Disruptive Vocalization and Depression in Older Nursing Home Residents

2000 ◽  
Vol 12 (4) ◽  
pp. 463-471 ◽  
Author(s):  
Michael Dwyer ◽  
Gerard J. A. Byrne
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mini Mental State Examination ◽  
Mmse Score ◽  
Nursing Home Residents ◽  
Confounding Variables ◽  
The Relationship ◽  
State Examination ◽  
Age And Sex

Screaming and other types of disruptive vocalization are commonly observed among nursing home residents. Depressive symptoms are also frequently seen in this group, although the relationship between disruptive vocalization and depressive symptoms is unclear. Accordingly, we sought to examine this relationship in older nursing home residents. We undertook a controlled comparison of 41 vocally disruptive nursing home residents and 43 non-vocally-disruptive nursing home residents. All participants were selected to have Mini-Mental State Examination (MMSE) scores of at least 10. Participants had a mean age of 81.0 years (range 63-97 years) and had a mean MMSE score of 17.8 (range 10-29). Nurse ratings of disruptive vocalization according to a semioperationalized definition were validated against the noisy behavior subscale of the Cohen-Mansfield Agitation Inventory. Subjects were independently rated for depressive symptoms by a psychiatrist using the Dementia Mood Assessment Scale, the Cornell Scale for Depression in Dementia, and the Depressive Signs Scale. Vocally disruptive nursing home residents scored significantly higher than controls on each of these three depresion-in-dementia scales. These differences remained significant when the effects of possible confounding variables of cognitive impairment, age, and sex were removed. We conclude that depressive symptoms are associated with disruptive vocalization and may have an etiological role in the generation of disruptive vocalization behaviors in elderly nursing home residents.

Correlates of agitation and depression in nursing home residents with dementia

2012 ◽  
Vol 24 (11) ◽  
pp. 1779-1789 ◽  
Author(s):  
Tomislav Majić ◽  
Jan P. Pluta ◽  
Thomas Mell ◽  
Yvonne Treusch ◽  
Hans Gutzmann ◽  
...  
Keyword(s):  
Nursing Home ◽  
Mini Mental State Examination ◽  
Nursing Home Residents ◽  
Regression Analyses ◽  
Dementia Severity ◽  
Advanced Stages ◽  
Severity Of Depression ◽  
And Gender ◽  
The Relationship ◽  
State Examination

ABSTRACTBackground:The purpose of this study was to investigate the relationship between dementia severity, age, gender, and prescription of psychotropics, and syndromes of agitation and depression in a sample of nursing home residents with dementia.Methods:The Cohen-Mansfield Agitation Inventory (CMAI) was administered to residents with dementia (N= 304) of 18 nursing homes. Agitation symptoms were clustered using factorial analysis. Depression was estimated using the Dementia Mood Assessment Scale (DMAS). Dementia severity was assessed categorically using predefined cut-off scores derived from the Mini-Mental State Examination (MMSE). The relationship between agitation and its sub-syndromes, depression, and dementia severity was calculated usingχ2-statistics. Linear regression analyses were used to calculate the effect of dementia severity and psychotropic prescriptions on agitation and depression, controlling for age and gender.Results:Increasing stages of dementia severity were associated with higher risk for physically aggressive (p< 0.001) and non-aggressive (p< 0.01) behaviors, verbally agitated behavior (p< 0.05), and depression (p< 0.001). Depressive symptoms were associated with physically aggressive (p< 0.001) and verbally agitated (p< 0.05) behaviors, beyond the effects of dementia severity. Prescription of antipsychotics was correlated with depression and all agitation sub-syndromes except hiding and hoarding.Conclusions:Dementia severity is a predictor for agitation and depression. Beyond that, depression increased with dementia severity, and the severity of depression was associated with both physically and verbally aggressive behaviors, indicating that, in advanced stages of dementia, depression in some patients might underlie aggressive behavior.

scholarly journals Study of cognitive functions in major idiopathic interstitial pneumonias

