behavioral symptoms
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2022 ◽  
pp. 1-9
Author(s):  
Els D. Bakker ◽  
Ingrid S. van Maurik ◽  
Arenda Mank ◽  
Marissa D. Zwan ◽  
Lisa Waterink ◽  
...  

Background: The COVID-19 pandemic poses enormous social challenges, especially during lockdown. People with cognitive decline and their caregivers are particularly at risk of lockdown consequences. Objective: To investigate psychosocial effects in (pre-)dementia patients and caregivers during second lockdown and compare effects between first and second lockdown. Methods: We included n = 511 (pre-)dementia patients and n = 826 caregivers from the Amsterdam Dementia Cohort and via Alzheimer Nederland. All respondents completed a self-designed survey on psychosocial effects of COVID-19. We examined relations between experienced support and psychosocial and behavioral symptoms using logistic regression. In a subset of patients and caregivers we compared responses between first and second lockdown using generalized estimating equation. Results: The majority of patients (≥58%) and caregivers (≥60%) reported that family and friends, hobbies, and music helped them cope. Support from family and friends was strongly related to less negative feelings in patients (loneliness: OR = 0.3[0.1–0.6]) and caregivers (loneliness: OR = 0.2[0.1–0.3]; depression: OR = 0.4[0.2–0.5]; anxiety: OR = 0.4[0.3–0.6]; uncertainty: OR = 0.3[0.2–0.5]; fatigue: OR = 0.3[0.2–0.4]; stress: OR = 0.3[0.2–0.5]). In second lockdown, less psychosocial and behavioral symptoms were reported compared to first lockdown (patients; e.g., anxiety: 22% versus 13%, p = 0.007; apathy: 27% versus 8%, p < 0.001, caregivers; e.g., anxiety: 23% versus 16%, p = 0.033; patient’s behavioral problems: 50% versus 35%, p < 0.001). Patients experienced more support (e.g., family and friends: 52% versus 93%, p < 0.001; neighbors: 28% versus 66%, p < 0.001). Conclusion: During second lockdown, patients and caregivers adapted to challenges posed by lockdown, as psychosocial and behavioral effects decreased, while patients experienced more social support compared to first lockdown. Support from family and friends is a major protective factor for negative outcomes in patients and caregivers.


2021 ◽  
Vol 12 ◽  
Author(s):  
Francesca Felicia Operto ◽  
Grazia Maria Giovanna Pastorino ◽  
Federica Pippa ◽  
Chiara Padovano ◽  
Valentina Vivenzio ◽  
...  

Introduction: The aim of this study was to identify the presence of emotional and behavioral symptoms in children and adolescents with epilepsy, to measure the stress levels in their parents, and to determine if and how parental stress was linked to emotional and behavioral symptoms of their children.Methods: We conducted a cross-sectional observational study including 103 children and adolescents with different form of epilepsy and 93 sex-/age-matched controls. Parental stress and emotional and behavioral symptoms were assessed through two standardized questionnaires: the Parenting Stress Index (PSI) and the Child Behavior Checklist (CBCL), respectively. We also considered the following variables: age, sex, maternal education level, family history of psychiatric disorders, duration of epilepsy, seizure frequency, seizure type, and number of antiseizure medications.Results: The statistical comparison showed that the epilepsy group obtained significantly higher scores than controls in almost all the CBCL and the PSI scales (p &lt; 0.05). The correlation analysis revealed a significant relationship between the PSI Total Stress scale and the following CBCL scales: total problems, internalizing problems, and externalizing problems (p &lt; 0.05). An earlier age of seizure onset was related to a greater presence of externalizing problems, total problems, and total stress (p &lt; 0.05).Conclusion: In the epilepsy group, we found higher levels of parental stress and higher presence of emotional and behavioral symptoms compared to controls, mainly represented by internalizing problems (anxiety and depression symptoms). Therefore, it is important to precociously detect these symptoms and monitor them over time, in order to prevent psychiatric problems. In addition, parents of children with epilepsy should be offered psychological support to cope with parental stress and to improve the relationship with their children.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 547-547
Author(s):  
Liming Huang ◽  
G Adriana Perez

Abstract Latinos are twice as likely to develop Alzheimer’s disease (AD) compared to non-Latino whites, yet, account for &lt;2% of clinical trial participants in AD research. This randomized controlled trial examined the feasibility, acceptability and effects of a culturally-adapted timed-activity intervention designed to promote quality of life (QOL) and reduce behavioral symptoms in older Latinos with AD and their caregivers. Healthy Patterns [Pautas Saludables] was implemented among 40 Spanish-speaking dyads. Measures assessed at baseline and 4 weeks post-intervention, indicate improvements in sleep efficiency (p=.06) and QOL (p=.01) among intervention participants. Pautas Saludables was found to be feasible and acceptable. Intervention attendance rate was &gt;90% with low attrition (n=0); no adverse events. Most (74%) rated timed-activity sessions as helpful and appropriate; 58% recommended refreshers. Results provide evidence that Latinos with AD will participate in clinical trials and can improve on key health outcomes, when interventions are adapted to meet their cultural needs.


