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Syndromes of behavioural and psychological symptoms in mild Alzheimer's disease
- Authors:
- MORAN Maria, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(4), April 2004, pp.359-364.
- Publisher:
- Wiley
Behavioural and psychological symptoms of dementia (BPSD) are common in Alzheimer's disease (AD), and are associated with significant distress for patient and carer. Certain behavioural and psychological symptoms have been associated with each other, leading to the suggestion that differences in symptom patterns among patients with AD may represent different syndromes within AD. The purpose of this study is to see if patients with AD could be meaningfully classified into syndromes, based on the relationships between their BPSD. The sample was recruited through a memory clinic. Two hundred and forty first visit patients with a diagnosis of very mild to mild AD were included. BPSD were assessed using the BEHAVE-AD. Latent class analysis was used to assess for different classes or groups of patients within the sample, based on their behavioural and psychological symptoms. Three classes were identified; Class 1 with a low prevalence of behavioural and psychological symptoms; Class 2 an anxiety/depressive symptom class and Class 3 an aggressive symptom class. The three classes (or groups) of patients obtained by LCA in this sample may be explained by a latent, as yet, unidentified factor. Further research is required to determine if these classes are stable over time, and to identify possible latent variables.
Assessing the cognitive abilities that differentiate patients with Alzheimer's disease from normals: single and multiple factor models
- Authors:
- OWNBY Raymond L., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(3), March 2004, pp.232-242.
- Publisher:
- Wiley
Understanding the structure of cognitive abilities in Alzheimer's disease (AD) has considerable practical and theoretical importance. Some investigators have argued that a single cognitive process underlies the deficits seen in AD, while others have argued for multiple cognitive processes. As deficits in cognitive abilities may reflect the pathological process or processes occurring in AD, determination of the structure of abilities in AD is important. The purpose of this study was to assess the utility of single and multiple ability factor models in differentiating patients with AD from normals. Findings show that although a single factor model accounts for a large part of the variability of a battery of measures used to differentiate patients and normals, a multiple factor model performed substantially better based on multiple fit criteria. At least in this sample, a multiple ability factor model of cognitive abilities fit data better than a single factor model in differentiating patients with AD from normals.
Evaluating the impact of intergenerational activities on elders' engagement and expressiveness levels in two settings
- Authors:
- XAVERIUS Pamela K., MATHEWS R. Mark
- Journal article citation:
- Journal of Intergenerational Relationships, 1(4), 2003, pp.53-69.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia
This study evaluated the impact of intergenerational activities on elders' engagement and expressiveness levels in two settings. Study 1 was conducted with 22 well elders at a senior center and approximately 15 children from a nearby grade school. Data were collected using a momentary time sampling procedure, and inter-observer reliability averaged 88% (ranging from 78% to 97%). Elders were significantly more engaged (t (85) = 4.60, p > .001) and expressive (t (85) = 5.55, p > .001) in the treatment condition than the control condition. Study 2 was conducted with 25 older adults diagnosed with dementia, living in a special care unit. Twenty-eight second-graders were in the experimental group and 32 second-graders were in the comparison group. A momentary time sampling procedure was used to observe engagement, expressiveness, and inappropriate behavior levels. Inter-observer agreement averaged 94% (ranged from 85% to 100%). Elders were significantly more engaged in the structured activities with children than the structured activities without children, and significantly more engaged in structured activities without children than the no-activity condition, F(1) = 60.1; p > .01. Elders were also significantly more expressive in structured activities with children than the structured activities without children, and significantly more expressive in the structured activities without children than the no-activity condition, F(1) = 26.5; p = 01. Further, there was no significant increase in inappropriate behaviors between any condition, F(1) = .322; p = .57. The analysis of variance regarding children's attitudes towards the elderly showed no significant differences whether they did or did not participate in the intergenerational activities (F 3.5, p < .05), with both groups maintaining positive attitudes of elders. These results reflect the importance of offering intergenerational activities to well and institutionalized elders as well as to children. (Copies of this article are available from: Haworth Document Delivery Centre Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Restraint removal and changes in social response among nursing home residents
- Authors:
- EJAZ Farida K., ROSE Miriam S., JONES James
- Journal article citation:
- Research on Social Work Practice, 8(1), January 1998, pp.47-62.