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Mohamed W. Zakaria ◽  
Reem I. El-Korashy ◽  
Mostafa O. Shaheen ◽  
Samah Selim ◽  
Kwashi J. Amum
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Mini Mental State Examination ◽  
Mmse Score ◽  
Control Group ◽  
Healthy Individuals ◽  
Co Morbidity ◽  
Impaired Lung Function ◽  
State Examination

Abstract Background Cognitive dysfunction in idiopathic interstitial pneumonia (IIP) is an important clinical co-morbidity that is associated with impaired lung function. The aim of the work is to assess cognitive function in major IIP and to find out the relation between cognitive dysfunction and the oxygenation parameters. Results Fifty individuals were involved in the study; 30 patients with major IIP and 20 healthy individuals. Patients with IIP had significantly lower mini mental state examination (MMSE) score compared to the control group (P < 0.001). Wechsler Deterioration Index (WDI) revealed that 33.3% (n = 10) of the patients with IIP had sure cognitive impairment and 26.6% (n = 8) had ongoing cognitive deterioration. Patients with idiopathic pulmonary fibrosis (IPF) had lower cognitive function than other IIP. Conclusion There is an impairment of cognitive function in patients with major IIP, particularly in IPF, as measured by WDI and MMSE. Further large studies are needed to assess the possible predictors of cognitive impairment and their effects on the patients’ outcome.

Effectiveness of laptop-based versus smartphone-based videoconferencing interaction on loneliness, depression and social support in nursing home residents: A secondary data analysis

2020 ◽  
pp. 1357633X2097200
Author(s):  
Hsiu-Hsin Tsai ◽  
Ching-Yu Cheng ◽  
Wann-Yun Shieh
Keyword(s):  
Social Support ◽  
Nursing Home ◽  
Depressive Symptoms ◽  
Data Analysis ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Secondary Data ◽  
Confounding Variables ◽  
Generalised Estimating Equations ◽  
Small Screen

Introduction The worldwide coronavirus disease 2019 pandemic re-emphasises the importance of Internet videoconferencing in supporting interactions between nursing home residents and their family and friends. However, there is a scarcity of comparative studies on how modalities of conferencing programs impact health outcomes. The purpose of this study was to compare laptop-based with smartphone-based videoconferencing programs on nursing home residents’ perceptions of loneliness, depressive symptoms and social support. Methods This retrospective secondary analysis used data from two previous studies on the effectiveness of videoconferencing programs (laptop-based and smartphone-based) to improve outcomes of loneliness, depressive symptoms and social support (type and source) among nursing home residents. Generalised estimating equations compared differences from baseline measures with measures at 1 and 3 months between the two groups with and without adjusting for the effects of confounding variables. Results With the exception of age, there were no differences in demographics between participants in the laptop and smartphone groups. Neither changes from baseline in mean scores for loneliness nor depressive symptoms differed between groups. However, changes in mean scores from baseline between groups were significantly greater in the smartphone-based group compared with the laptop-based group for three types of social support: informational and appraisal at 1 and 3 months; and emotional at 3 months. Changes from baseline in mean scores for social support from friends (at 1 and 3 months) and other sources (at 3 months) were also significantly greater for the smartphone group compared with the laptop group. Discussion The two modalities of videoconferencing did not differ in effects on depressive symptoms or loneliness. However, smartphones had a greater effect on the type and source of social support compared with laptops. Whether the small screen of a smartphone reduces users’ anxiety and allows them to talk more on screen is worth studying.

scholarly journals APOE Variant (rs405509) might Modulate the Effect of Sex and Educational Level on Cognitive Impairment Risk in a Taiwanese Population

2019 ◽  
Vol 16 (10) ◽  
pp. 1732 ◽  
Author(s):  
Tsui-Wen Hsu ◽  
Disline Manli Tantoh ◽  
Pang-Li Liu ◽  
Pei-Hsin Chen ◽  
Oswald Ndi Nfor ◽  
...  
Keyword(s):  
High School ◽  
Cognitive Impairment ◽  
Junior High School ◽  
Educational Level ◽  
Mini Mental State Examination ◽  
Mmse Score ◽  
Taiwanese Population ◽  
Educational Group ◽  
University Level ◽  
State Examination