2021 ◽  
Vol 10 (12) ◽  
pp. 205846012110664
Author(s):  
Mala Naik ◽  
Morteza Esmaeili ◽  
Owen Thomas ◽  
Jonn T Geitung

Background Dementia is one of the leading public health concerns as the world’s population ages. Although Alzheimer’s disease (AD) is the most common dementia diagnosis among older patients, some patients have additional behavioral symptoms. It is therefore important to provide an exact diagnosis, both to provide the best possible treatment for patients and to facilitate better understanding. Purpose To investigate whether magnetic resonance imaging (MRI) with fractional anisotropy (FA) can accurately find patients with behavioral symptoms within a group of AD patients. Material and Methods Forty-five patients from the geriatric outpatient clinic were recruited consecutively to form a group of patients with AD and behavioral symptoms (AD + BS) and a control group of 50 patients with established AD. All patients had a full assessment for dementia to establish the diagnosis according to ICD-10. MRI included 3D anatomical recordings for morphometric measurements, DTI for fiber tracking, and quantitative assessment of regional white matter integrity. The DTI analyses included computing of the diffusion tensor and its derived FA index. Results We found a significant difference in FA values between the patient groups’ frontal lobes. The FA was greater in the study group in both left (0.39 vs 0.09, p < 0.05) and right (0.40 vs 0.16, p < 0.05) frontal lobes. Conclusion MRI with FA will find damage in frontal tracts and may be used as a diagnostic tool and be considered a robust tool for the recognizing different types of dementia in the future.


2021 ◽  
Vol 15 (4) ◽  
pp. 510-523
Author(s):  
Maria Carolina Dias de Azevedo ◽  
Helenice Charchat-Fichman ◽  
Vera Maria Marsicano Damazio

ABSTRACT The built environment can be a home to compensatory strategies aimed at increasing the independence of elderly people with Alzheimer’s disease, by mitigating the cognitive impairment caused by it. Objective: The aim of this study was to find out which interventions were performed in indoor environments and observe their impacts on the relief of behavioral symptoms related to the disorientation of elderly people with probable Alzheimer’s disease. Methods: A systematic review was carried out using the preferred reporting items for systematic review and meta-analyses criteria in the MEDLINE/PubMed database. Two researchers carried out the selection of the studies, following the same methodology. The third author contributed during the writing process and in the decision-making. Results: Of note, 375 studies were identified and 20 studies were included in this systematic review. The identified interventions were classified into environmental communications and environmental characteristics. Conclusions: Environmental communications had positive results in guiding and reducing agitation. In contrast, while reducing behavioral symptoms related to orientation, environmental characteristics showed improvements mainly in social engagement and functional capacity.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 986-986
Author(s):  
Samantha Smith ◽  
Allison Lindauer ◽  
Leslie Tran

Abstract Frontotemporal dementia (FTD) often presents with pronounced behavioral symptoms that contribute to family Care Partner (CP) burden and psychological strain. FTD-specific interventions that support the unique challenges of FTD-CPs are lacking. The present focus group study (Phase 1), elicited feedback from twelve CPs of persons with FTD on the multi-component video-based STELLA intervention (Support via TEchnology: Living and Learning with Advancing ADRDs), to inform the revision and adaptation of STELLA for FTD-CPs (Phase 2). Using Thomas’s (2006) analytic approach to evaluation data, the investigators reviewed the raw text from two focus groups and used an inductive approach to create categories that informed future STELLA adaptation and revision. To address trustworthiness, each investigator independently analyzed the transcripts and CP-annotated STELLA booklets. Six commonalities emerged. Three address the caregiver experience: Burden and living with complex behaviors; Difficulties in getting a diagnosis; and Barriers to participation. The other three reflect specific intervention adaptations: Make a Roadmap, STELLA-FTD Structure, and Booklet edits. The focus group findings offer practical suggestions to create a revised STELLA intervention to address the needs of families living with FTD. The suggestions are nested in the intense caregiving experience of living with complex behavioral symptoms, feeling burdened, isolated, and “living in darkness.” Both the investigators and caregivers appreciate the difficulty in crafting an intervention that meets the needs of all families living with FTD, but the caregivers encouraged the team to develop “something”: “…You won't be able to solve every problem or meet every need… [but] please, please do something.”


