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The Use of Estrogen to Decrease Aggressive Physical Behavior in Elderly Men with Dementia
Author(s) -
Kyomen Helen H.,
Nobel Kenneth W.,
Wei Jeanne Y.
Publication year - 1991
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1991.tb02878.x
Subject(s) - medicine , dementia , gerontology , estrogen , disease
lzheimer’s disease and other types of dementia are associated with many problematic behaviors. A These include hitting, yelling, grabbing people, wandering, hoarding, and repetitive gestures and q~estioning.’-~ Behaviors which have been cited as serious problems for family members who care for these patients include acts of physical aggression such as physical violence and hitting3 All of these problematic behaviors are often grouped together as “agitation” or “agitated behavior.” Treatments for “agitation” associated with dementia include behavioral and psychosocial therapies and the single or combination administration of neuroleptics, benzodiazepines, beta-blockers, calcium channel blockers, carbamazepine, serotonergic agents, or lithi~m.~-’ ’ Neuroleptics are commonly used to treat “agitation” in patients with dementia, but are only modestly effe~t ive.~,~ Currently available data suggest that only 18 dementia patients out of 100 will respond to neuroleptic treatment, above the percentage who would have responded to p la~ebo.~ In the treatment of “agitation,” it may be useful to delineate the particular type of “agitated behavior” and target the specific behavioral symptoms to be treated. Cohen-Mansfield and Billig” categorized “agitation” into behaviors which were physically or verbally (1) repetitious, (2) abusive/aggressive or (3) inappropriate to social standards. Verbal aggression may be defined as speech which crosses personal boundaries and causes or threatens to cause emotional harm to others or oneself. Physical aggression may be defined as overt acts which cross personal boundaries and cause or threaten to cause physical and/or emotional harm to others, oneself, or the environment. These behaviors can be targeted for treatment. We present here two cases of elderly men with dementia whose aggressive “agitated” behaviors were most problematic. They were given a trial of estrogen compounds to alleviate their aggressive behavior.