Behavioral Symptoms Of Dementia Research Articles

Waiting for home: The experience of delayed discharge for people with dementia.

Individuals who remain in hospital once their health has stabilised experience delayed discharge. This often occurs for people with dementia when care needs exceed what can be managed at home. There is little research that takes into account the experience and needs of these patients. This Interpretive Description (ID) study, theoretically grounded in personhood and social citizenship perspectives, focused on the perspectives of people with dementia experiencing delayed discharge to address this gap in research and to better understand how nursing care can be improved for them. Twenty-one individuals participated in this study: eight patient participants experiencing delayed discharge and living with dementia, six family members, and seven nurses. Data collection methods primarily included participant observations, totalling 100h of observations. Fourteen semi-structured interviews were also conducted with family members and nurses and with one patient participant. Informal conversations were undertaken with patient participants who did not take part in interviews. Thematic analysis resulted in three main themes, encapsulating the patients' experiences: (1) Living and Waiting; (2) Distress and Behaviours; and (3) Looking Beyond the Designation. Findings are discussed in the context of the passive nature of delayed discharge care, the need for person-centred care, and prevailing discourses around the behavioural symptoms of dementia. Implications for nursing practice include the need to acknowledge and foster the abilities of people with dementia. The behaviour narrative and labelling prevalent in hospitals must also be challenged. Lastly, nurses need to recognise the significant transition that is the delayed discharge experience, especially for people with dementia. This study advocates for person-centred and inclusive nursing care, where ongoing needs are recognised and addressed, particularly for people with dementia experiencing delayed discharge, who are waiting for home.

Deficiency Citations on Inappropriate Psychotropics Use Related to Care for Behavioral Symptoms of Dementia.

The Centers for Medicare and Medicaid (CMS) initiated the National Partnership to Improve Dementia Care in Nursing Homes in 2012, which helped decrease antipsychotics use. However, inappropriate use of antipsychotics and other psychotropic medications to control behavioral symptoms associated with dementia persists. Nursing homes (NHs) can be flagged for inappropriate psychotropics use as a deficiency of care citation (F-758 tag). The purpose of this study was to comprehensively explore inappropriate psychotropic medication use deficiency, F-758 citations, in caring for NH residents with dementia. A mixed-methods study was performed. During the first quarter of 2018 (January-March), 3526 NHs were surveyed, of which 642 received F-758 tags. Of the 642, the sample was confined to the 444 NHs that received the citation for the care of residents with dementia. Information on deficiencies was obtained from 2018 Certification and Survey Provider Enhanced Reporting data. Inspection reports for deficiencies were obtained from Centers for Medicare and Medicaid Nursing Home Compare and ProPublica. Quantitative analysis was used to examine the frequency of involved psychotropic medications, scope/severity of F-758 deficiency citations, and reasons for the citations. Reasons for F-758 citations by psychotropic medication categories and scope/severity of the citations were also examined using χ² tests. Qualitative data analysis was conducted using content analysis with an inductive coding approach to summarize the inspection reports. Antipsychotics were the most involved drug category for F-758 tag citations. The 3 most common reasons for F-758 citations included failure to identify and/or monitor behavioral symptoms (178 NHs), attempt gradual drug reduction (131 NHs), and maintain 14-day limitations on Pro Re Nata (PRN) psychotropic orders (121 NHs). Compared with those with no involvement of antipsychotic drugs, facilities with antipsychotics-related F-758 tags had higher rates of failure to identify/monitor behavioral symptoms (P<.001), attempt gradual drug reduction (P < .001), and provide adequate indications for psychotropics use (P < .001). NHs with F-758 tags related to inappropriate antianxiety medication use had a higher prevalence of failure to maintain 14-day limitation on PRN orders (P < .001) and provide nonpharmacologic interventions (P < .001). This study suggests areas for improvement that could potentially reduce inappropriate psychotropics use. Supporting quality of dementia care workforce and improving cooperation within healthcare staff and professionals are recommended to ensure proper nonpharmacologic and pharmacologic interventions.