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 647-647
Author(s):  
Theresa Scott ◽  
Ying-Ling Jao ◽  
Kristen Tulloch ◽  
Yates Eloise ◽  
Nancy Pachana

Abstract The majority of people living with dementia in the early and middle stages are cared for at home by family caregivers. Participation in meaningful activities is important for good quality of life. Recreation based on horticulture is beneficial for people living with dementia in residential settings, yet evidence within community settings is less clear. The aim of this research was to examine the existing evidence for the impact of using contact with nature, gardens and plants to enhance well-being of people living with dementia in the community. Our secondary aim was to explore the outcome domains and instruments that were employed in the existing research studies, to inform future research efforts and guide clinical practice. A systematic search was conducted covering several databases and gray literature. Original studies that examined group or individual horticulture-based activities or interventions were included. Of 2127 articles identified through searching, 10 were selected for full review. The findings reveal that horticulture-based intervention showed positive impacts on food intake, social interaction, and well-being in older adults with dementia. Some evidence shows that horticulture-based activities may alleviate stressful symptoms associated with living with dementia. Future research may further evaluate the effect of the interventions on cognitive function, physical function, and behavioral symptoms in a more rigorous intervention design.


Author(s):  
Andrea E. Spencer ◽  
Rachel Oblath ◽  
Rohan Dayal ◽  
J. Krystel Loubeau ◽  
Julia Lejeune ◽  
...  

Abstract Background There is concern about the effect of the COVID-19 pandemic on psychosocial functioning among school-age children, who have faced unusual stressors during this time. Our goal was to assess mental health symptoms and social risks during COVID-19, compared to before the pandemic, for urban, racial and ethnic minority school-age children, and investigate the relationship between mental health and social risks. Methods We conducted a cohort study from September 2019 until January 2021 of children age 5–11 years old recruited from an urban safety net hospital-based pediatric primary care practice. We measured emotional and behavioral symptoms (including attention, internalizing, and externalizing symptoms) before and during the pandemic with the Pediatric Symptom Checklist (PSC-17). We measured social risks (including food and housing insecurity) before and during the pandemic with the THRIVE screener. We measured additional mid-pandemic COVID-related stressors with items on school participation, screens/media use, illness exposure, and caregiver mental health. We compared pre- and mid-pandemic PSC-17 symptom scores across 4 domains (total, attention, internalizing, and externalizing) and used path analysis to examine the relationship between mental health and social risks pre- and mid-pandemic. Results Caregivers of 168 children (54% non-Hispanic Black, 29% Hispanic, and 22% non-English speaking) completed the study. Children had significantly higher levels of emotional and behavioral symptoms midpandemic- vs. pre-pandemic in all domains. Significantly more children had a positive PSC-17 total score (18% vs. 8%, p < 0.01) and internalizing (depression and anxiety) score (18% vs. 5%, p < 0.001) during the pandemic vs. before, indicating clinical concerns in these areas. Caregivers reported significantly more social risks during vs. before the pandemic (p < 0.001). Mental health symptoms significantly correlated with number of social risks before the pandemic, but not during the pandemic. Less school assignment completion, increased screen time, and caregiver depression were all significantly associated with worse mid-pandemic mental health in children. Conclusion The COVID-19 pandemic has led to a dramatic increase in depression/anxiety problems and social risks among urban, racial and ethnic minority school-age children compared to before the pandemic. More research is needed to understand if these changes will persist.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 155-155
Author(s):  
Elizabeth Galik

Abstract The effectiveness of EIT-4-BPSD was based on testing the following hypotheses: (1) Settings exposed to EIT-4-BPSD will demonstrate improvements in Environment and Policy assessments, better quality of care interactions, and more person-centered care approaches for management of behavioral symptoms in care plans compared to Education Only settings; and (2) Residents in EIT-4-BPSD settings will have fewer behavioral symptoms and less pain, maintain or improve function, use fewer psychotropic medications, and have improved quality of life compared to residents in Education Only settings. There was not a significant treatment effect at the setting or resident level. Reasons for lack of effectiveness include limited evidence of behavioral symptoms at baseline, nationally based environment and policy requirements related to behavioral management, and measurement challenges in identifying behaviors and other outcomes. Future work should focus more on process and changing how staff approach care which was demonstrated in this trial.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 279-280
Author(s):  
Kimberly Convery ◽  
Tessa Jones ◽  
Aditi Durga ◽  
Abraham Brody ◽  
Shih-Yin Lin

Abstract COVID-19 infection control precautions (e.g., social distancing) and associated isolation and changes to routines can worsen dementia-related behavioral symptoms. A cross-sectional online survey was administered to 101 hospice staff (95% female; mean age 49) to investigate what dementia-related behavioral symptoms in their care recipients had changed from before to after the COVID-19 outbreak. Of the 101 participants, 47 (46.5%) reported changes in symptoms, three (3%) had not been able to physically observe/assess their care recipients, two (2%) reported changes in routines, and 49 (48.5%) reported no changes. The most common changes in symptoms were increased agitation (N=19), depression (N=16), confusion (N=10), and anxiety (N=6). Some participants (N=14) also commented on potential causes, including not having visitors and inability to go outside for normal activities while not understanding why. Interventions to normalize social environments for hospice recipients with dementia are likely imperative to alleviate behavioral symptoms exacerbated by COVID-19-related precautions.


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