- Publisher:
- Sage
Investigates whether removing physical restraints from previously restrained nursing home residents would change their social response. Findings suggest that restraint removal had no effect on changing social response over time. Even after attempting to control for differences between groups, social response was significantly related to subjects' cognitive abilities and physical activities of daily living status. The control group was better functioning in both areas, and this affected their ability to respond socially at much higher level throughout the study than the experimental group.
A pilot study of behavioural and psychological signs and symptoms of dementia in patients of Indian sub-continent origin admitted to a dementia day hospital in the United Kingdom
- Authors:
- HAIDER Imran, SHAH Ajit
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(12), December 2004, pp.1195-1204.
- Publisher:
- Wiley
There is a paucity of cross-cultural studies of behavioural and psychological symptoms of dementia (BPSD). BPSD were examined in a consecutive series of Indian sub-continent origin and white indigenous elders admitted to a dementia day hospital using the BEHAVE-AD. The correlates of individual BPSD in each of the two ethnic groups and the differences between the two ethnic groups were examined. There were no differences between the two groups on most of the demographic and clinical variables examined, except that Indian sub-continent elders had a greater number of children. There were no differences between the two groups on the MMSE scores, BEHAVE-AD total scores and BEHAVE-AD subscale scores (with one exception). Indian sub- continent origin patients had lower scores on the anxiety and phobias subscale. Within the Indian sub-continent origin group, Alzheimer's disease (AD) was associated with activity disturbance and vascular dementia with affective disturbance. Within the indigenous group, aggressivity was associated with males and prescription of neuroleptics, and affective disturbance with prescription of antidepressants. There is a need to develop and evaluate translated versions of instruments that measure BPSD. After development of these instruments there is a need for cross-cultural population-based epidemiological studies of BPSD.
Agitated behaviours among the institutionalized elderly with dementia: validation of the Korean version of the Cohen-Mansfield Agitation Inventory
- Author:
- SUH Guk-Hee
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(4), April 2004, pp.378-385.
- Publisher:
- Wiley
The aim was to analyze the factor structure, the criterion validity, the internal consistency, inter-rater reliability and test-retest reliability of the Korean version of Cohen-Mansfield Agitation Inventory, to provide data on the frequency and distribution of agitated behaviours, and to compare patterns of agitated behaviours among the institutionalized elderly with Alzheimer's disease (AD) or Vascular dementia (VaD). The Korean version of the Cohen-Mansfield Agitation Inventory (CMAI-K) was administered to a total of 257 elderly with AD or VaD in a nursing home in Seoul, Korea. Three kinds of reliability and criterion validity were tested. Factor analysis using principal component analysis with the varimax rotation was performed. To identify different patterns of agitated behaviours, multiple logistic regression analysis was used. This study demonstrated satisfactory reliability and validity for the CMAI-K as an instrument measuring agitation in Korean dementia sufferers in nursing homes. Eighty-three percent of the subjects manifested one or more agitated behaviours at least once a week. Factor analysis yielded four subtypes of agitation: physically aggressive behaviours, physically nonaggressive behaviours, verbally agitated behaviours, and hiding/hoarding behaviours. These results indicate that the CMAI-K is a reliable and valid instrument to measure agitated behaviours in Korean elderly with AD or VaD. These results validate and expand previous research on the agitation in dementia, and guide in the development of interventions.
Physical activity and physique anxiety in older adults: fitness, and efficacy influences
- Authors:
- McAULEY E., et al
- Journal article citation:
- Aging and Mental Health, 6(3), August 2002, pp.222-230.
- Publisher:
- Taylor and Francis
This article documents the effects of six months of physical activity and six month follow-up on reduction in social physique anxiety (SPA) in older adults. In addition, the role played by changes in behavioral, physiological, and psychological predictors of changes in SPA were examined. Participants were randomly assigned to one of two activity groups and engaged in a six-month structured exercise program. Measures of physique anxiety were taken at baseline, six and twelve months. Latent growth curve analyses revealed significant reductions in SPA over the course of the 12-month period. Structural analyses controlling for treatment condition indicated that improvements in self-efficacy and fitness were significant predictors of changes in SPA but that changes in body fat and exercise frequency did not contribute to variation in SPA. Overall this model accounted for 19% of the variation in SPA changes. The extent to which changes in SPA may contribute to continued physical activity participation in older adults and how exercise programs might effectively influence predictors of SPA are discussed.