why does alzheimer’s increase the likelihood of aggression/anger in older people?
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Confusion and fear. For example When my grandma had it, she forgot she was diabetic and having her blood tested by “strangers” was scary. Also caring for someone in that state is very taxing so they’re on edge making the person with Alzheimer’s on edge.
Not an expert, but went through this with an older family member. The things that the rest of us agreed about plus the comments from the medical staff:
1) Frustration when you know you can’t do something you used to be able to do. Maybe you try and you try and keep failing and then get angry about the failure.
2) In lucid moments, feeling insulted that they won’t let you drive, or that they sold your house without your permission to pay for your long-term care, or that they treat you like a child when you used to change their diapers.
3) We spend a lot of time every day NOT saying every mean thing that comes into our heads. As your brain works less and less, you lose some of the filters that helped you get along with people.
4) Awareness that your life is going to end and there’s nothing anyone can do about it, and people say “I know how you feel” but really, they don’t know how you feel. You’re dying and they aren’t. You can’t drive and they can. And they’re sitting there being condescending to you and thinking that “I know how you feel” is going to help anything, when it’s obviously and stupidly false.
Wouldn’t you be mad if you were confused all the time?
For my Dad, it was simply watching his faculties disappear day by day. It was terrifying to watch from afar, but to him it was also enraging. I know there’s physical cognitive reasons for it too, but he expressed his anger and frustration many times. Until he didn’t, anymore, because he didn’t remember that he forgot.
I guess forgetting all that shit would make you angry
I guess forgetting all that shit would make you angry
I guess forgetting all that shit would make you angry
Dementia can cause one to perceive threats, feel paranoid, have cognitive issues causing them to feel misunderstood, or experience hallucinations. It actually temporarily happens in people coming out of surgery, especially children.
There are a lot of different reasons, but I’ll go through a few of the more common ones I see in my practice (I deal a lot with Organic brain diseases, of which Alzheimer’s is one).
Everything is new. Everybody is new. They know you, they know your name, but you don’t know them. This weird person shows up every day and makes you take pills. You don’t know why, but they keep telling you that you have to take them. You need to do something. But you don’t remember what it is. But you need to do something, but you don’t remember what it is. You NEED to do something, but you don’t remember that you need to do something…. Memory issues often lead to mild to moderate anger and significant depression. Sometimes people will lash out because they just aren’t sure what is going on.
Another reason is damage to a part of the brain called the prefrontal cortex. This is at the very front of the the brain and is what makes humans human, in essence. All of our higher social functioning, reasoning, emotional regulation etc… happen here (and in areas around it),. This is also a very common place for damage. A good example of the changes when there is damage here is a case study of a guy named Phineas Gage. [The article is worth a read](https://en.wikipedia.org/wiki/Phineas_Gage?wprov=sfla1)
Another very common reason is people ending up in “survival mode” 24/7. The brain is good at keeping us alive, so it prioritizes all of our most important functions like breathing and heart beat. This “primitive brain” focuses on us making quick decisions to keep us from dying, so this is where our Fight or Flight response comes from. Imagine being in a dark alley with a person trying to attack you. Your brain focuses all of its power into staying alive. Organic brain diseases (like Alzheimer’s) usually start in the non-primitive brain, and as these other parts shut down, the brain is now in permanent Fight or Flight mode. Everybody is a stranger, strangers are dangerous so I need to protect myself. This is where a great deal of raw aggression comes from.
Organic brain diseases are incredibly varied, so there are dozens more reasons, but for the sake of ELI5 I’ve narrowed them down and generalized.
Loss of the filter that we developed while becoming members of civilized society for sure. It works for other emotions too. Nice people get nicer (sometimes to an annoying level). I have seen several sad cases of people who had (but never acted on) VERY perverse thoughts.
In addition to everything else that was said, certain medications can cause aggression in people with Alzheimer’s. Medical staff managed to determine that one of my Mom’s epilepsy medications was triggering the behavior. A medicine she had been in for almost 40 years. They weened her off and onto a different anti seizure medication. Made a big difference.
Confusion and disorientation do generally bring out aggression. It’s just that for people without these conditions it’s much harder and more rare to be as confused as a person with Alzheimer’s.
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