Towards defining restlessness in individuals with dementia

Research output: Contribution to journalArticle

Abstract

Objectives: Most individuals with dementia develop significant behavioral problems. Restlessness is a behavioral symptom frequently endorsed by caregivers as distressing, yet is variably defined and measured. Lack of conceptual and operational clarity hinders an understanding of this common behavioral type, its prevalence, and development of effective interventions. We advance a systematic definition and understanding of restlessness from which to enhance reporting and intervention development. Method: We reviewed the literature for existing definitions and measures of restlessness, identified common elements across existing definitions, assessed fit with relevant theoretical frameworks, and explored the relationship between restlessness and other behavioral symptoms in a data set of 272 community-dwelling persons with dementia. Results: Twenty-five scales assessing restlessness were identified. Shared components included motor/neurological, psychiatric, and needs-based features. Exploratory analyses suggest that restlessness may co-occur primarily with argumentation, anxiety, waking the caregiver, delusions/hallucinations, and wandering. We propose that restlessness consists of three key attributes: diffuse motor activity or motion subject to limited control, non-productive or disorganized behavior, and subjective distress. Restlessness should be differentiated from and not confused with wandering or elopement, pharmacological side effects, a (non-dementia) mental or movement disorder, or behaviors occurring in the context of a delirium or at end-of-life. Conclusion: Restlessness appears to denote a distinct set of behaviors that have overlapping but non-equivalent features with other behavioral symptoms. We propose that it reflects a complex behavior involving three key characteristics. Understanding its specific manifestations and which components are present can enhance tailoring interventions to specific contexts of this multicomponent behavioral type.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalAging and Mental Health
DOIs
StateAccepted/In press - Jan 1 2016

Fingerprint

Psychomotor Agitation
Dementia
Behavioral Symptoms
Caregivers
Independent Living
Delusions
Delirium
Hallucinations
Movement Disorders
Mental Disorders
Psychiatry
Motor Activity
Anxiety
Pharmacology

Keywords

  • behavioral symptoms
  • definition
  • dementia
  • neurocognitive disorder
  • Restlessness

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Gerontology
  • Phychiatric Mental Health
  • Psychiatry and Mental health

Cite this

Towards defining restlessness in individuals with dementia. / Regier, Natalie; Gitlin, Laura N.

In: Aging and Mental Health, 01.01.2016, p. 1-10.

Research output: Contribution to journalArticle

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