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Perez H, Miguel Cruz A, Neubauer N, Daum C, Comeau AK, Marshall SD, Letts E, Liu L. Risk Factors Associated with Missing Incidents among Persons Living with Dementia: A Scoping Review. Can J Aging 2024:1-15. [PMID: 38297497 DOI: 10.1017/s0714980823000776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
Worldwide, over 55-million people have dementia, and the number will triple by 2050. Persons living with dementia are exposed to risks secondary to cognitive challenges including getting lost. The adverse outcomes of going missing include injuries, death, and premature institutionalization. In this scoping review, we investigate risk factors associated with going missing among persons living with dementia. We searched and screened studies from four electronic databases (Medline, CINAHL, Embase, and Scopus), and extracted relevant data. We identified 3,376 articles, of which 73 met the inclusion criteria. Most studies used quantitative research methods. We identified 27 variables grouped into three risk factor domains: (a) demographics and personal characteristics, (b) health conditions and symptoms, and (c) environmental and contextual antecedents. Identification of risk factors associated with getting lost helps to anticipate missing incidents. Risk factors can be paired with proactive strategies to prevent incidents and inform policies to create safer communities.
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Affiliation(s)
- Hector Perez
- Faculty of Health, University of Waterloo, Waterloo, ON, Canada
| | - Antonio Miguel Cruz
- Faculty of Health, University of Waterloo, Waterloo, ON, Canada
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Glenrose Rehabilitation Research, Innovation & Technology (GRRIT) Hub, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada
| | | | - Christine Daum
- Faculty of Health, University of Waterloo, Waterloo, ON, Canada
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Aidan K Comeau
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | | | - Elyse Letts
- Faculty of Health, University of Waterloo, Waterloo, ON, Canada
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Lili Liu
- Faculty of Health, University of Waterloo, Waterloo, ON, Canada
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Connelly C, Kim K, Liu Y, Zarit SH. Temporal Patterns of Behavioral and Psychological Symptoms of Dementia and Caregiver Distress: Associated Daily and Individual Factors. J Appl Gerontol 2023:7334648231216382. [PMID: 37987697 DOI: 10.1177/07334648231216382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023] Open
Abstract
This study examined daily occurrences of behavioral and psychological symptoms of dementia (BPSD) and whether caregivers' perceived distress towards BPSD varies throughout four phases of the day (i.e., morning, daytime, evening, and night). Family caregivers residing with relatives who were using adult day services (ADS) participated in an 8-day daily diary study (caregiver N = 173; caregiver-day N = 1,359). BPSD occurred most frequently in the evenings. ADS use, sleep disturbances, and dementia severity were significantly associated with BPSD occurrence for some phases of the day. Caregivers' distress towards BPSD occurrences increased throughout the day (i.e., most stressful at night). However, caregivers showed lower reactivity to BPSD at night on days when their relatives used ADS. Evidence of temporal patterns of BPSD in community-dwelling older adults and caregiver distress demonstrated the importance of ADS use for BPSD reactivity and identified potential target windows and associated contextual factors for individualized interventions.
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Affiliation(s)
- Caitlin Connelly
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA
| | - Kyungmin Kim
- Department of Child Development and Family Studies, Seoul National University, Seoul, South Korea
| | - Yin Liu
- Department of Human Development and Family Sciences, Utah State University, Logan, UT, USA
| | - Steven H Zarit
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
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Pyun JM, Kang MJ, Yun Y, Park YH, Kim S. APOE ɛ4 and REM Sleep Behavior Disorder as Risk Factors for Sundown Syndrome in Alzheimer’s Disease. J Alzheimers Dis 2019; 69:521-528. [DOI: 10.3233/jad-190032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Jung-Min Pyun
- Department of Neurology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Min Ju Kang
- Department of Neurology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Younghwa Yun
- Department of Neurology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Young Ho Park
- Department of Neurology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
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Boronat AC, Ferreira-Maia AP, Wang YP. Sundown Syndrome in Older Persons: A Scoping Review. J Am Med Dir Assoc 2019; 20:664-671.e5. [PMID: 31043358 DOI: 10.1016/j.jamda.2019.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To map comprehensive investigations of the sundown syndrome (SS), highlighting its key definition and associated characteristics. DESIGN Scoping review of published articles on SS in PubMed, OVID, EMBASE, Scopus, CINAHL, and Science Direct. SETTING Post-acute and long-term health care settings. PARTICIPANTS Older adults aged ≥60 years. MEASURES Articles must present primary data on specific SS behavior, with explicit psychopathological and quantitative outcomes; and/or evening disruptive behavior. RESULTS From a total number of 460 articles focusing on psychopathology and standardized outcomes of SS, 23 were retained for the final analysis (n = 1210 subjects). The mean age of participants was 63.2 years, and slightly more participants were women. The samples were recruited by convenience from long-term care facilities and tertiary outpatient clinics. The frequency of SS varied from 2% to 82%, without evident difference between genders and race/ethnicity. Generally, the sundown episode occurred during later daytime, when psychomotor alterations and cognitive disturbance manifested repeatedly. The symptomatic manifestations of SS were heterogeneous across the studies. Demographic risk factors were inconsistent. Although some authors have viewed cognitive impairment as a substantive predisposing factor to SS, others supported SS as a predictor of looming cognitive decline. The disrupted circadian rhythm was the most accepted pathophysiology. To date, clinical trials to guide the management of SS with specific pharmacologic and nonpharmacologic approaches are scant. CONCLUSIONS AND IMPLICATIONS SS can be viewed as a cyclic delirium-like condition affecting the older population around the sunset hour that may last for a few hours. The scarcity of comprehensive studies makes it difficult to determine whether and to what extent it can represent a distinct disease, a prodromal stage of dementia, or an epiphenomenon of incipient or worsening dementia. Extensive gathering of clinical data from multiple health care settings, using uniform measurement tools, is much needed.