The relationship between daily stressors, social support, depression and anxiety among dementia family caregivers: a micro-longitudinal study

Objectives: This study aimed to examine the relationships between daily stress, social support, and the mental health of dementia family caregivers. Methods: A national sample of family caregivers (N = 165) completed daily diary surveys over 21 days (n = 2,841). Mixed-level models were used to examine the daily odds of experiencing depression and anxiety-related symptoms when risk factors, such as the stress of managing behavioral symptoms of dementia (BSDs) exhibited by the person living with dementia, and protective factors, such as social support, were reported on a given day. Results: Dementia caregivers were more likely to report depression and anxiety-related symptoms when BSDs were present and perceived as more bothersome than usual. Specific BSDs, including restless behaviors and intense emotions, were also found to increase the daily odds of experiencing depression and anxiety symptoms. The daily odds of depression symptoms decreased on days when caregivers reported receiving instrumental support, while the daily odds of anxiety symptoms increased on days when caregivers reported receiving emotional support. Conclusions: The daily odds of experiencing depression and anxietyvary based on the presence of specific BSDs and social support. These findings support the need for targeted interventions to improve the day-to-day well-being of dementia family caregivers.

The Use of ECT in the Elderly-Looking Beyond Depression.

We reviewed recent evidence on the use of electroconvulsive therapy (ECT) in the geriatric population. This review looked at the literature on depression, for which there is a breadth of data, as well as other conditions that have historically not been as well studied, as well as attempting to provide practical recommendations for ECT practitioners. This review also examined the impact of the COVID-19 pandemic on ECT in the elderly. ECT shows robust efficacy across many psychiatric diseases, from depression and bipolar disorder to psychosis and catatonia. It has also shown positive results at improving behavioral symptoms of dementia, as well as improving motor symptoms seen in Parkinson's disease. It is routinely found to be a safe treatment as well, generally with only minimal transient side effects. ECT should not be considered a "last-resort" treatment for geriatric patients suffering from psychiatric disorders. It has historical and recent literature supporting its use in many psychiatric disorders and has been shown to be safe with minimal side effects when appropriate considerations are taken for the elderly population.

Deficiency of Care Reports on Inappropriate Psychotropic Medication Use Related to Care for Behavioral Symptoms of Dementia

The Centers for Medicare and Medicaid (CMS) initiated the National Partnership to Improve Dementia Care in Nursing Homes in 2012, which led to a steady decline in antipsychotics use. However, inappropriate use of antipsychotics and other psychotropic drugs remains in nursing home (NH) residents with behavioral symptoms of dementia despite limited efficacy and the risk of adverse effects. NHs can receive a deficiency of care citation (F-758 tag) for inappropriate psychotropic medication use. The purpose of this study was to examine the nature of inappropriate psychotropic drug use deficiency citations in caring for NH residents with dementia.

Nurse staffing and deficiency of care for inappropriate psychotropic medication use in nursing home residents with dementia.

