No abstract

This study investigated the ability of recognizing emotion in dementia. Twenty-five patients with dementia of the Alzheimer type (DAT), 25 patients with vascular dementia (VD), and 12 normal control subjects were evaluated as to general cognition, visuoperception and emotion recognition. The score on the emotion recognition task significantly correlated with that of the Mini-Mental State Examination for VD patients while this was not the case for DAT patients. Moreover, VD patients performed significantly worse than DAT patients on the emotion recognition task in spite of the fact that there was no difference in the general cognitive and visuoperceptual abilities between them. The result of this study coupled with the past studies led to the hypothesis that the relationship between intellectual deficits and the deterioration in recognizing emotions differs according to type of dementia. Caregivers in nursing homes and hospitals need to take into account their patients’ intellectual deficits but also their deteriorating ability of identifying emotions.

The aim of this study was to investigate the ability of patients with dementia to recognize facial expressions and emotional situations. We evaluated 16 patients with dementia of the Alzheimer type (DAT) and 15 with vascular dementia (VD) for general cognition, discrimination of facial expressions and individual faces, and recognition of facial expressions and emotional situations. VD patients performed significantly worse than DAT patients at recognizing facial emotions, even though there was no difference between them in their general cognition and visuoperceptual abilities. There was no significant difference between them in their ability to recognize emotional situations. The results of this and past studies suggest that caregivers in nursing homes and hospitals need to be aware that VD patients lose the ability to comprehend facial expressions.

The study examined the impact of dementia severity on repeat fallers among the institutionalized elderly. A secondary analysis of a dataset containing information on 466 residents (86 of whom were fallers) of nine care facilities around Tokyo was carried out. Descriptive statistics were used to determine the baseline characteristics. Then, logistic regression analysis was carried out to identify the risk factors between the non-fallers and fallers and between the single and repeat fallers. Finally, the relative risks that had an impact on the repeat fallers were calculated. Sixty-one persons (13.1%) were identified as single fallers and 25 (5.4%) were identified as repeat fallers. An unstable gait was a dominant risk factor. In addition, the person's sex and the facility type were identified as risk factors for the fallers, while severe dementia was identified as a risk factor for the repeat fallers. Nurses should recognize the combination of severe dementia and unstable gait as a warning sign for potential repeat fallers.

Aim:  The purpose of this research was to describe the incidence of witnessed and unwitnessed falls among the elderly with dementia and to examine the differences between them. Methods:  We analyzed 276 reports from nine nursing homes in Japan. Descriptive statistics were used to investigate the situations when a fall occurred or when an incident was found. Fisher’s exact test was used to calculate the P‐value to examine the association between witnessed or unwitnessed falls and the variables set in each component of our model. After identifying the variables possibly associated with witnessed and unwitnessed falls, we examined the compounded effects among these variables and classified them into two groups: witnessed and unwitnessed falls. Then, we scrutinized the distribution of the observational data among the variables. Results:  Fourteen percent of the falls were witnessed. Four variables, the careworker/nurse as the reporter, Clinical Dementia Rating, depression in the elderly, and the time of the fall/discovery of the fall, were identified as variables that were different between the witnessed and unwitnessed falls. When compared to nurses, careworkers witnessed more falls specifically during the day. Falls were rarely witnessed among the subjects with mild dementia, although they were found after the incident throughout the day. The number of severely impaired fallers that were either witnessed or found were equal during every hour of the day. Conclusion:  The cognitive level of the elderly and the work shift of the care professionals potentially influenced the large number of unwitnessed falls. Nursing home administrators should consider these elements in fall prevention, especially for the elderly with dementia.