Dataset Information

The association of physical activity and behavioral and psychological symptoms among a sample of hospitalized older adults living with dementia.

ABSTRACT:

Objectives

The aims of this study were to: (1) describe the prevalence of behavioral and psychological symptoms of dementia in hospitalized older adults living with dementia and (2) examine the association of physical activity and behavioral and psychological symptoms of dementia among hospitalized older adults living with dementia, after controlling for covariates.

Methods

Physical activity was measured using the Physical Activity Survey and behavioral and psychological symptoms of dementia were measured using the Neuropsychiatric Inventory. Descriptive analysis and multiple linear regressions were run using baseline data on 294 older adults with dementia hospitalized on general medical units from an ongoing study entitled Function Focused Care for Acute Care Using the Evidence Integration Triangle.

Results

Participants performed an average of 7.92 (SD = 4.49) of 34 possible activities "in the last 24 h" prior to the Physical Activity Survey administration. A total of 132 participants (45.5%) had at least one behavioral and psychological symptom of dementia. We found that physical activity was not associated with behavioral and psychological symptoms of dementia (b = 0.01; p = 0.56), after controlling for covariates.

Conclusions

Although this study found no evidence of an association between physical activity and behavioral and psychological symptoms of dementia, evidence of physical activity did not exacerbate these behaviors. Thus, given the benefits of physical activity, it is important to continue to encourage patients living with dementia to engage in activity.

SUBMITTER: Drazich BF

PROVIDER: S-EPMC10495074 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

The association of physical activity and behavioral and psychological symptoms among a sample of hospitalized older adults living with dementia.

Drazich Brittany F BF Boltz Marie M Kuzmik Ashley A Galik Elizabeth E Kim Nayeon N McPherson Rachel R Holmes Sarah S Resnick Barbara B

International journal of geriatric psychiatry 20230201 2

<h4>Objectives</h4>The aims of this study were to: (1) describe the prevalence of behavioral and psychological symptoms of dementia in hospitalized older adults living with dementia and (2) examine the association of physical activity and behavioral and psychological symptoms of dementia among hospitalized older adults living with dementia, after controlling for covariates.<h4>Methods</h4>Physical activity was measured using the Physical Activity Survey and behavioral and psychological symptoms ...[more]

PMID: 36734152

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Project description:BackgroundBehavioral and Psychological Symptoms of Dementia (BPSD) are core and highly detrimental symptoms of dementia. Previous research has suggested a potential association between pain and BPSD, but pieces of evidence are lacking.ObjectiveThis study aimed to investigate the association between pain and BPSD in patients with dementia.MethodsSeven databases were searched from inception to February 2024, including PubMed, Web of Science, Embase, CINAHL, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WanFang Data. Cross-sectional and longitudinal studies were included. We included studies that involved older adults with dementia and assessed the pain and BPSD by using validated tools. The quality of cohort studies was assessed using the Newcastle-Ottawa Scale, and the quality of cross-sectional studies was evaluated using AHRQ criteria. Two researchers independently screened the articles, extracted the data, and assessed the quality of the studies. A meta-analysis was conducted using Stata 15.0. Data not suitable for meta-analysis was analyzed through a qualitative synthesis to provide a comprehensive overview of the findings.ResultsA total of 12 studies were included, comprising nine cross-sectional studies and three longitudinal studies. All studies were of medium to high quality. Studies reported that pain was associated with 13 different types of BPSD, including agitation, aggression, abnormal thought process, anxiety, care refusal, delirium, depression, delusions, hallucinations, sexual disinhibition, sleep disturbances, socially inappropriate behavior, and wandering. A pooled odds ratio (OR) of 1.25 (95%CI [1.17,1.33], p < 0.001) indicated a significant positive association between pain and BPSD. Specifically, pain was positively associated with aggression (OR = 1.07, 95%CI [1.00,1.13], p = 0.035), agitation (OR = 1.17, 95%CI [1.14, 1.21], p < 0.001), and depression (OR = 2.11, 95%CI [1.76,2.52], p < 0.001). However, pain was significantly negatively associated with wandering (OR = 0.77, 95%CI [0.73, 0.81], p < 0.001).ConclusionsPain was significantly positively associated with BPSD in patients with dementia, specifically with aggression, depression, and agitation. However, pain was negatively associated with wandering. This emphasizes the importance of further research in this area and improved interventions for pain and BPSD management.Trial registrationwww.crd.york.ac.uk CRD42023432320, registered 08/08/2024.

