Intended for healthcare professionals


Abuse of people with dementia by family carers: representative cross sectional survey

BMJ 2009; 338 doi: (Published 23 January 2009) Cite this as: BMJ 2009;338:b155
  1. Claudia Cooper, MRC research training fellow in health services research and health of the public,
  2. Amber Selwood, honorary senior lecturer,
  3. Martin Blanchard, senior lecturer in old age psychiatry,
  4. Zuzana Walker, senior lecturer in old age psychiatry,
  5. Robert Blizard, principal research fellow,
  6. Gill Livingston, professor of older people’s mental health
  1. 1Department of Mental Health Sciences, University College London, W1W 7EJ
  1. Correspondence to: C Cooper c.cooper{at}
  • Accepted 4 November 2008


Objective To determine the prevalence of abusive behaviours by family carers of people with dementia.

Design Representative cross sectional survey

Setting Community mental health teams in Essex and London.

Participants 220 family carers of people newly referred to secondary psychiatric services with dementia who were living at home.

Main outcome measure Psychological and physical abuse (revised modified conflict tactics scale).

Results 115 (52%, 95% confidence interval 46% to 59%) carers reported some abusive behaviour and 74 (34%, 27% to 40%) reported important levels of abuse. Verbal abuse was most commonly reported. Only three (1.4%) carers reported occasional physical abuse.

Conclusions Abusive behaviour by family carers towards people with dementia is common, with a third reporting important levels of abuse and half some abusive behaviour. We found few cases of physical or frequent abuse, although those with the most abusive behaviour may have been reluctant to report it.


  • We thank the carers and patients who took part in the study, Colm Owens for doing some of the interviews, the Alzheimer’s Society (Islington branch), Shirley Nurock for her assistance in developing the study, Camden and Islington Foundation Trust, North Essex Partnership Foundation NHS Trust, and North East London NHS Foundation Trust; in particular Ruth Allen, Suzanne Joels, Vincent Kirchner, and Tim Stevens.

  • Contributors: CC, GL, and MB conceived and designed the study. CC analysed the data and drafted the manuscript. She is guarantor. All authors were involved in the interpretation of the data, revised the manuscript critically for important intellectual content, and approved the version to be published.

  • Funding: This research was funded by a research training fellowship awarded to CC by the Medical Research Council. The authors’ work was carried out independently of the funders.

  • Competing interests: None declared.

  • Ethical approval: This study was approved by the London multicentre research ethics committee.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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