Psychotropic medications are used to manage behavioral symptoms of dementia in nursing homes despite limited efficacy and the risk of adverse effects, and may be considered an easier solution for the treatment of behavioral symptoms. However, non-pharmacologic interventions are preferable but are most effective with consistent staffing. To address this, the Centers for Medicare and Medicaid Services implemented additional regulatory scrutiny through F-tag for deficiencies of care, targeting inappropriate psychotropic medication use (F-758 tag). The purpose of this study was to examine associations between nurse staffing levels and the occurrence of deficiency citations for inappropriate psychotropic medication use in residents with dementia symptoms. This was secondary data analysis of a cross-sectional study using CASPER (Certification and Survey Provider Enhanced Reporting) and PBJ (Payroll-Based Journal) data from 14,548 Medicare or Medicaid-certified facilities surveyed between December 1, 2017 and December 31, 2018. Staffing measures included nursing hours per resident day and registered nurse skill-mix. Generalized linear mixed models with facilities nested within states, were used to estimate the magnitude of the associations between the occurrence of inappropriate psychotropics use deficiency citations and nurse staffing levels. Covariates included facility location, size, ownership, the presence of dementia special care units, and the proportion of residents with dementia, depression, psychiatric disorders, mental behavioral symptoms, and residents with Medicare/Medicaid. There were 1875 facilities with deficiency citations regarding inappropriate psychotropics use for residents with dementia. When controlling for covariates, facilities with greater hours per resident day for registered nurses (odds ratio [OR]=0.54, 95% confidence interval [CI]=0.44-0.67), certified nursing assistants (OR=0.87, 95% CI=0.77-0.99) and total nurse staff (OR=0.87, 95% CI=0.79-0.96) had significantly lower odds of inappropriate psychotropics use deficiency citations. Nursing homes with greater registered nurse skill-mix had significantly lower odds of receiving the deficiency tags (OR=0.10, 95% CI=0.04-0.26). Citations for inappropriate psychotropic medication use among residents with dementia were less likely to occur in facilities with higher staffing levels for registered nurses, certified nursing assistants, total nurse staff, and greater registered nurse skill-mix. Facilities need to be equipped with adequate nurse staffing levels to facilitate the use of non-pharmacological interventions and reduce inappropriate psychotropic medication use. Adequate nursing staffing is associated with fewer deficiencies related to the use of psychotropic medications to treat behavioral symptoms. Nursing home administrators and policymakers need to focus on assuring adequate nurse staffing levels to provide safe and high-quality dementia care.

Therapeutic Touch in the Management of Responsive Behaviors in Patients with Dementia

Introduction: This study aimed to investigate the use of therapeutic touch (TT) in the management of responsive behaviors in patients with dementia. Methods: A randomized, double-blinded control trial was used to compare response to TT in a population with responsive behaviors in dementia, in 3 phases, pretreatment, treatment, and posttreatment each lasting 5 days. The participants were divided into three groups: experimental, placebo, and control. The experimental group received regular TT, the placebo group received mimic TT, and the control group received regular routine care. Behavior was observed and recorded by trained research assistants every 20 min during the study time throughout each of the phases. Modified Agitated Behavior Rating Scale (ABRS) and Revised Memory and Behavior Check (RMBC) scores were used to assess the behavioral symptoms of dementia throughout the study. Results: All groups had decreasing RMBC scores during the pretreatment period, however; the experimental TT group was the only group whose RMBC scores continued to decrease during the treatment period. All groups had a similar pattern of rates of change in ABRS scores over the 15-day period, with no differential pattern of results related to experimental TT. Conclusion: Despite limited evidence, TT should be explored as an adjunctive therapy for reducing behavioral symptoms in individuals with dementia. Further research is needed to determine the effects of TT on responsive behaviors in dementia. There is a need for studies with larger sample sizes, equal distribution of participants between groups (in terms of dementia stages), and longer post study follow-ups.

Dynamic structural equation modelling evaluating the progressively lowered stress threshold as an explanation for behavioural symptoms of dementia

AimTo evaluate the progressively lowered stress threshold (PLST) conceptual model as an explanation for behavioural symptoms of dementia and test several of its hypothesized propositions. The PLST model suggests that due to impairments in coping, persons living with dementia have a reduced threshold for stress and respond with more behavioural symptoms of dementia as stress accumulates throughout the day.DesignIntensive longitudinal design.MethodsA sample of N = 165 family caregivers completed brief daily diary surveys for 21 days between the dates of 7/2019 and 8/2020, reporting on a total of 2841 days. Dynamic structural equation modelling was used as the analytic technique to examine the impact of caregiver and care recipient environmental stressors on the diversity of behavioural symptoms of dementia to account for the nested data structure and autoregressive relationships.FindingsResults show direct relationships between environmental stressors and diversity of behavioural symptoms of dementia that same day and the following day.ConclusionFindings provide support for the PLST model propositions. Further, findings suggest an extension to the conceptual model is warranted given evidence of an exposure/recovery trajectory and the lagged effects of stress exposure on behavioural symptoms of dementia presentation.ImpactThis study tested whether a commonly used nursing model does in fact explain the occurrence of behavioural symptoms of dementia. The main findings support using the model as an intervention framework and suggest the model should be adapted to consider recovery trajectories. Since behavioural symptoms of dementia represent complex and dynamic temporal phenomena, traditional longitudinal assessments and analyses are an insufficient measurement modality for testing models. Findings inform the design of environmental‐modification type interventions for behavioural symptoms of dementia management and the methods to evaluate such interventions.