Project description:Background: Behavioral and psychological symptoms of dementia (BPSD, also known as neuropsychiatric symptoms (NPS), changed behaviors and responsive behaviors), occur in up to 90 percent of people living with dementia (PLWD). These symptoms and behaviors strongly correlate with functional and cognitive impairment and contribute to ~30% of overall dementia costs. As decisions regarding care and strategies for BPSD are generally based on professional frames of reference, this study investigates whether the perspectives of PLWD and families/care partner on BPSD terminology can inform a more nuanced conceptualization of BPSD. Methods: PLWD and families/care partners participated in one-on-one semi-structured interviews. A thematic iterative approach was used to code the data and identify common themes until theoretical saturation was reached. Themes were compared between groups. Data were analyzed deductively in relation to pre-existing terminology regarding BPSD, and inductively to discover new ideas on use of such terminology as perceived by PLWD and others. Results: Forty-one volunteers were interviewed: 21 PLWD, mean age 71 yrs, mean Mini-Mental State Examination score 25, and 20 family members/care partners. Three main themes emerged from the data: (1) descriptions of BPSD from people with lived experience compared to clinical terms, (2) viewpoints on interpreting causes, and (3) experiences of concurrent BPSD. The experiences described and terms used by PLWD and families/care partners differed from terms used in existing professional frameworks (e.g., "disinhibition" described as 'loss of filter') and there were differences between PLWD and family members' interpretations of BPSD causes. Discussion/Conclusion: Reports from PLWD and families/carers describing their experiences of BPSD suggest a reconceptualization of BPSD terminology is needed to understand and de-stigmatize these symptoms and behaviors. For example, the term "agitated/hard to handle" would benefit by clearer, contextualized description, such as "frustrated with cognitive decline, discriminatory behavior and inadequate support systems." In better understanding individual expressions of BPSD, families, professionals and societies will be able to respond in ways that are helpful for PLWD. An informed, integrated understanding of BPSD and improved terminology use will have the potential to improve the quality of care and support for PLWD.

Project description:BackgroundDementia presents significant challenges, including social exclusion, which can be exacerbated by public stigma. This study aimed to clarify how social distances, a common measure of public stigma, towards people living with dementia and its associated factors vary with clinical stage, presence of behavioral and psychological symptoms of dementia (BPSD), and living arrangements.MethodsThe study involved 2,589 Japanese participants aged 40 to 90 years. They were exposed to one of four vignettes depicting an 80-year-old woman progressing from normal ageing to mild, moderate, and severe dementia: Vignette A (living with husband, without BPSD); Vignette B (living with husband, with BPSD); Vignette C (living alone, without BPSD); and Vignette D (living alone, with BPSD).ResultsSocial distance showed no significant differences in the normal aging and mild stage of dementia across all vignettes. At the moderate stage, social distance was higher for individuals exhibiting BPSD, regardless of living arrangement. At the severe stage, the lowest social distance was observed towards individuals living with their family without BPSD, whereas the highest was towards those living alone, exhibiting BPSD. For Vignette A, possession of social capital (p<0.001) and having experience of social contact with people living with dementia (PLWD) (p = 0.001-0.007) were independently associated with lower social distance across all dementia stages. In addition, in the mild stage of dementia, high perceived social support (p = 0.005) and having knowledge about dementia (p = 0.036) were associated with lower social distance, but not in the moderate or severe stage of dementia. For Vignette D, possession of social capital (p≤0.001) and having experience of social contact with PLWD (p<0.001 to p = 0.006) were independently associated with lower social distance across all dementia stages. In mild dementia, female sex (p = 0.004) and knowledge about dementia (p = 0.026) were associated with lower social distance. Furthermore, in mild and moderate dementia, living in rural area (p = 0.003-0.048) was associated with lower social distance.ConclusionsSocial distance is higher toward PLWD who live alone and exhibit BPSD than toward those who live with family and/or do not show BPSD, indicating a higher risk of exclusion for the former. Moreover, factors affecting social distance towards PLWD vary across different clinical stages of dementia. While greater knowledge about dementia is associated with lower social distance toward PLWD, this effect appears to be most pronounced in the mild stage. In contrast, opportunities for social contact with PLWD are crucial for achieving lower social distance across all stages of dementia. The findings underscore the need for stage-specific interventions to address stigma, with a focus on education and opportunities for social contact. Targeted efforts are especially important for promoting the inclusion of PLWD who live alone and exhibit BPSD.

Dataset Information

The association of physical activity and behavioral and psychological symptoms among a sample of hospitalized older adults living with dementia.

Objectives

Methods

Results

Conclusions

Publications

The association of physical activity and behavioral and psychological symptoms among a sample of hospitalized older adults living with dementia.

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