Education, sex, and the APOE-rs405509 variant are associated with Alzheimer’s disease and cognitive performance. We investigated if the rs405509 TT, TG, and GG genotypes modulate the effect of sex and education on cognitive impairment in Taiwanese adults. Data on cognitive health (defined by Mini-Mental State Examination (MMSE) scores) and rs405509 were from Taiwan Biobank. Participants included 2105 men and 2027 women with a mean age of 64 years. Education below university level was significantly associated with lower MMSE scores. The odds ratios (ORs) were 1.82; 95% confidence interval (CI) 1.38–2.41 for senior high school, 3.39; 95% CI 2.50–4.59 for junior high school, and 11.94; 95% CI 9.91–15.50 for elementary school and below (p-trend < 0.05). The association between MMSE score and sex was significant only in the lowest educational group (elementary and below), with lower odds of having a low MMSE score in men compared to women (OR = 0.51; 95% CI 0.34–0.77). After stratification by rs405509 genotypes, this association was significant only among TT genotype carriers (OR = 0.481; CI = 0.253–0.915). In conclusion, a significant association between MMSE score and sex was observed in the lowest educational group, especially among carriers of rs405509 TT genotypes.

The Nottingham Health Profile: a feasible questionnaire for nursing home residents?

2011 ◽  
Vol 24 (3) ◽  
pp. 416-424 ◽  
Author(s):  
Manuela Tabali ◽  
Elke Jeschke ◽  
Theo Dassen ◽  
Thomas Ostermann ◽  
Cornelia Heinze
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Nursing Homes ◽  
Mmse Score ◽  
Nottingham Health Profile ◽  
Nursing Home Residents ◽  
Health Profile ◽  
Operating Characteristics ◽  
Missing Items ◽  
Administration Rate

AbstractBackground:The Nottingham Health Profile (NHP) assesses perceived emotional, social, and physical health problems and the extent to which such problems affect daily activities. The objective of our study was to determine the feasibility of the NHP for nursing home residents.Methods:A prospective multicenter observational study was conducted in 11 nursing homes from April 2008 to December 2009 in which 286 newly admitted residents were included. Cognitive status was evaluated using the Mini-Mental State Examination (MMSE). The feasibility of the NHP was determined by administration rate, time and type of administration, and missing items. A cut-off point stating the MMSE score up to which the NHP can be applied was determined with receiver operating characteristics curves (ROC). Internal consistency (Cronbach's α) and test–retest reliability (intraclass correlation; ICC) were evaluated.Results:Administration rate was 44.4% (n = 127) ranging from 76.1% for normal residents to 5.9% for residents with a severe cognitive impairment. An average of 12.6 (SD + 6.0) minutes was required for data collection and 92.1% (n = 117) of the questionnaires were completed during an interview. Frequently missing items were in the domain “Pain” (47.2). MMSE scores were significantly higher in the group with a completed NHP (P < 0.001) and analyses of ROC curves indicated a cut-off point of >16 on the MMSE score. Cronbach's α was >0.7 in four domains and >0.6 in two domains, while the ICC in all domains was >0.7.Conclusion:The NHP is a feasible questionnaire for residents with normal cognitive function and moderate cognitive impairment, and can be administered in nursing homes.

