Is fidgeting a symptom of dementia? Understanding restlessness and agitation

Oct 19, 2025 4 min read •

senior care Behavioral Health dementia

While fidgeting is a common behavior, particularly in older adults, when it presents as persistent restlessness, it can be a sign of underlying issues. So, is fidgeting a symptom of dementia? It is often an associated behavior, signaling unmet needs, anxiety, or discomfort in individuals living with a cognitive disorder.

Quick Summary

Fidgeting is frequently linked to dementia and Alzheimer's, but it is not a defining symptom on its own. It is typically a form of agitation or restlessness that stems from confusion, anxiety, boredom, or physical discomfort, and understanding the root cause is crucial for effective care and support.

Key Points

Fidgeting as a Symptom: Persistent fidgeting can be an associated behavior of dementia, often a non-verbal cue for anxiety, confusion, or unmet needs.
Identifying Triggers: Pay close attention to what happens before fidgeting starts. Triggers can be environmental (noise, clutter), emotional (anxiety, loneliness), or physical (discomfort, pain).
Soothing Techniques: Offering sensory items like fidget blankets or weighted objects can provide a calming outlet for restless hands.
Environmental Management: Maintaining a calm, predictable environment with a consistent routine helps reduce confusion and agitation that can cause fidgeting.
Effective Communication: Responding with a gentle, calm demeanor and using simple reassurance is more effective than demanding the behavior stop.
Rule Out Other Causes: It is important to consult a doctor to ensure fidgeting isn't a side effect of medication or another medical condition like restless leg syndrome.

Understanding the Connection Between Fidgeting and Dementia

Fidgeting, the act of making small, repetitive movements, is a behavior often observed in individuals with dementia. These movements can include rubbing hands together, picking at clothes, twisting fingers, or pacing. While fidgeting can be a normal human behavior, when it becomes persistent and accompanies other cognitive and behavioral changes, it may be an indicator of dementia or another underlying health issue. For caregivers and family members, recognizing this behavior and its potential root causes is an important step toward providing effective and compassionate support.

Why Do People with Dementia Fidget?

For someone living with dementia, the world can become an increasingly confusing and overwhelming place. This often leads to feelings of anxiety, fear, and frustration that they may not be able to express verbally. Fidgeting, restlessness, and other repetitive actions are often non-verbal cues that something is wrong. The behavior can be a way to release nervous energy, self-soothe, or cope with distress when language fails. This is especially common in the later stages of the disease when verbal communication becomes more difficult.

Common Causes of Restlessness and Fidgeting

Several factors can trigger fidgeting and agitation in a person with dementia. Understanding these triggers is key to addressing the behavior effectively.

Environmental Factors:

Changes in environment, such as a new room or different furniture arrangements, can cause confusion and anxiety.
Loud noises, bright lights, or other forms of overstimulation can overwhelm an individual, leading to restlessness.
Understimulation or boredom can also be a significant trigger, as the person may be searching for something to occupy their time or hands.

Psychological and Emotional Factors:

Anxiety, a common symptom of dementia, often manifests as fidgeting.
Confusion and disorientation can cause unease.
Loneliness or a feeling of detachment can lead to a need for comfort and self-soothing behaviors.

Physical Factors:

Physical discomfort or pain, such as hunger, thirst, or needing to use the restroom, can trigger restlessness, especially if the person cannot articulate their needs.
Uncomfortable clothing or bedding can cause agitation.
Fatigue or sleep disturbances can contribute to restlessness.
Medication side effects are another potential cause. Some medications, including certain antipsychotics or other drugs used to manage dementia symptoms, can have restlessness as a side effect.

How to Respond to Fidgeting in Individuals with Dementia

Addressing fidgeting requires a patient and compassionate approach. Simply telling the person to stop can increase their distress. Instead, focus on understanding and addressing the underlying need.

1. Identify Triggers

Observe and record: Keep a log of when the fidgeting occurs. Note the time of day, location, and any surrounding events. Is it during mealtimes? During a transition from one activity to another? Is the person alone or with others? This information can help pinpoint specific triggers.
Rule out physical discomfort: First, ensure the person is not in pain or uncomfortable. Check for common issues like a full bladder, hunger, or tight clothing.

