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Agitation in the morning: symptom of depression in dementia?
- Authors:
- THEISON Anna-Katharina, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(4), April 2009, pp.335-340.
- Publisher:
- Wiley
Data were collected from three independent nursing homes in an urban setting in Germany. Trained nursing home staff pre-selected 110 demented and agitated patients with a minimum age of 60 years. Three main groups were formed based on agitation peak either: in the morning, evening or none. Each is respectively: sunrisers, sundowners and constants. Agitation was assessed by the same staff twice a day for a 2-week timeframe using the CMAI (Cohen-Mansfield Agitation Inventory); MMSE (Mini-Mental State Examination) for dementia re-evaluation and staging; CSDD (Cornell Score for Depression in Dementia) for depression screening. Sixty-three (60%) of all patients were depressive but only 16 patients of them were treated with antidepressants. Forty-four patients were classified as belonging to the sunriser group, 38 to the sundowners and 23 to the constants. There were no significant differences in depression between the three groups. The data supports that the diagnosis of depression is still often overlooked in demented and agitated persons .
Psychotic symptoms in Patients with Dementia
- Authors:
- BALLARD Clive, OYEBODE Femi
- Journal article citation:
- International Journal of Geriatric Psychiatry, 10(9), September 1995, pp.743-752.
- Publisher:
- Wiley
Reviews the current state of knowledge pertaining to psychotic symptoms in patients with dementia, drawing on over 70 studies in this area.
Does exposure to information about dementia change stigma? An experimental study
- Authors:
- ZHANG Fan, SHEUNG-TAK Cheng
- Journal article citation:
- Aging and Mental Health, 24(7), 2020, pp.1161-1166.
- Publisher:
- Taylor and Francis
Objectives: Educational programs on dementia may backfire, as recipients could feel more negatively about people with dementia after exposure to the alarming symptoms (e.g., behavioral and psychological symptoms of dementia, or BPSD). This study aimed to investigate whether such exposures had any effect on stigma. Methods: 200 adults aged 18–83 years were randomly assigned to three groups. The first group read vignettes describing fictitious older adults with memory impairment. The second group read the same vignettes that were expanded to include descriptions of BPSD (i.e., memory impairment cum BPSD). After reading the vignettes, both groups answered questions about stigma, while the third group directly responded to this questionnaire without reading any vignette (i.e., not exposed to experimental manipulation). ANOVA was performed to analyze the effect of experimental manipulation, as well as that of age, education, whether having relatives with dementia, and belief about treatability of dementia.Results: At posttest, the level of stigma was moderate and was comparable across the three groups, suggesting that exposures to information about cognitive and behavioral symptoms did not change people’s stigmatizing attitude. The absence of group effect in stigma did not vary by age, education, whether having a relative with dementia, or belief about prognosis. Only the main effects of age and education were significant, where younger and least educated participants reported higher stigma. Conclusion: There was no evidence that stigma would be affected by exposure to information about symptoms of dementia, including the more disturbed ones (i.e., BPSD). (Publisher abstract)
The Psychogeriatric Assessment Scales (PAS): psychometric properties in French and German speaking populations
- Authors:
- MACKINNON Andrew, MULLIGAN Reinhild
- Journal article citation:
- International Journal of Geriatric Psychiatry, 16(9), September 2001, pp.892-899.
- Publisher:
- Wiley
Investigates the structure and measurement properties of the Psychogeriatric Assessment Scales (PAS) in a community sample, studies the performance of French and German translations of the PAS, determines the power of PAS scales to discriminate dementia and depression diagnosed to DSM-IV criteria. The measures were gathered as part of a large community survey. Responses to PAS items were obtained in the course of the administration of the Canberra Interview for the Elderly. Demographic variables, the mini-mental state examination and measures of premorbid intelligence robust to current intellectual impairment were also gathered in the course of the survey. There were 465 participants from Zurich and 456 from Geneva. Concludes that the study supports the PAS as a valid and reliable summary of the status of older persons with respect to the impairments, changes and symptomatology that lie at the core of dementing and depressive disorders. This study not only supports the results found in the original development sample, but demonstrates that it performs well against DSM-IV diagnostic criteria and amongst speakers of French and German.
Assessing disruptive behavior in older adults: the Disruptive Behavior Scale
- Authors:
- BECK C., et al
- Journal article citation:
- Aging and Mental Health, 1(1), February 1997, pp.71-79.
