Sufferers of Alzheimer’s disease and other forms of dementia don’t like being talked down to any more than healthy, competent adults do, according to new research. So-called “elderspeak” may actually lead to disruptive behavior.

The new study, conducted by researchers at the University of Kansas, found that cognitively impaired nursing home residents react badly when spoken to as if they were infants. Researchers videotaped 20 nursing home residents with moderate dementia to discover their reactions to demeaning dialogue. Residents who were talked down to were twice as likely to resist care—by crying out, hitting, kicking, yelling or other methods—than those who were spoken to as adults.

Researchers speculate that, as dementia patients lose their cognitive abilities, they struggle to maintain some semblance of personal identity. When they are spoken to in “elderspeak,” they may feel they are not getting the respect they feel they deserve but are unable to communicate their distress, so they act out in disruptive ways. The findings of the study were presented Monday at the Alzheimer’s Association’s International Conference on Alzheimer’s Disease.