Can systematic registration of behavior and diurnal rhythm predict aggression and irritation in elderly psychiatric inpatients?

Background: Aggression is a challenge in elderly psychiatric patients with neuropsychiatric symptoms and there is a need for new knowledge and preventative measures. Aim: To see if systematic registration of behavior and diurnal rhythm can predict risk of aggression based on diagnosis and psychological symptoms. Method: The study follows the STROBE checklist. We registered behavior and diurnal rhythm in 134 inpatients to explore their risk of aggression. We explored aggression and irritation in relation to diagnosis, sleep, unrest, mood swings, confusion, hallucinations and delusions, and pain.Results: Odds of aggression and irritation increased significantly in patients with more psychological symptoms, but the association varied in time. Time trends were stable in patients with organic and psychotic disorders whereas patients with neurotic or affective disorders were at higher risk the first three weeks.Conclusion: Results show that systematically registering behavior and diurnal rhythm can contribute to prediction of aggression in elderly patients, by looking to diagnosis and psychological symptoms.