Abstract
Online tools can be used by people with dementia and their caregivers to self-identify and track troubling symptoms, such as verbal repetition. We aimed to explore verbal repetition behaviors in people with dementia. Participants were recruited via an online resource for people with dementia and their caregivers. Respondents were instructed to complete information about symptoms that are most important to them for tracking over time. In this cross-sectional study, we analyzed data pertaining to individuals with dementia who had at least three symptoms selected for tracking. Of the 3,573 participants who began a user profile, 1,707 fulfilled criteria for analysis. Verbal repetition was identified as a treatment target in 807 respondents (47.3%). Verbal repetition was more frequent in individuals with mild dementia compared to those with moderate and severe dementia (57.2% vs. 36.0% and 39.9%, p < 0.01) and in those with Alzheimer's disease versus other dementias (65.2% vs. 29.7%, p < 0.001). Repetitive questioning was the most frequent type of verbal repetition (90.5% of individuals with verbal repetition). Verbal repetition was most strongly associated with difficulties operating gadgets/appliances (OR 3.65, 95%CI: 2.82-4.72), lack of interest and/or initiative (3.52: 2.84-4.36), misplacing or losing objects (3.25: 2.64-4.01), and lack of attention and/or concentration (2.62: 2.12-3.26). Verbal repetition is a common symptom in people at all stages of dementia but is most commonly targeted for monitoring and treatment effects in its mild stage. Much research is required to further elucidate the underlying mechanisms and the effect of different treatment strategies.
Highlights
The clinical expression of disease in dementia varies both within and between individuals
Verbal repetition was the most common of the 60 possible symptoms reported as a target for monitoring, in 807 individuals (47.2%)
For these 828, verbal repetition was more often targeted in people with AD than in those with other dementias (373/572; 65.2%, 76/256; 29.7%, p < 0.001)
Summary
The clinical expression of disease in dementia varies both within and between individuals. Cultural background, co-morbidities, cognitive reserve, compensatory changes, neuropathological features, and disease stage all contribute to the intrinsic heterogeneity of dementia (Cohen-Mansfield, 2000; Rockwood, 2010). Study of individual symptom types and a focus on individual goal setting and attainment can enhance patientcentered care. To this end, we have structured aspects of collateral history by employing the SymptomGuideTM (SG), a standardized dementia. Online tools can be used by people with dementia and their caregivers to self-identify and track troubling symptoms, such as verbal repetition. We aimed to explore verbal repetition behaviors in people with dementia
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