Aggression in the elderly.

Aggression is a common behavioral symptom of dementia. Aggression is associated with frontotemporal dementia, greater dementia severity, cognitive decline, and other behavioral and psychological disturbances. It is influenced by the environment and has been correlated with neuropathologic changes and certain polymorphisms. Aggression in dementia patients results in higher psychotropic use and distress to family caregivers and nursing home staff; it is predictive of institutionalization. There is empirical evidence for the efficacy of pharmacotherapy and more limited evidence for psychosocial interventions in the successful management of aggression in persons with dementia. Management of aggression should include comprehensive assessment of medical, psychological, and environmental variables.