Exploring how caregivers for people living with dementia use strategies to overcome work system constraints

Informal caregivers for persons living with dementia (PLWD) require interventions that incorporate caregiving context. We used the Patient Work System model to characterize caregiving context by identifying work system constraints experienced by caregivers during dementia care events (e.g., managing behavioral symptoms of dementia) and strategies used to overcome constraints. We conducted twenty semi-structured interviews with caregivers. We performed upward abstraction and strategy mapping and identified seven work system constraints and eight strategies used to overcome constraints across three care events. We found that strategies used by caregivers either directly modified a constraint or emphasized other positive work system components to overcome a constraint. For example a caregiver modified their bathroom to support the PLWD in bathing themselves properly and safely. These findings provide an understanding of how real-world context influences how caregivers deliver dementia care and the design and implementation of systems that support dementia caregivers.

Unsupervised Deep Learning to Detect Agitation From Videos in People With Dementia

Behavioural symptoms of dementia present a significant risk within Long Term Care (LTC) homes, which face difficulties supporting residents and monitoring their safety with limited staffing resources. Many LTC facilities have installed video surveillance systems in common areas that can help staff to observe residents; however, typically these video streams are not monitored. In this paper, we present the development of a computer vision algorithm to use these video streams to detect episodes of clinically important agitation in people with dementia. Given that episodes of agitation are rare in comparison to normal behaviours, we formulated this as an anomaly detection problem. This involves using the video camera to monitor the scene rather than tracking individuals. We developed a customized spatio-temporal convolution autoencoder that is trained on the normal behaviours and then identified agitation during testing as anomalous behaviour. We present a proof-of-concept using video data collected from a specialized dementia unit and annotated for agitation events. We trained the unsupervised neural network on approximately 24 hours of normal activities and tested on 11 hours of videos containing both normal activities and agitation events, and obtained an area under the curve of the receiver operating characteristic curve of 0.754. This research paves the way for leveraging existing surveillance infrastructure in LTC and other mental health settings to detect agitation or aggression, with the potential for improved health and safety.

Family Caregiver Needs and Preferences for Virtual Training to Manage Behavioral Symptoms of Dementia

STAR-Caregivers Virtual Training and Follow-up (STAR-VTF) is adapted from an evidence-based, in-person program that teaches family caregivers to manage behavioral and psychological symptoms of dementia (BPSD). The study objective was to understand the needs of family caregivers for improving BPSD management and the extent to which caregivers perceived that STAR-VTF could address those needs. We conducted 15 semi-structured interviews with family caregivers of people with dementia. We showed caregivers prototypes of STAR-VTF online self-directed materials. We obtained caregiver feedback, focusing on needs and preferences and perceived barriers to using STAR-VTF. We used a hybrid approach of inductive and deductive coding and aggregated codes to develop themes. The idea of a virtual training program for learning to manage BPSD appealed to caregivers. They said healthcare providers did not provide adequate education in the early disease stages about the personality and behavior symptoms that can affect people with dementia. Caregivers found it unexpected and frustrating when the person with dementia began experiencing BPSD, symptoms they felt unprepared to manage. Accordingly, caregivers expressed a strong desire for the healthcare organization to offer programs such as STAR-VTF much sooner. Many were interested in the virtual aspect of the training due to the convenience of receiving help from home and the perception that help from a virtual program would be timelier than traditional service modalities. Given caregivers’ limited time, they suggested dividing the STAR-VTF content into chunks to review as time permitted. Caregivers reported a preference for having the same coach for the program duration.

