• Diagnosis of Dementia, of the following subtypes,

‣ Alzheimer's dementia, according to NIA-AA Criteria for dementia

⁃ Vascular dementia based on:

• i. History consistent with insidious onset of illness and gradual clinical decline ii. MRI evidence of microvascular ischemic disease (microinfarcts) iii. Physical and neurological examination do not indicate current or prior stroke c. Frontotemporal dementia d. Dementia with Lewy Bodies

• Mini Mental Status Exam (MMSE) less than or equal to 15

• Cohen-Mansfield Agitation Inventory Nursing Home Version (CMAI) score of 5 or more on at least one item or score of 4 on two items of aggression or physical nonaggression that holds potentially dangerous consequences including hitting (including self), kicking, grabbing onto people, pushing, throwing things, biting, scratching, spitting, hurting self or other, tearing things or destroying property, making physical sexual advances, trying to get to a different place, or intentional falling (items 1-11, 14, 15) OR one score of 5 or more in items of verbal aggression including screaming, making verbal sexual advances, and cursing or verbal aggression (items 22-24).

• At least one failed pharmacological intervention to manage behavioral symptoms

• Medically stable for safe administration of ECT verified by standard physical examination, urinalysis and serum chemistries and brain imaging when clinically indicated

• Comprehension of English language

• Authorized legal representative able and willing to give informed consent

• Age 40 and above