Incontinence predicts subsequent ADL functional levels. The relationship between balance dysfunction and subsequent ADL dependence could be causal. Future studies of the causal relationships between impairments and ADL should examine the effectiveness of impairment interventions on ADL as well as these relationships in different subgroups of nursing home residents.
our findings support using IADL scale to screen older community-dwelling residents for dementia: it has discriminant power comparable to that of the AD8 and MMSE. Combining the IADL and the AD8 improves specificity.
Aim
To determine whether giving dementia caregivers active psychoeducational intervention is more efficacious than passive intervention for improving their caregiving skills and reducing their caregiving burden.
Methods
This study was a prospective, single‐blinded, controlled trial with 43 caregiver/person‐with‐dementia dyads. The dyads were randomly assigned to the active psychoeducational intervention (AP) group, which used role‐play, discussion, and development of problem‐solving capacity to build up their caregiving skills and competence, or the passive psychoeducational intervention (PP) group, which gave caregivers educational materials on common caregiving strategies. Primary outcomes were the levels of caregiver competence (Care Skill Inventory [CSI]), burden (Chinese Zarit Burden Inventory [CZBI]), and distress caused by the behavioral and psychological symptoms of dementia (Neuropsychiatric Inventory‐Questionnaire [NPI‐Q]). Outcomes were assessed pre‐test, post‐test and after 3 months. Repeated measures one‐way analysis of variance was used to compare mean‐change scores between time‐points, and generalized estimating equations (GEE) were used to compare groups.
Results
Post‐test or 3‐month (or both) Care Skill Inventory, Chinese Zarit Burden Inventory and Neuropsychiatric Inventory‐Questionnaire distress levels were significantly (p < 0.05) better in the AP but not in the PP group. The generalized estimating equation intergroup comparison, adjusted for potential confounders, showed that Care Skill Inventory in the AP group was more significantly improved than in the PP group, and that Chinese Zarit Burden Inventory nearly reached significance.
Conclusions
Active rather than passive psychoeducation, even in a short (3 months) intervention of six visits, was more efficacious for improving caregiving competence. Future studies will require larger samples. Geriatr Gerontol Int 2018; 18: 750–757.
ObjectivesGeneric and disease-specific health-related quality of life (HRQoL) instruments may reflect different aspects of lives in patients with Parkinson’s disease (PD) and thus be associated with different determinants. We used the same cluster of predictors for the generic and disease-specific HRQoL instruments to examine and compare the determinants of HRQoL.MethodHRQoL was measured in 92 patients with PD by the 36-item Short-Form Health Survey (SF-36) and the 39-item Parkinson’s Disease Questionnaire (PDQ-39). The predictors included demographic and disease characteristics, and motor and non-motor symptoms. Multiple regression analyses were used to identify HRQoL determinants.ResultsDepressive symptoms and motor difficulties of daily living were the first two significant determinants for both instruments. The other significant determinant for the SF-36 was fatigue and non-motor difficulties of daily living, and for the PDQ-39 was motor signs of PD.ConclusionsThe results suggest the importance of the evaluation and intervention focused on depressive symptoms and motor difficulties of daily living in patients with PD. In addition, the SF-36 seems more related to non-motor symptoms, while the PDQ-39 appears more associated with motor symptoms. This information is important for understanding results from these two instruments and for choosing which to use.
The present study provides insight into how caregivers perceived the usefulness of AT devices, and how that varied with context. Indicators of devices perceived as useful can serve as guidelines for modifying existing devices and designing new devices. Future application could also incorporate the points of view from the persons with dementia.
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