Agitation and aggression associated with Alzheimer’s disease have been linked to faster mental decline, greater emotional and financial burden for caregivers, earlier nursing home placement, and increased risk of other illnesses and death. Agitation and aggression occur in approximately 50 percent of Alzheimer’s disease patients.

A different focus

Distraction is one way to deal with agitation. “When someone is agitated, you find something else for them to think about — something they find interesting or enjoyable, like taking a walk or listening to music,” says Dr. Paul Rosenberg, associate director of the Memory and Alzheimer’s Treatment Center Division of Geriatric Psychiatry and Neuropsychiatry at Johns Hopkins University School of Medicine. “But we still need medicines, particularly when the agitation is severe.”

The right path

Fortunately, experts say, new treatments are en route to handle these symptoms associated with Alzheimer’s. “Medications that target various chemical pathways in the brain have shown varying degrees of promise in alleviating agitation in Alzheimer’s disease but no treatment has yet been approved by the FDA” says Dr. Cedric O’Gorman, a psychiatrist and the senior vice president of clinical development and medical affairs at Axsome Therapeutics, which is studying a potential treatment for agitation associated with Alzheimer’s disease.

It is important, Dr. O’Gorman says, to understand that agitation, aggression and irritability are very common in Alzheimer’s disease: “Agitation is very much a symptom of the illness and it is not the case that the individual is being difficult or acting out. Greater empathy is required.”

The cause of agitation likely lies in certain pathways of patients’ brains that cause them to feel agitated, irritable and aggressive, and new medications in development target those pathways. “What little we know is [agitation] is probably related to mechanisms that have to do with how we interpret threat, and how anxious we get in the face of that,” Dr. Rosenberg says.

New medicines, such as the one Axsome Therapeutics is currently researching, may have the potential to help patients as well as to possibly relieve associated burdens for both patients and caregivers.

Families can learn more about such clinical research studies at ClinicalTrials.gov, but caregivers can also take immediate steps to help their loved ones with resources like alz.org (Alzheimer’s Association website) and by turning to the patient’s primary care doctor for insight.