A Path Analysis of Agitation in Persons with Alzheimer Disease

Abstract This study tested a theory-driven path model of predictors and outcomes of agitated behavioral symptoms in persons with Alzheimer Disease (AD) guided by the Nursing Theory of Unpleasant Symptoms. This secondary analysis included data from 48 persons with AD from institutional residences in Midwestern United States. Data included measures of physical, psychological, and situational antecedents of agitation, the symptom of agitation, and functional outcomes of agitation with 15 instruments and subscales. The data were a good fit for the empirical path model (χ2 = 1.049, df = 2, p = .592). Statistically significant paths were found from measures of physical, psychological, and situational antecedents to agitation (B = 0.58, 0.446, and 0.51; p ≤ .001) which explained 63% of the variance in agitation. Functional performance was influenced only by physical antecedents, which explained 66% of the variance in functional performance. While physical and psychological states may be comorbid to the AD disease process and therefore less modifiable, the situational measure was primarily defined by measures related to caregiver burden. Therefore, future agitation interventions should target strategies to improve caregiver burden.

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Feeling Gratitude and Depletion: The Ambivalent Consequences of Receiving Help in the Workplace

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18042039 ◽

2021 ◽

Vol 18 (4) ◽

pp. 2039

Author(s):

Yuanfang Zhan ◽

Jinfan Zhou ◽

Huan Cheng ◽

Renyan Mu

Keyword(s):

Social Exchange ◽

Organizational Citizenship ◽

Social Exchange Theory ◽

Ego Depletion ◽

Helping Behavior ◽

Daily Basis ◽

Path Model ◽

Full Time ◽

Psychological States ◽

Using Data

Drawing from social exchange theory, we developed a dual-path model of employees’ reactions to episodic help received from colleagues. Through a diary study, using data collected from 127 full-time employees working in a large Chinese bank, we tested this model, revealing that receiving episodic help from colleagues is positively related to the help receivers’ gratitude and ego depletion. Through these two ambivalent psychological states, help receivers were found to simultaneously engage in more organizational citizenship behaviors and deviance behaviors on a daily basis. These empirical findings contribute to research that adopts a target-centric perspective in examining the consequences of helping behavior in the workplace.

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The Impact of Dementia Severity on Caregiver Burden in Frontotemporal Dementia and Alzheimer Disease

Alzheimer Disease & Associated Disorders ◽

10.1097/wad.0b013e318247a0bc ◽

2013 ◽

Vol 27 (1) ◽

pp. 68-73 ◽

Cited By ~ 81

Author(s):

Eneida Mioshi ◽

David Foxe ◽

Felicity Leslie ◽

Sharon Savage ◽

Sharpley Hsieh ◽

...

Keyword(s):

Alzheimer Disease ◽

Frontotemporal Dementia ◽

Caregiver Burden ◽

Dementia Severity ◽

The Impact

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Functional and Mood Outcomes in Bipolar Disorder Patients With and Without Substance Use Disorders Undergoing Psychotherapy

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.661458 ◽

2021 ◽

Vol 12 ◽

Author(s):

William Moot ◽

Marie Crowe ◽

Maree Inder ◽

Kate Eggleston ◽

Christopher Frampton ◽

...

Keyword(s):

Bipolar Disorder ◽

Substance Use ◽

Social Adjustment ◽

Functional Outcomes ◽

Secondary Analysis ◽

Adjunctive Treatment ◽

Life Score ◽

The Social ◽

Negative Effect ◽

Social Rhythm

Objectives: Research suggests that patients with co-morbid bipolar disorder (BD) and substance use disorder (SUD) have a poorer illness course and clinical outcome. The evidence is limited as SUD patients are often excluded from BD studies. In particular, evidence regarding long term outcomes from studies using psychotherapies as an adjunctive treatment is limited. We therefore examined data from two studies of Interpersonal Social Rhythm Therapy (IPSRT) for BD to determine whether lifetime or current SUD affected outcomes.Methods: Data were analyzed from two previous clinical trials of IPSRT for BD patients. Change in scores on the Social Adjustment Scale (SAS) from 0 to 78 weeks and cumulative mood scores from 0 to 78 weeks, measured using the Life Interval Follow-Up Evaluation (LIFE), were analyzed.Results: Of 122 patients (non-SUD n = 67, lifetime SUD but no current n = 43, current SUD n = 12), 79 received IPSRT and 43 received a comparison therapy—specialist supportive care—over 18 months. Lifetime SUD had a significant negative effect on change in SAS score but not LIFE score. There was no effect of current SUD on either change in score. Secondary analysis showed no correlation between symptom count and change in SAS total score or LIFE score.Conclusion: Current SUD has no impact on mood or functional outcomes, however, current SUD numbers were small, limiting conclusions. Lifetime SUD appears to be associated with impaired functional outcomes from psychotherapy. There is limited research on co-morbid BD and SUD patients undergoing psychotherapy.