Vocally disruptive behaviour in nursing home residents in Ireland: a descriptive study

2020 ◽  
pp. 1-11
Author(s):  
C. Nwogbunyama ◽  
B. D. Kelly ◽  
C. Cooney
Keyword(s):  
Nursing Home ◽  
Mini Mental State Examination ◽  
Nursing Home Residents ◽  
Target Population ◽  
Care Plan ◽  
Disruptive Behaviour ◽  
Two Factors ◽  
Randomised Controlled ◽  
State Examination ◽  
Study Inclusion

Background: Vocally disruptive behaviour (VDB) is relatively common in nursing home residents but difficult to treat. There is limited study on prevalence and treatment of VDB. We hypothesise that VDB is a result of complex interaction between patient factors and environmental contributors. Methods: Residents of nursing homes in south Dublin were the target population for this study. Inclusion criteria were that the residents were 65 years or over and exhibited VDB significant enough for consideration in the resident’s care plan. Information on typology and frequency of VDB, Interventions employed and their efficacy, diagnoses, Cohen-Mansfield Agitation Inventory scores, Mini-Mental State Examination scores, and Barthel Index scores were obtained. Results: Eight percent of nursing home residents were reported to display VDB, most commonly screaming (in 39.4% of vocally disruptive residents). VDB was associated with physical agitation and dementia; together, these two factors accounted for almost two-thirds of the variation in VDB between residents. One-to-one attention, engaging in conversation, redirecting behaviour, and use of psychotropic medication were reported by nurses as the most useful interventions. Analgesics were the medications most commonly used (65.7%) followed by quetiapine (62.9%), and these were reportedly effective in 82.6% and 77.2% of residents respectively. Conclusions: VDB is common, challenging, and difficult to manage. The study of VDB is limited by a variety of factors that both contribute to this behaviour and make its treatment challenging. Issues relating to capacity and ethics make it difficult to conduct randomised controlled trials of treatments for VDB in the population affected.

scholarly journals Associations between Pain and Quality of Life in Severe Dementia: A Norwegian Cross-Sectional Study

2017 ◽  
Vol 7 (1) ◽  
pp. 109-121 ◽  
Author(s):  
Hanne Marie Rostad ◽  
Martine T.E. Puts ◽  
Milada Cvancarova Småstuen ◽  
Ellen Karine Grov ◽  
Inger Utne ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Depressive Symptoms ◽  
Daily Living ◽  
Neuropsychiatric Symptoms ◽  
Nursing Home Residents ◽  
Severe Dementia ◽  
Cross Sectional ◽  
The Relationship

Background/Aims: Many variables influence the quality of life in older adults with dementia. We aim to quantify how the relationship between pain and quality of life in nursing home residents with severe dementia can be explained by neuropsychiatric symptoms, depressive symptoms, and activities of daily living. Methods: This article presents cross-sectional baseline data from a cluster randomised controlled trial. Results: The total and direct effects of pain on quality of life were statistically significant. Both neuropsychiatric and depressive symptoms partially mediated the relationship between pain and quality of life. Activities of daily living acted as a mediator only when modelled together with depressive symptoms. Conclusion: Pain, neuropsychiatric symptoms, and depressive symptoms appear to be important factors that influence the quality of life for nursing home residents with severe dementia. Therefore, multidimensional interventions may be beneficial for maintaining or improving quality of life in this population.

Agitation and Touch in the Nursing Home

1989 ◽  
Vol 64 (3_suppl) ◽  
pp. 1019-1026 ◽  
Author(s):  
Marcia S. Marx ◽  
Perla Werner ◽  
Jiska Cohen-Mansfield
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Positive Relationship ◽  
Nursing Home Residents ◽  
Personal Space ◽  
Interpersonal Distance ◽  
Aggressive Behaviors ◽  
Severe Cognitive Impairment ◽  
The Relationship

The relationship between manifestations of agitated behaviors and interpersonal distance was examined in 24 nursing home residents with high agitation and severe cognitive impairment. Analysis indicated that agitated residents displayed divergent responses to touch: touch was related to an increase in aggressive behaviors and to a decrease in physically nonaggressive behaviors (e.g., strange movements). The positive relationship between aggressiveness and touching suggests that residents may interpret touching as a violation of their personal space. The finding that residents exhibited fewer strange movements when touched suggests that touching can act as a quieting and comforting form of communication. The implications of these findings for caregivers are discussed.

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