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Affiliation(s)
- Alexandre C Boronat
- Instituto de Psiquiatria (LIM-23), Hospital das Clinicas HC FMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Ana Paula Ferreira-Maia
- Instituto de Psiquiatria (LIM-23), Hospital das Clinicas HC FMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Yuan-Pang Wang
- Instituto de Psiquiatria (LIM-23), Hospital das Clinicas HC FMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
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Kim SC, Berry B, Young L. Aggressive behaviour risk assessment tool for long-term care (ABRAT-L): Validation study. Geriatr Nurs 2018; 40:284-289. [PMID: 30545569 DOI: 10.1016/j.gerinurse.2018.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 11/12/2018] [Accepted: 11/19/2018] [Indexed: 11/30/2022]
Abstract
This prospective cohort study was conducted to validate the usefulness of the Aggressive Behaviour Risk Assessment Tool for Long-Term Care (ABRAT-L) in predicting aggressive events. A total of 615 newly admitted residents at 22 long-term care homes in Canada were included. The risk of aggression was assessed using the six-item ABRAT-L within 24 hours of admission, and incident reports of aggressive events occurring within 30 days of admission were collected. Forty-seven residents out of 615 had one or more aggressive events (7.6%). The receiver operating characteristics analysis of ABRAT-L showed a good discriminant ability at the previously recommended cut-off score of 4, with satisfactory sensitivity and specificity. The usefulness of ABRAT-L in identifying potentially aggressive residents at the time of admission was confirmed. This validation study supports the adoption of a proactive risk assessment tool, ABRAT-L, as a part of routine admission assessments at long-term care homes.
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Affiliation(s)
- Son Chae Kim
- St. David's School of Nursing, Texas State University, 100 Bobcat Way, Round Rock, TX 78665. USA.
| | - Brigette Berry
- Extendicare Inc., Unit 227, 333 Aspen Glen Landing SW, Calgary, Alberta T3H 0N6. Canada.
| | - Lori Young
- Extendicare Inc., Unit 227, 333 Aspen Glen Landing SW, Calgary, Alberta T3H 0N6. Canada.