2. Provide Sensory Stimulation

Offer a fidget blanket or toy, which can provide a safe and soothing outlet for restless hands. These are often designed with various textures and activities, such as zippers, buttons, and ribbons.
Engage in a calming activity. Activities like folding laundry, sorting small objects, or listening to familiar music can provide a structured, calming focus.
Provide a weighted blanket or stuffed animal for comfort and a sense of security.

3. Adjust the Environment

Create a calm and familiar environment. Reduce clutter and keep noise levels low.
Use soft lighting to avoid confusion caused by harsh or changing light sources.
Establish a consistent daily routine to provide a sense of predictability and security. Try to schedule potentially stressful activities, like bathing or doctor's appointments, during the person's best time of day.

4. Offer Reassurance and Comfort

Approach the person calmly and gently. Use a reassuring tone of voice.
Offer a warm touch, like holding their hand, if they are receptive to it.
Engage them in a simple, gentle conversation to redirect their attention.

Comparing Dementia-Related Fidgeting with Other Causes


Feature	Dementia-Related Fidgeting	General Restlessness	Parkinson's Disease	Anxiety Disorder
Underlying Cause	Unmet needs, confusion, brain changes from dementia.	Boredom, impatience, temporary stress.	Neurological damage affecting motor control.	Psychological and emotional distress.
Frequency/Pattern	Often persistent, repetitive, and can worsen in late afternoon (sundowning).	Occasional, situational, and resolves when the trigger is removed.	Characterized by tremors, slowed movement, and stiffness.	Episodes may vary based on stress levels; not always repetitive hand movements.
Associated Symptoms	Memory loss, confusion, communication difficulty.	No other cognitive or memory issues.	Tremors, stiffness, balance problems.	Panic attacks, excessive worry, fatigue.
Response to Intervention	Responds well to calming sensory input and addressing unmet needs.	Responds quickly to distraction or change of activity.	Requires specific medication and physical therapy.	May require therapy, medication, or specific coping mechanisms.

Conclusion

Is fidgeting a symptom of dementia? While it is not a standalone diagnostic criterion, persistent restlessness and fidgeting are often a significant indicator of agitation, anxiety, or unmet needs in someone with dementia. For caregivers, understanding the potential triggers and responding with patience and compassion is vital. By providing a calm environment, offering sensory distractions, and addressing underlying physical and emotional needs, it is possible to reduce the frequency and intensity of fidgeting behaviors, improving the quality of life for the individual and those who care for them. If you notice a sudden change in behavior, it is always wise to consult with a healthcare provider to rule out other causes. The Alzheimer's Association offers a wealth of resources on managing behavioral changes associated with dementia.

Frequently Asked Questions

While fidgeting is not typically one of the earliest signs of dementia, a significant increase in restlessness or agitation that accompanies other cognitive changes could be a red flag. Early signs often include memory loss, difficulty with problem-solving, and mood changes.

Normal fidgeting is usually situational and temporary, caused by boredom or impatience. Dementia-related fidgeting is often more persistent, repetitive, and less responsive to typical distractions, driven by anxiety, confusion, or discomfort that the person cannot articulate.

Yes, for many individuals, fidget toys and blankets are very effective. They provide a safe and engaging way to occupy restless hands and offer sensory stimulation, which can reduce anxiety and promote a sense of calm.

Start by identifying the cause. Are they in pain or bored? Offer a fidget toy, put on calming music, or engage them in a simple task like folding towels. A calm environment and a reassuring presence can also make a big difference.

Yes, sundowning is a phenomenon where confusion and agitation worsen in the late afternoon or evening. This can frequently manifest as increased restlessness and fidgeting. A regular, predictable evening routine can sometimes help manage this.

It is possible. Some medications, particularly those used for behavioral management in dementia, can have restlessness as a side effect. It is crucial to discuss any new or worsening symptoms with their doctor to review their medications.

Do not try to force them to stop. Instead of interrupting the behavior, try to redirect their attention with a calming activity or object. Approaching with a gentle, empathetic tone and a soothing distraction is often more successful and less likely to cause further distress.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.