Restlessness in The Elderly – Dementia, Anxiety or Agitation?

Anxiety is at the root of restlessness in the elderly. Agitation and restlessness, especially in a person with dementia, can wear out the patient as well as the caregiver. Reducing anxiety, restlessness, and agitation can be achieved with lifestyle changes as well as the use of supplements that come without the side effects of medications.

George is the perfect example of extreme restlessness in the elderly. George doesn’t seem to be able to sleep, sit or rest for more than 15 minutes at a time. George is wearing out himself as well as his caregivers. George has diabetes and is in renal failure. He has definite signs of early dementia; however, his family doesn’t seem able to hear that, much less address it.

But wait, what appears to be signs of early dementia may really be at the root of his restlessness.

Drugs for anxiety and restlessness.

While the family would like a pill to stop this restlessness “right now,” all they know of drug side effects are keeping them from making the request of George’s doctor. From blurred vision, drowsiness, dizziness, problems with coordination, and confusion, all leading to possible falling and digestive problems. Loss of appetite, constipation, weight loss, nausea, dry mouth, and the list goes on. So in the meantime, they will wait for and ask for medication and try to find the cause of the restlessness.

Another major downside of using drugs for anxiety is the problem of drug interactions. While the use of multiple supplements has not been shown to be problematic, using a supplement can cause a negative interaction when used with a drug. So persons on multiple medications will need to consult their physician about the use of supplements.

Restlessness – start with the diet.

Start with the elimination of all known foods that lead to inflammation. Dietary guidelines for reducing inflammation will reduce inflammation in the brain, causing anxiousness. Eliminate “white foods,” sugar, flour, rice, potatoes, and dairy, and go to colorful foods such as vegetables, berries, and high-quality protein. Avoid all processed foods, especially junk foods that are mainly cheap carbohydrates that raise blood sugar levels.

Just starting with these elimination foods will bring about a decrease in restlessness. Starting the day with a green drink will bring feelings of well-being and overcome anxiety. Vegetables are known to increase a sense of happiness and contentment. Go Mediterranean; there are many sources for guidelines for a non-inflammatory Mediterranean way of eating.

Restlessness – eliminate stimulants.

Take it further by eliminating caffeine, alcohol, and sugar. Yes, sugar is a known stimulant. The surest way to get the jitters is being hooked on coffee loaded with sugar. Persons with a history of anxiety or panic attacks may be more sensitive to caffeine. Switching to decaf coffee and eliminating black tea can also go a long way to improving sleep.

Restlessness – look at sleep – quality and quantity.

Lack of sleep or poor quality sleep can quickly look like dementia in the elderly. The brain has its own system using enzymes to clean up junk and debris – “a good night’s sleep.” During the day, the high metabolic rate damages these enzymes requiring some deep, restful sleep to facilitate when this vital function happens.

Everyone knows how it feels to suffer from a lack of sleep. It can cause confusion, memory loss, problems with concentration and attention, fatigue, and headaches. Most dramatically shown by traffic accidents due to sleep deprivation, and this is in the regular population.

For the elderly with dementia, it is even more important to have a good night’s sleep. Avoid all sleep medications, as well as high carbohydrate snacks, before bed. In the evening, use soothing music, low lights, herbal teas, reading, and a snack of protein such as 2 slices of chicken or nut butter on a celery stick before bed.

Known supplements for sleep:

  • Melatonin – use a low dosage of 3mg. Larger doses can cause excessive drowsiness.
  • Magnesium – there are several types of Magnesium available. However, several are linked to problems with loose stool. In fact, they are often used as a laxative. A safe form is Magnesium L-Threonate has less of a laxative effect and also supports memory enhancement.
  • 5-HTP – as well as supporting good sleep, also helps the brain to produce increased serotonin and contributes to a positive mood and well-being. As stated before, consult with your healthcare provider before starting supplements. 5-HTP can interact with prescription anti-anxiety and antidepressant medications.

Restlessness – exercise and fresh air.

Move the body for at least 20 minutes a day. This can be done by becoming a “Mall Walker,” a wonderful exercise that gives the elder the opportunity to see other people and be social by greeting them when passing. Exercise has been shown to be as effective for depression as medication.

When the elder was a child in grade school, they went out for recess three times a day. Research now tells us that having those short bursts of exercise supports brain health. Over 20% of the oxygen in your body is in the brain. Increasing the percent of oxygen to the brain increases alertness, supports increased focus is calming, and will regulate behaviors.

When children go out for recess, people will say, “it’s good for them. It gives them a chance to run off energy.” What those children are doing instead of running something off is taking in more oxygen through exercise. All the while increasing the oxygen to their brain.

Short bursts of exercise have been shown to be beneficial for brain function for all age groups. Especially beneficial to the frontal lobes of the brain, which helps with self-control and emotional control.

Improving the quality of oxygen is brain positive. What is brain negative is becoming a couch potato, especially when the potato is watching TV. Finding opportunities for oxygen-promoting exercise throughout the day is so necessary.

Walking outdoors, opening the windows while you vacuum, gardening, sweeping the sidewalk – everyone, it seems, can benefit from “recess.”

Anxiety, restlessness, and agitation.

Diet, sleep, activity, and much more contribute to anxiety, agitation, and restlessness in the elderly.


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