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Angulo Sevilla D, Carreras Rodríguez MT, Heredia Rodríguez P, Fernández Sánchez M, Vivancos Mora JA, Gago-Veiga AB. Is There a Characteristic Clinical Profile for Patients with Dementia and Sundown Syndrome? J Alzheimers Dis 2018; 62:335-346. [DOI: 10.3233/jad-170488] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- David Angulo Sevilla
- Department of Neurology, Alzheimer’s Disease and Other Cognitive Disorders Unit, La Princesa Health Research Institute, La Princesa University Hospital, Madrid, Spain
| | - María Teresa Carreras Rodríguez
- Department of Neurology, Alzheimer’s Disease and Other Cognitive Disorders Unit, La Princesa Health Research Institute, La Princesa University Hospital, Madrid, Spain
| | - Patricia Heredia Rodríguez
- Department of Neurology, Alzheimer’s Disease and Other Cognitive Disorders Unit, La Princesa Health Research Institute, La Princesa University Hospital, Madrid, Spain
| | - Marisa Fernández Sánchez
- Department of Neurology, Alzheimer’s Disease and Other Cognitive Disorders Unit, La Princesa Health Research Institute, La Princesa University Hospital, Madrid, Spain
| | - José Aurelio Vivancos Mora
- Department of Neurology, Alzheimer’s Disease and Other Cognitive Disorders Unit, La Princesa Health Research Institute, La Princesa University Hospital, Madrid, Spain
| | - Ana Beatriz Gago-Veiga
- Department of Neurology, Alzheimer’s Disease and Other Cognitive Disorders Unit, La Princesa Health Research Institute, La Princesa University Hospital, Madrid, Spain
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Shih YH, Pai MC, Huang YC, Wang JJ. Sundown Syndrome, Sleep Quality, and Walking Among Community-Dwelling People With Alzheimer Disease. J Am Med Dir Assoc 2017; 18:396-401. [PMID: 28057424 DOI: 10.1016/j.jamda.2016.10.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 10/28/2016] [Accepted: 10/31/2016] [Indexed: 10/20/2022]
Abstract
PURPOSES Sundown syndrome and sleep disturbances cause people with Alzheimer disease (PAD) and caregivers suffering. Studies have indicated that physical exercise could have a positive impact on sundown syndrome, yet no research has ever explored the relationship between walking and sundown syndrome. The aims of this study were to examine the relationship between sundown syndrome and sleep quality, and determine whether the severity of dementia, sleep quality, and weekly duration of walking influenced sundown syndrome, and to assess differences in sundown syndrome and sleep quality in relation to the accompanying walker and weekly duration of walking among people with Alzheimer disease living in the community. DESIGN A cross-sectional observation study was conducted. METHODS A total 184 participants were recruited from dementia outpatient clinics of several hospitals and long-term care resource management centers in southern Taiwan. The Chinese version of the Cohen-Mansfield Agitation Inventory, Community form was used to assess sundown syndrome, and the Chinese version of the Pittsburgh Sleep Quality Index was used to measure sleep quality. Pearson correlation, multiple regression, and 1-way analysis of variance were performed for data analysis. RESULTS The results indicated that sundown syndrome was significantly correlated with sleep quality (r = 0.374), whereas severity of dementia, sleep quality, and weekly duration of walking were influencing factors of sundown syndrome and accounted for a total of 24.8% of the variance (adjusted R2 = 0.222, F6,177 = 9.709). In addition, PAD who walked with relatives showed less sundown syndrome (F3,180 = 4.435, P = .005) and better sleep quality (F3,180 = 3.565, P = .015) compared with those walking with nonrelatives. Also, longer walking time led to less sundown syndrome (F4,179 = 4.351, P = .002) and better sleep quality (F4,179 = 3.592, P = .008). CONCLUSIONS Advanced dementia, poor sleep quality, and shorter weekly duration of walking were the influencing factors of sundown syndrome. Walking with relatives and regular longer walking time could improve sleep quality and alleviate sundown syndrome. It is suggested that a well-designed walking intervention considering these factors could be an appropriate strategy to manage sundown syndrome and sleep quality for PAD and their caregivers.
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Affiliation(s)
- Yen-Hua Shih
- Institute of Allied Health Science, National Cheng Kung University, Tainan City, Taiwan, Republic of China; Tzu Hui Institute of Technology, Pingtung County, Taiwan, Republic of China
| | - Ming-Chyi Pai
- Division of Behavioral Neurology, Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China
| | - Ying-Che Huang
- Department of Neurology, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan, Republic of China
| | - Jing-Jy Wang
- Institute of Allied Health Science, National Cheng Kung University, Tainan City, Taiwan, Republic of China.
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Pavese N. Imaging the aetiology of sleep disorders in dementia and Parkinson's disease. Curr Neurol Neurosci Rep 2015; 14:501. [PMID: 25341374 DOI: 10.1007/s11910-014-0501-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Sleep disorders are commonly observed in patients with neurodegenerative disorders such as Alzheimer's disease and Parkinson's disease and often represent an early manifestation of the underlying degenerative process. The pathophysiology of sleep dysfunction in these conditions is complex and incompletely understood. However, in recent years, functional imaging in vivo with SPECT and PET has significantly improved our understanding of the possible molecular mechanisms. These include dysfunction of both dopaminergic and non-dopaminergic pathways involved in sleep/wakefulness control. This paper summarizes the main findings of the imaging studies performed to elucidate the aetiology of sleep disorders in Alzheimer's disease and Parkinson's disease.
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Affiliation(s)
- Nicola Pavese
- Division of Brain Sciences-Neurology Imaging Unit (NIU), Imperial College London, 1st Floor, B Block Hammersmith Campus DuCane Road, London, W12 0NN, UK,
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