Patients with Alzheimer disease often show disruptive behavior during the course of the illness. Scarmeas et al correlated this behavior with different outcomes. The authors are from multiple institutions in the United States and Europe.


Disruptive behaviors may include:

(1) wandering

(2) physical threats and/or violence

(3) verbal outbursts and/or threats

(4) sundowning

(5) agitation and restlessness


Sundowning refers to increased confusion in the evening or at night. It may be accompanied by increased anxiety, yelling or hyperkinesis.


These behaviors were associated with clinical decline (cognitive, functional, need for being institutionalized) but not mortality.


Disruptive behavior may fluctuate during the course of the illness but tends to occur more frequently as the disease progresses.


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