Adaptation of the Care Ecosystem Intervention for Individuals with Dementia in a High-Risk, Care Management Program

The Care Ecosystem (CareEco) model is a telephone-based dementia care program providing standardized, personalized and scalable support and education for caregivers and persons living with dementia (PLWD), medication guidance, and promotion of proactive decision-making. It has demonstrated improvement in quality of life for PLWD and reduced unnecessary healthcare expenditures. We initiated a pragmatic, embedded randomized pilot trial of an adapted CareEco model for nurses who provide high-risk care management and are embedded in primary care practices within a large healthcare system. Outcomes include feasibility of collecting emergency department visits, usability and acceptability of the intervention by nurse care managers, caregiver strain, behavioral symptoms of dementia and healthcare expenditures. Challenges of implementation include engaging key care management leaders, adaptation of the CareEco training modules for nurses, identification of primary caregivers, training and reinforcing knowledge and skills of the nurses, embedding clinical assessments into care manager workflows and integration with the EMR.

Can Remote Monitoring Measure Life Activity and Caregiver Experience? Early Results of Multi-modal Assessments

Subjective assessments of dementia caregiver burden are vulnerable to recall and recency biases. Objective continuous home assessment using passive technologies (e.g., bed mats, actigraphy watches) can provide ecologically valid detail on caregiver stress and family function. We tested the utility of objective assessment of activity before, during and after the behavioral intervention of STELLA (Support via Technology: Living and Learning with Advancing AD) which facilitates effective online management of behavioral symptoms of dementia. We present preliminary data on objective measures of sleep and step counts, and subjective measures of burden. We captured data from three caregivers caring for a family member with dementia. Each family lives in home with unobtrusive monitoring devices that recorded data on sleep (Emfit sleep mat) and daily steps (Withings watch). Self-report assessments of burden, depression and grief were collected prior to and after the 2-month intervention. Objective data was collected continuously. Pre/post subjective assessments suggest that the STELLA intervention has the potential to reduce behavioral symptom frequency and caregiver reactivity to symptoms (pre-STELLA behavior frequency=44.9, post=39.2; pre-STELLA reactivity=50.5; post=38.5). Step count ranged from 775 steps/day to 5065, with each participant trending fewer steps during the intervention. Mean sleep time ranged from 6.3 to 8.6 hours and didn’t change during the intervention. The small sample size limits interpretation but provides evidence that it is feasible to collect continuous objective life-activity data during caregiver interventions. This digital data has the potential to inform the validity of subjective findings by limiting recall and recency biases.

Perceived Appreciation for Care Associates with Higher Quality Caregiving Day-to-Day

Family members are critical to dementia care and the U.S. long-term services system. Yet, little is known about how to support the quality of care provided by family members, who often receive little training. We hypothesize that on days when caregivers feel more appreciated, they report providing a higher quality of care. To test this hypothesis, we asked spousal dementia caregivers (N=21) to complete 14 daily surveys that asked about their daily caregiving experiences. Our measure for “quality of care” was based on the Exemplary Caregiving Scale, and included 3-items pertaining to provision of care (e.g., “You considered your spouse's wishes and opinions when providing assistance”). Response options included “Most of the time,” “Some of the time,” and “Never”; scores were summed (range 0 to 6). Caregivers were also asked to what extent their spouse appreciated the care provided (“Not at all,” “Some,” or “A lot”). We applied multi-level mixed models to the data, and controlled for age, gender, Hispanic ethnicity, number of behavioral symptoms of dementia each day and months since diagnosis. In adjusted models, we found that on days when caregivers believed care recipients appreciated care provided “Some” or “A lot,” they reported providing higher quality care (B=0.52, p=0.010 and B=0.79, p<0.001, respectively) compared with days when caregivers believed care recipients appreciated care provided “Not at all”. Preliminary results may inform programs to support caregivers’ ability to provide high quality care (e.g., by helping caregivers to perceive rewards) and to identify caregivers at risk of providing low-quality care.

