Is improvement possible in the measurement of behaviour disturbance in dementia?

Shah, Ajit; Allen, Harry

doi:10.1002/(sici)1099-1166(199907)14:7<512::aid-gps986>3.0.co;2-8

Cited by 6 publications

(4 citation statements)

References 82 publications

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“…Increased distress in caregivers can escalate behavioral problems or agitation in dementia patients, and presents both therapeutic challenge and opportunity for intervention (Devanand and Lawlor, 2000). Significantly higher mean total BEHAVE-AD-K scores in AD patients living in their home without treatment may reflect either the caregiver's neglect in delaying medical treatment in spite of higher BPSD or resignation in caring for AD patients due to the higher care burden (Shah and Allen, 1999). This may be related to health-care seeking behaviors and the characteristics of the Korean health insurance system, whereby the insured or dependents are required to share a part of the medical expenses when receiving medical services provided by the medical insurance program.…”

Section: Discussionmentioning

confidence: 99%

Behavioral and Psychological Signs and Symptoms of Dementia (BPSD) in antipsychotic-naïve Alzheimer's Disease patients

Suh

Kim

2004

Int. Psychogeriatr.

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Background/Objective: There were few studies identifying the natural unfolding of behavioural and psychological symptoms of dementia (BPSD) in the course of Alzheimer's disease (AD) progression in antipsychotic-naïve AD patients. This study aims to examine the specific nature of the association between BPSD in AD and the global severity of illness measured by Global Deterioration Scale(GDS) in antipsychotic-naïve AD patients in Korea.Methods: A total of 562 antipsychotics-naïve AD patients were recruited from four different groups [a geriatric mental hospital (n=145), a semi-hospitalized dementia institution (n=120), a dementia clinic (n=114) and community-dwelling dementia patients (n=183)]. BPSD exhibited by AD patients were measured using the 25-item Korean version of the BEHAVE-AD.Results: Ninety-two percent (n=517) of AD patients had at least one BPSD, while 56% (n=315) had 4 or more BPSD. Specific kinds of behavioral disturbance peak at the stages of moderate AD (GDS stage 5) or moderately severe AD (GDS stage 6). AD patients left at home without any treatment had higher frequency of BPSD than did other groups seeking treatment, although all of them were antipsychotic-naïve.Conclusion: BPSD potentially remediable to treatment were highly frequent in Korean AD patients. Health policies to meet the unmet needs of elderly Koreans are urgently needed, especially for AD patients at home without treatment.

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Section: Discussionmentioning

confidence: 99%

Behavioral and Psychological Signs and Symptoms of Dementia (BPSD) in antipsychotic-naïve Alzheimer's Disease patients

Suh

Kim

2004

Int. Psychogeriatr.

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“…While the statistical technique employed in this study to account for missing data is not as good as having the actual data, it did estimate parameters by taking into account all available patient information and allowed estimation of patient aggression scores for all patients. Traditional analytic techniques that delete patients with missing data from the analyses can lead to selection bias and incorrect findings (Maxwell & Delaney, 1990;Shah & Allen, 1999). This technique, therefore, is better than traditional analytic techniques that delete patients with missing data from the analyses because analyses include all possible information from patients.…”

Section: Discussionmentioning

confidence: 99%

“…In conclusion, critical decisions are made for older patients based on their aggression scores such Downloaded by [Washington University in St Louis] at 08:22 22 December 2014 as whether to refer a patient for nursing home placement, whether to change the amount or frequency of medication, or whether to restrain a patient (Shah & Allen, 1999). Measuring aggression in older adults using latent variable modeling may have clinical utility and results in a reliable measure that broadly covers the construct of aggression.…”

Section: Discussionmentioning

confidence: 99%

Measuring aggression in older adults: A latent variable modeling approach

O'Malley¹,

Orengo²,

Kunik³

et al. 2002

Aging & Mental Health

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This cross-sectional measurement study demonstrates a technique for combining information from several aggression scales into one aggression score using latent variable modeling. Participants included male patients (n = 49) with a DSM-IV diagnosis of dementia at The Veterans Affairs Medical Center Outpatient Geriatric Psychiatry Clinic. Data from seven aggression scales were used to indicate the latent aggression variable. Results provided evidence that a unidimensional latent variable model of aggression adequately represented the data. Reliability of the aggression latent variable was estimated as 0.90, whereas reliability of the separate scales estimated with this sample were less than 0.84. Our findings suggest that combining multiple scales into one aggression score using latent variable modeling results in comprehensive and reliable aggression scores that offer researchers several advantages over current methods for measuring aggression.

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“…Furthermore, the severity of BPSD is often associated with the stage of dementia (Thompson et al., 2010). It is believed that BPSD without adequate treatment leads to poorer prognosis of dementia (Bourgeois et al., 1996; Shah and Allen, 1999; Brodaty et al., 2003; Huang et al., 2012).…”

Section: Behavioral and Psychological Symptoms Of Dementia Is Common mentioning

confidence: 99%

The Role of N-Methyl-D-Aspartate Receptor Neurotransmission and Precision Medicine in Behavioral and Psychological Symptoms of Dementia

Lin

Lane

2019

Front. Pharmacol.

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While the world’s population is aging, the prevalence of dementia and the associated behavioral and psychological symptoms of dementia (BPSD) rises rapidly. BPSD are associated with worsening of cognitive function and poorer prognosis. No pharmacological treatment has been approved to be beneficial for BPSD to date. Dysfunction of the N-methyl-D-aspartate receptor (NMDAR)-related neurotransmission leads to cognitive impairment and behavioral changes, both of which are core symptoms of BPSD. Memantine, an NMDAR partial antagonist, is used to treat moderate to severe Alzheimer’s disease (AD). On the other hand, a D-amino acid oxidase inhibitor improved early-phase AD. Whether to enhance or to attenuate the NMDAR may depend on the phases of dementia. It will be valuable to develop biomarkers indicating the activity of NMDAR, particularly in BPSD. In addition, recent reports suggest that gender difference exists in the treatment of dementia. Selecting subpopulations of patients with BPSD who are prone to improvement with treatment would be important. We reviewed literatures regarding the treatment of BPSD, focusing on the NMDAR-related modulation and precision medicine. Future studies examining the NMDAR modulators with the aid of potential biomarkers to tailor the treatment for individualized patients with BPSD are warranted.

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Is improvement possible in the measurement of behaviour disturbance in dementia?

Cited by 6 publications

References 82 publications

Behavioral and Psychological Signs and Symptoms of Dementia (BPSD) in antipsychotic-naïve Alzheimer's Disease patients

Behavioral and Psychological Signs and Symptoms of Dementia (BPSD) in antipsychotic-naïve Alzheimer's Disease patients

Measuring aggression in older adults: A latent variable modeling approach

The Role of N-Methyl-D-Aspartate Receptor Neurotransmission and Precision Medicine in Behavioral and Psychological Symptoms of Dementia

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