Agitation, aggression and sleep problems in dementia
डिमेंशिया में व्यवहार बदलाव (BPSD)
Most people with dementia develop behavioural or psychological symptoms at some stage. These are often the hardest part of caregiving.
Many causes are treatable — pain, infection, constipation, medicines or a noisy environment — so a careful review comes before any sedative.
Medically reviewed by Dr. Kuldeep Budania, MBBS, MD Psychiatry
Common symptoms
- Agitation, shouting, aggression
- Suspicion — believing things are stolen
- Wandering, night-time restlessness, day–night reversal
- Apathy, low mood, seeing things that are not there
Causes
- Brain changes of dementia
- Unmet needs: pain, hunger, toilet, boredom, fear
- Infections, dehydration, constipation or medicine side-effects
Risk factors
- Moderate to severe dementia
- Poor hearing or vision, changes in surroundings
How it is diagnosed
- Review of physical health and all medicines
- Ruling out delirium (sudden confusion) which needs urgent care
- Behaviour diary: what happens before and after episodes
Treatment options
- 1Non-drug approaches first: routine, activity, music, reassurance
- 2Treating pain, infection, constipation and sleep problems
- 3Medicines only when needed, at the lowest dose, with regular review — some carry risks in older adults
Psychotherapy and counselling
- Caregiver training and support
Guidance for family
- Keep a simple daily routine, good lighting and familiar objects
- Speak slowly, one instruction at a time; avoid correcting or arguing
- Remove hazards: lock away medicines, gas knobs and sharp tools; consider an ID bracelet
- Caregivers need rest and support too — share duties within the family
When to see a psychiatrist
- Sudden worsening of confusion — possible delirium, urgent
- Aggression that puts anyone at risk
- Caregiver exhaustion
Thoughts of self-harm or a medical emergency? Call Tele-MANAS 14416 (24×7, free) or 112.
Frequently asked questions
Should we give sleeping pills?
Not without a doctor's review. Some sleeping pills increase falls and confusion in older adults.
Should the family join the consultation?
Yes, family input is very helpful — especially for children, teenagers, eating disorders and memory problems. Part of the session can also be private.
Can this be treated by online consultation?
Many people can be assessed and followed up by private video. If a physical examination, tests or admission are needed, you will be guided to the right local service.
Help is available — confidential, in Hindi or English.
Private video consultation from anywhere in India with an Ajmer-based psychiatrist. Psychiatry consultation ₹500.
This page is for education and does not replace a personal consultation. Do not start or stop any medicine without a doctor's advice.