Each week, nearly seven percent of American nursing home residents act out aggressively toward others. Hitting, pushing, even sexual assault are not uncommon. Previous research has often linked dementia, or a progressive loss of normal brain function, to a rise in physical aggression. But new research reveals other factors may come into play.

Findings published in the Archives of Internal Medicine show that a variety of problems, such as delusions, hallucinations, depressive symptoms and even constipation, are associated with increased odds of physical aggression among nursing home residents. Researchers studied more than one-hundred-thousand nursing home residents in five states. More than seven-thousand of the residents had been physically aggressive during the week before the data were gathered. The dataset included information about residents’ physical and cognitive abilities.

The study suggests that many of the factors that eventually contribute to physical or verbal outbursts from one resident to another… or from resident to caregiver… are modifiable. Nursing home personnel, therefore, should seek to identify and treat the symptoms that can lead to aggression, or take proactive steps to prevent it.

The experts also concluded that verbal or physical aggression by nursing facility residents, directed at either other residents or personnel, can be a serious cause of distress in nursing homes in general.

The study’s prescription could have an effect on nursing home care nationwide, suggesting that the proper treatment of depression, delusions, hallucination and constipation could ultimately reduce aggression among some nursing home residents.