What is aggression?

Aggression in dementia is angry behavior that may be verbal or physical. The Alzheimer's Association says it can happen suddenly with no clear reason or follow a frustrating situation, and that the person is not acting this way on purpose. Because dementia can leave them unable to identify or explain physical discomfort, such as pain or an infection, they may express it through aggression.

The Alzheimer's Association groups the causes into three kinds. Physical discomfort, including pain, infections such as urinary tract infections, tiredness, hunger, thirst and medication side effects. Environmental factors, such as loud noise, clutter, crowds or unfamiliar people. And poor communication, such as instructions that are too complex, too many questions at once, or the person picking up on a caregiver's stress.

Look for the trigger and respond to the feeling, not the facts. The Alzheimer's Association suggests ruling out pain, speaking slowly in a soft tone, limiting distractions, and shifting to a relaxing activity such as music or a walk. If you can do so safely, step away for a moment. If the person cannot calm down, get help, and call 911 in an emergency.

There is no fixed stage. The National Institute on Aging says people with Alzheimer's may become agitated or aggressive as the disease gets worse, so it is more common as dementia advances. It usually has a cause, such as pain, too little sleep, a sudden change of routine, or too much noise. A medical exam can look for physical problems that may be driving it.

Sometimes, after other causes are checked. The National Institute on Aging says a doctor can examine the person for physical problems behind the aggression and, in certain cases, may prescribe medicine to ease symptoms. It advises talking to a doctor if aggressive behavior worsens, keeping a safe distance during an episode, locking away keys and weapons, and calling 911 in an emergency.