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Effects of Inappropriate Sexual Behaviors and Neuropsychiatric Symptoms of Patients With Alzheimer Disease and Caregivers’ Depression on Caregiver Burden

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/0891988719874123 ◽

2019 ◽

Vol 33 (5) ◽

pp. 243-249 ◽

Cited By ~ 1

Author(s):

Faik Ilik ◽

Hüseyin Büyükgöl ◽

Fatih Kayhan ◽

Devrimsel Harika Ertem ◽

Timur Ekiz

Keyword(s):

Alzheimer Disease ◽

Caregiver Burden ◽

Sexual Behaviors ◽

Rating Scale ◽

Neuropsychiatric Symptoms ◽

Clinical Dementia Rating ◽

Statistical Manual ◽

Diagnostic And Statistical Manual ◽

Prevalence Of Depression ◽

State Examination

Objective: We investigated the effects of inappropriate sexual behaviors (ISBs) and neuropsychiatric symptoms (NPSs) of patients with Alzheimer disease (AD), and of caregivers’ depression, on the caregiver burden. Method: One hundred forty three patients with AD and their caregivers were included in the study. Sixty-five patients without AD who needed care due to their disability and their caregivers were enrolled for the comparison. Depression in caregivers was diagnosed using The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (SCID-I). The Mini-Mental State Examination (MMSE) and Clinical Dementia Rating Scale were used to evaluate the severity of AD. The Neuropsychiatric Inventory (NPI) was used to assess the NPSs of patients. Caregiver burden was evaluated using the Zarit Burden Interview (ZBI). Results: Inappropriate sexual behaviors were found in 13 (9.1%) of the AD group. Inappropriate sexual behaviors were more common in moderate or severe AD ( P = .009, χ2 = 9.396). The prevalence of depression (n = 38, 26.6%) was higher in caregivers of AD group with ISBs ( P = .000, χ2 = 24.69). The ZBI scores of caregivers of patients with AD were higher than the comparison group. In addition, the ZBI scores of caregivers of patients with AD were significantly higher in the AD group with ISB, a high total score of NPI, and a low score of MMSE. The caregivers of AD group with depression had higher ZBI scores ( P < .05). Conclusions: The severity of AD, the presence of NPSs in patients, and major depression in caregivers were risk factors for an increased caregiver burden.

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The Association Between Caregiver Burden and Caregiver Health-Related Quality of Life in Alzheimer Disease

Alzheimer Disease & Associated Disorders ◽

10.1097/00002093-200107000-00004 ◽

2001 ◽

Vol 15 (3) ◽

pp. 129-136 ◽

Cited By ~ 96

Author(s):

Chaim M. Bell ◽

Sally S. Araki ◽

Peter J. Neumann

Keyword(s):

Quality Of Life ◽

Alzheimer Disease ◽

Caregiver Burden ◽

Health Related Quality ◽

Caregiver Health ◽

Related Quality ◽

Health Related

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P1-188: CSF Orexin-A/Hypocretin-1 Changes in the Alzheimer Disease Process

Alzheimer s & Dementia ◽

10.1016/j.jalz.2016.06.936 ◽

2016 ◽

Vol 12 ◽

pp. P476-P476

Author(s):

Audrey Gabelle ◽

Isabelle Jaussent ◽

Christophe Hirtz ◽

Sophie Navucet ◽

Caroline Grasselli ◽

...

Keyword(s):

Alzheimer Disease ◽

Disease Process ◽

Orexin A ◽

Hypocretin 1

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Functional Outcomes After De-escalated Chemoradiation Therapy for Human Papillomavirus–Positive Oropharyngeal Cancer: Secondary Analysis of a Phase 2 Trial

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2017.10.045 ◽

2018 ◽

Vol 100 (3) ◽

pp. 647-651 ◽

Cited By ~ 6

Author(s):

John V. Hegde ◽

Narek Shaverdian ◽

Carol Felix ◽

Pin-Chieh Wang ◽

Darlene Veruttipong ◽

...

Keyword(s):

Human Papillomavirus ◽

Oropharyngeal Cancer ◽

Functional Outcomes ◽

Secondary Analysis ◽

Chemoradiation Therapy ◽

Phase 2 ◽

Phase 2 Trial

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The Link Between Physical Activity and Cognitive Dysfunction in Alzheimer Disease

Physical Therapy ◽

10.2522/ptj.20140212 ◽

2015 ◽

Vol 95 (7) ◽

pp. 1046-1060 ◽

Cited By ~ 32

Author(s):

Cristy Phillips ◽

Mehmet Akif Baktir ◽

Devsmita Das ◽

Bill Lin ◽

Ahmad Salehi

Keyword(s):

Physical Activity ◽

Cognitive Function ◽

Alzheimer Disease ◽

Cognitive Decline ◽

Cognitive Dysfunction ◽

Physical Therapist ◽

Disease Process ◽

Sufficient Evidence ◽

Brain Disorder ◽

Neuroprotective Effects

Alzheimer disease (AD) is a primary cause of cognitive dysfunction in the elderly population worldwide. Despite the allocation of enormous amounts of funding and resources to studying this brain disorder, there are no effective pharmacological treatments for reducing the severity of pathology and restoring cognitive function in affected people. Recent reports on the failure of multiple clinical trials for AD have highlighted the need to diversify further the search for new therapeutic strategies for cognitive dysfunction. Thus, studies detailing the neuroprotective effects of physical activity (PA) on the brain in AD were reviewed, and mechanisms by which PA might mitigate AD-related cognitive decline were explored. A MEDLINE database search was used to generate a list of studies conducted between January 2007 and September 2014 (n=394). These studies, along with key references, were screened to identify those that assessed the effects of PA on AD-related biomarkers and cognitive function. The search was not limited on the basis of intensity, frequency, duration, or mode of activity. However, studies in which PA was combined with another intervention (eg, diet, pharmacotherapeutics, ovariectomy, cognitive training, behavioral therapy), and studies not written in English were excluded. Thirty-eight animal and human studies met entry criteria. Most of the studies suggested that PA attenuates neuropathology and positively affects cognitive function in AD. Although the literature lacked sufficient evidence to support precise PA guidelines, convergent evidence does suggest that the incorporation of regular PA into daily routines mitigates AD-related symptoms, especially when deployed earlier in the disease process. Here the protocols used to alter the progression of AD-related neuropathology and cognitive decline are highlighted, and the implications for physical therapist practice are discussed.

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