- Publisher:
- Taylor and Francis
Disruptive behaviours in older adults with dementia negatively affect their quality of life, their quality of care and resource efficiency. This article discusses the development and testing of an instrument to assess the severity of disruptive behaviour in geropsychiatric patients. Results found that the use of weighting in the Disruptive Behaviour Scale improved the ability to predict perceived patient disruptiveness over other schemes to score disruptive behaviour. The scale also provided a measure of patient disruptiveness that takes into account the frequency and impact of individual behaviours.
Mental illness and the use of restraints in nursing homes
- Author:
- BURTON Lynda C.
- Journal article citation:
- Gerontologist, 32(2), 1992, pp.164-170.
- Publisher:
- Oxford University Press
Describes research on newly admitted residents to identify predictors of restraint use.
Integrating qualitative evidence in practice guideline development: meeting the challenge of evidence-based practice for social work
- Author:
- GOULD Nick
- Journal article citation:
- Qualitative Social Work, 9(1), March 2010, pp.93-109.
- Publisher:
- Sage
The production of practice guidelines is a relatively recent development in social work. Because of their antecedents in evidence-based medicine, methods for producing guidelines have been dominated by quantitative approaches to systematic reviewing with relatively little attention given to the integration of qualitative forms of knowledge. The under-representation of qualitative research, and dependence on meta-analysis of randomised controlled trials, threatens to marginalise important perspectives such as process and implementation data, as well as the voice of service users. Increasing integration of health and social care services also requires that practice guidance incorporates forms of knowledge that are relevant to social care. This article describes methods used to develop the first two national practice guidelines for England and Wales (for dementia care and parent-education/training programmes in the management of children with conduct disorders) produced jointly by the Social Care Institute for Excellence and National Institute for Clinical and Health Excellence. These guidelines demonstrate innovation in their approaches to incorporation of qualitative perspectives. The implications of these two exemplars are considered for future guideline development.
Vocally disruptive behaviour in the elderly: a systematic review
- Authors:
- GUNTEN Armin Von, et al
- Journal article citation:
- International Psychogeriatrics, 20(4), 2008, pp.653-672.
- Publisher:
- Cambridge Journals
Vocally disruptive behaviour is a common condition in the elderly, especially among those with advanced dementia, but is difficult to treat. This review examines the current state of knowledge about prevalence, causes and treatments, both pharmacological and psychosocial. The evidence base remains very limited and (in the case of interventions) largely anecdotal, despite the prevalence of the condition and its deleterious effects on other patients, carers and professional staff. The heterogeneous and multiple contributory factors suggest that a range of different interventions tailored to the individual’s needs, and based on careful assessment of the origins and purposes of the behaviour, will be needed.
Pre-intervention assessment for disruptive behaviour problems: a focus on staff needs
- Authors:
- CASSIDY E.L., SHEIKH J.I.
- Journal article citation:
- Aging and Mental Health, 6(2), May 2002, pp.178-185.
- Publisher:
- Taylor and Francis
Mental health professionals are often called upon to assist institutions in their struggle to manage the behaviour problems associated with dementia. This article provides an example of a typical behavioural consultation. The various methods of assessment, including topographical. functional and observational are described in the context of planning future interventions. Results indicate that a large proportion of staff time, approximately 40%, is spent implementing such interventions. Although the time required is great, frontline staff are adept at utilizing less invasive interventions first. Implications for subsequent interventions, needs for continued evaluation reassessing levels of staff burden are discussed.
Frequency of behavioural symptoms characterizes agitation in Alzheimer's disease
- Authors:
- TRACTENBERG Rochelle E., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 16(9), September 2001, pp.886-891.
- Publisher:
- Wiley
This study describes two well-characterized groups of Alzheimer's disease (AD) patients with similar levels of cognitive functioning, but with different overall behavioural disturbance levels. Seeks to determine the nature of this difference - whether AD patients with higher levels of behavioural disturbance differ from less disturbed AD patients in terms of the range of symptoms exhibited; the frequency of occurrence of these symptoms; or both of these. Results found that differences occurred in the frequency of 10 out of 21 behaviours, rather than in a variety of endorsed behaviours. These 10 behaviours, observed at different frequencies in both groups, may be useful for monitoring change in studies of drugs or behavioural interventions for behavioural disturbance in persons with AD.