A study of aggression among referrals to a community-based psychiatry of old age service

Int J Geriatr Psychiatry. 1997 Mar;12(3):384-8.


Objective: The aims of the study were to examine the prevalence of aggressive behaviour in a non-selected community-based population, to identify clinical and sociodemographic variables associated with aggression and to examine the relationship between aggression and outcome at 2-year follow-up.

Design: Case series, using the Ryden Aggression Scale as a retrospective measure of aggression.

Setting: A community-based specialist psychiatry of old age service.

Participants: All referrals to the service over a 3-month period.

Results: Of the 42 subjects included in the study, 25-patients had a diagnosis of dementia. Aggressive behaviour was reported in 18 patients, this being verbal only in nine cases and both verbal and physical in nine cases. Sexual aggression and self-injurious behaviour were each reported in one case only. Aggression was found to be positively associated with a diagnosis of dementia and high physical dependency but was not found to be associated with age, sex, physical illness or the use of psychotropic medication. At 2-year follow-up, aggressive patients were found to have a higher rate of admission to psychiatric inpatient or residential care and tended to have a higher use of neuroleptic drugs.

Conclusions: These findings suggest that aggression is a significant problem for community-based elderly people and their carers, may increase the likelihood of admission into long-term care and that a reliable instrument to measure aggression would be useful in the clinical assessment of this population.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aggression / psychology*
  • Alzheimer Disease / diagnosis
  • Alzheimer Disease / epidemiology*
  • Alzheimer Disease / psychology
  • Community Mental Health Centers / statistics & numerical data*
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Geriatric Assessment
  • Health Services for the Aged / statistics & numerical data*
  • Humans
  • Ireland / epidemiology
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Referral and Consultation / statistics & numerical data*
  • Specialization