Operant Conditioning in Older Adults with Alzheimer’s Disease

Abstract

Behavioral interventions based on operant principles are commonly attempted to manage agitation in older adults with dementia. The extent to which operant conditioning can occur in persons with particular dementias, however, is unclear. The present study involved use of a button-pressing task to evaluate the sensitivity of the responding of older individuals with and without probable Alzheimer's disease (AD) to changes in schedules of reinforcement. It was expected that participants with AD would acquire the experimental task and that they would demonstrate less sensitivity to changes in schedules of reinforcement than participants without AD. Results indicated that operant conditioning can occur in older adults with AD and that they can respond to different schedules of reinforcement. The responding of 3 participants with AD was highly sensitive to a transition from a fixed interval schedule to an extinction schedule. Two participants with AD demonstrated responding that was sensitive to a more subtle transition. Participants with AD failed to show spontaneous recovery of responding after a delay. The performances of participants with and without AD are compared, and implications of findings for behavioral interventions in AD are discussed.Alzheimer's disease (AD) is the most common cause of dementia, affecting approximately 4 million Americans (Alzheimer's Association, 2002). Approximately 10% of adults older than 65 years and almost half of those over 85 years have the disease (Alzheimer's Association). The organic pathology that underlies AD can produce a variety of maladaptive behaviors, including aggression, screaming, and wandering, typically referred to as agitation (Cohen-Mansfield and Billig, 1986). Agitation

A Review of Behavioural Gerontology and Dementia Related Interventions

“…As mentioned previously, individuals with dementia meet extinction criteria at an advanced pace compared to individuals with no pathological neurocognitive changes. 19 Thus, it can be argued that the limitation of this technique concerns the maintenance of the strategy after the researcher has left. Long term care facilities have limited staff resources to meet the demands of individualised reinforcement contingencies with haphazard application or the cessation of the intervention leading to the extinction of the previously reinforced non-wandering behaviour.…”