Supplementary Material for: Exploring Modifiable Factors Influencing Agitation in Alzheimer's Disease: A Comprehensive Assessment

Introduction: This study aimed to comprehensively assess the impact of caregiver, environmental, and individual factors on agitation symptoms in Alzheimer's disease (AD) patients, identifying key modifiable factors. Methods: From October 2022 to June 2023, 220 participants (110 AD patients and their caregivers) were recruited from Shanghai Mental Health Center. AD patients completed demographics, lifestyle, medical history surveys, and neuropsychological tests, e.g. MMSE, Geriatric Depression Scale (GDS). Caregivers completed the Neuropsychiatric Inventory, environmental factors questionnaire, and emotional state assessments (Hamilton Depression & Anxiety Scales). Agitation severity was assessed using the Cohen-Mansfield Agitation Inventory (CMAI). Group differences and relationships between potential factors and agitation were analyzed. Results: Among 110 AD patients, 56.36% exhibited agitation. The agitation group had more male patients (p=0.012) and female caregivers (p=0.003), lacked courtyard/garden views (p=0.007), had lower MMSE (p=0.005) and GDS scores (p=0.012). After adjusting variables, access to rooms with courtyard/garden views (OR=0.218, p=0.023), male caregivers (OR=0.235, p=0.004), and higher MMSE scores (OR=0.197, p=0.003) emerged as protective factors against agitation. Male caregiver presence was associated with lower agitation incidence. Conclusions: Improving living environments, promoting male caregivers, enhancing caregiver support, and early cognitive intervention may reduce agitation in AD patients.