarding

Mood changes are also common in people with dementia, including:

• Apathy
• Depression
• Anxiety and fear

What causes behavioral disturbances in dementia patients?

The common behavioral disturbances seen in people with dementia are caused by cognitive decline due to the progressive deterioration of brain cells. A lack of stimulating activities or stressors like pain, sleep problems, and feelings of loss of control can also contribute to behavioral changes in Alzheimer’s and other dementias. Dementia patients often become increasingly sensitive to their surroundings. This means that certain environmental triggers, such as excessive noise or sudden changes in routine, can also play a part in behavior problems.

How common is dementia without behavioral disturbances?

Dementia can occur without behavioral symptoms, especially in earlier stages of the condition. However, as dementia progresses and a person's disease severity increases, changes in mood and behavior associated with progressive damage to brain cells become more likely. Less than 10% of patients experience dementia without behavioral disturbances.

What is unspecified dementia with and without behavioral disturbances?

Several conditions may cause dementia. Unspecified dementia is when confusion or mild cognitive impairment can’t be clearly diagnosed as a specific type of dementia. A diagnosis may be more challenging in people with other coexisting conditions, such as neurodegenerative diseases, physical diseases, and mental disorders. Doctors often run tests to determine the cause of someone's cognitive decline, but sometimes an unidentifiable yet observable case of dementia may occur.

Like other forms of dementia, unspecified dementia can occur with or without behavioral disturbances. People who have unspecified dementia with behavioral disturbances may experience some of the same changes in mood and behavior as those with other types of dementia. People with unspecified dementia without behavioral disturbances may have mild cognitive symptoms that may progress over time

Behavioral disturbances by dementia type

Behavioral disturbances may vary depending on the type of dementia a person has. The lists below explore the similarities and differences.

The following behavioral disturbances may be more commonly seen in patients with Alzheimer’s disease:

• Wandering and pacing
• Increased anxiety or agitation
• Depression
• Hiding things or believing others are hiding things
• Hallucinations, delusions, and paranoia
• Unusual sexual behavior
• Hitting others
• Misunderstanding things they see or hear
• Wearing the same clothes every day

Patients with vascular dementia may experience the following symptoms:

• Wandering
• Sleep disturbances
• Apathy
• Depression
• Agitation
• Anger

Common behavioral disturbances in patients with Lewy body dementia may include:

• Sleep disturbances
• Depression
• Apathy
• Anxiety or fear
• Agitation or restlessness
• Hallucinations, delusions, and paranoia

The following behavioral disturbances may be more common in patients with frontotemporal dementia:

• Acting impulsively or inappropriately
• Apathy
• Repeating the same activity or speech

Care options for managing behavioral disturbances in people with dementia

Dementia behaviors can put a great deal of strain on family and caregiver relationships. At first, you may have a good handle on your loved one’s behavioral symptoms, but it’s still necessary to take breaks for your health and well-being. Consider adding an in-home caregiver to your care team or enrolling your loved one in an adult day care program. The extra support can help prevent caregiver burnout and allow you to maintain a healthy relationship with your loved one.

As dementia progresses, extreme behavioral symptoms can become difficult to cope with alone. Memory care training techniques and clever, person-centered approaches may be necessary to handle more severe behavioral symptoms.

If you’re struggling to manage a loved one’s care at home, you may want to consider transitioning them to a memory care community, where around-the-clock staff is trained to handle behavioral disturbances in a calm and objective manner. The specialized techniques, therapies, and controlled environments in these secured memory care units can help improve your loved one’s safety and well-being.

Sources:
Management of neuropsychiatric symptoms of dementia (https://www.uptodate.com/contents/management-of-neuropsychiatric-symptoms-of-dementia)
Dementia Unspecified: A Multidisciplinary Approach (https://pubmed.ncbi.nlm.nih.gov/32706944/)
Managing Personality and Behavior Changes in Alzheimer's (https://www.nia.nih.gov/health/managing-personality-and-behavior-changes-alzheimers)
Vascular Dementia: Causes, Symptoms, and Treatments (https://www.nia.nih.gov/health/vascular-dementia)
What Is Lewy Body Dementia? Causes, Symptoms, and Treatments (https://www.nia.nih.gov/health/what-lewy-body-dementia-causes-symptoms-and-treatments)
What Are Frontotemporal Disorders? Causes, Symptoms, and Treatment (https://www.nia.nih.gov/health/what-are-frontotemporal-disorders)