Factors Affecting Verbal Agitation in Dementia Patients Living in Nursing Homes, South Korea

Abstract

The purpose of this study using secondary data analysis was to identify factors affecting verbal agitation in patients with dementia staying at nursing home. This study is a secondary analysis of an existing original quantitative data set (n = 193). A total of 166 subjects' data were included in this current study after 27 subjects' data were excluded from the original data because they did not appear verbal agitation. Multiple regression analyses identified hallucination (β = 0.27), total number of physiologic discomforts (β = 0.19) and pain (β = 0.17) as significant predictors of verbal agitation and these factors explained 27.8% of the variance in the model. The findings of this study showed that hallucination, total number of physiologic discomforts and pain with dementia need to be considered when intervention programs to control verbal agitation in patients with dementia were developed.

Physiological Profiling of Agitation in Dementia: Insights From Wearable Sensor Data

“…The larger, positive coefficient estimates and higher number of significant explanatory variables for the phasic and tonic features when predicting verbal agitation could indicate a more consistent state of arousal with verbal agitation compared to the limited number of significant EDA-derived variables for motor agitation. This hypothesis is in line with the current state of the art specifically focused on verbal agitation that has linked verbal agitation and other related vocalizations specifically to “physiological discomfort” or pain ( Hoti et al, 2023 ; Husebo et al, 2022 ; Kim & Park, 2018 ). The difference in estimates when compared to motor agitation could also be due to additional factors, ranging from differences in care practices with this agitation type (e.g., differing medication administration or timing of care administration) to the quality of the resulting EDA signal when a patient is verbally agitated compared to motorically agitated.…”

“…However, a more comprehensive understanding of agitation necessitates an additional focus on different types of agitation expressed. The majority of research focused on responses when a specific kind of agitation is expressed, focused on verbal agitation, and linked verbal agitation to either pain, physiological arousal, or other kinds of discomfort ( Cohen-Mansfield et al, 1992 ; Husebo et al, 2022 ; Kim & Park, 2018 ). Stress, a concept closely tied to arousal ( Tutunji et al, 2023 ; Winsky-Sommerer et al, 2005 ), has been related to behavioral symptoms in people with dementia in the Progressively Lowered Stress Threshold model ( Gerdner et al, 2005 ; Hall & Buckwalter, 1987 ; Richards & Beck, 2004 ).…”