Aggressive, violence and sleeplessness.

Psychological symptoms and behavioral abnormalities are common and prominent characteristics of dementia. They include symptoms such as depression, anxiety psychosis, agitation, aggression, disinhibition, and sleep disturbances. Patients with dementia suffer from such behavioral disorders. There are complex interactions between cognitive deficits, psychological symptoms, and behavioral abnormalities. AIthough cognitive decline and deficits in social competence are the hallmarks of progressive neurodegeneration, behavioral abnormalities are common and important characteristics of dementia.  A wide range of behavioral disturbances afflict the majority of patients with dementia. Behavioral disturbances, such as verbal or physical aggression, urinary incontinence, and excessive wandering, are a major source of caregiver burden and an important contributor to the decision to admit these patients to institutionalized long-term care.

Treatment of behavioral problems can improve the quality of life of the patient and the carer, and may help avoid premature institutionalization. The basis of the diagnosis of behavioral and psychological symptoms of dementia comprises a clinical interview, direct observation of the patient with dementia, and/or a proxy report, from a carer or other observers.

Many of the psychological symptoms and behavioral problems are likely to be responsive to pharmacological interventions or nonpharmacological management.

Dear mam I can imagine it must be tough for your family as well as him. Such presentation at this age can be due to various reasons like dementia or confusion. Often it can occur due to a combination of these problems. He needs an evaluation which might include blood tests and scan to understand the cause. Treatment depends on the underlying cause and responds to medications as well as other lifestyle measures. Please see a neurologist / physician for an evaluation and further management. Thanks Regards Dr Ankita Mishra

Hello, At 93years of age there are high chances that he might be going into delerium. In delerium patient appears confused, visualise frightening things, reversal of sleep etc. These symptoms can be taken care.

Consult nearby physician to rule out any electrolyte or metabolic disturbance. If delerium is ruled out consult a psychiatrist.