Cognitive impairment associated with global sensory processing abnormalities

AbstractBackgroundRecognition of the impact of primary sensory impairment on cognitive status and decline in the aging population has spurred research in this area. Most prior studies have focused on primary sensory function, with few studying the potential impact of central nervous system sensory processing and modulation in relation to cognitive status.MethodThis study sought to evaluate sensory processing abnormalities rather than primary sensory deficits in community‐residing older adults through administration of the Adult Sensory Profile (ASP), a 60‐item, norm‐referenced assessment evaluating central nervous system sensory processing. The ASP items assess six sensory modalities: taste/smell, movement, visual, touch, auditory, and activity level. Participants ranked items based on their likelihood to engage in activities within each group. Responses were tabulated into four processing categories (sensation avoiding, sensory sensitivity, sensation seeking, and low registration) and compared with age‐cohort normative data. Identification of more than one category outside of normative results was indicative of sensory processing abnormalities compared to same‐aged peers. Participants were categorized based on the ASP as normal (&lt;2 categories outside of normal range) or abnormal (2‐4 categories outside of normal range). Chi‐square tests compared cognitively normal participants to those with cognitive impairment.ResultSeventeen participants completed the ASP. Eight were cognitively normal at the time of completion and nine were diagnosed with cognitive impairment. Of those with normal cognition, two were considered to have abnormal sensory processing (25%). Of those with cognitive impairment, seven were considered abnormal (78%), indicating a significant difference in global sensory processing between groups (x2=4.73, p=0.029).ConclusionGlobal sensory processing abnormalities were more frequent in those diagnosed with cognitive impairment compared to those that remained cognitively intact. It is likely that cortical neurodegeneration in sensory association areas is responsible for the increased prevalence of sensory processing abnormalities seen in the older adults with cognitive impairment in this study. Abnormal sensory processing abilities could contribute to increased behavioral and psychiatric symptoms, similar to that seen in children with severe sensory processing disorders. Larger studies are needed to confirm these results and investigate the relationship between impaired sensory processing and behavioral symptoms in dementia.

Reduction of behavioural inhibition disorders in behavioural variant frontotemporal dementia patients observed under semi‐ecological conditions

AbstractBackgroundBehavioural variant frontotemporal dementia (bvFTD) is characterised by a progressive deterioration of personality, social conduct and cognition. Especially, inhibition troubles are reported, impairing the daily lives of patients and caregivers. However, assessment and characterisation of disinhibition are still poorly known, leading to a limited management of these disorders. We aim to identify activities related to an increase or a decrease of behavioural disinhibition, in order to better apprehend these disorders and set up non‐pharmacological approaches to limit these troubles.MethodWe assess behavioural disinhibition in a semi‐ecological setting, noting occurrences of 16 behaviours – derived from clinical criteria of bvFTD – related to compulsivity, impulsivity or social disinhibition, in a population of 25 bvFTD and 25 healthy controls (HC). Subjects are placed in a waiting room during 45 minutes, instructions are to get comfortable and enjoy the room. During the scenario, they are firstly free to explore the room (Free Phase) and are then guided by a questionnaire to be filled in (Guided Phase). Duration of activity related behaviours and motor patterns are also collected to look for correlations with behavioural disinhibition scores.ResultTo date, we included 22 bvFTD and 24 HC. We found out that disinhibition behaviours are not constant during the scenario. BvFTD patients are less impulsive during the guided phase compared to the free phase (p=0.014, Wilcoxon test), and show more social disinhibition than HC during the free phase and at the end of the guided phase (p=0.014 and p=0.026 respectively, Mann‐Whitney U tests), but not during the guided phase. Compulsive behaviours remain unchanged. Moreover, looking for correlations between behavioural disinhibition and activity related behaviours or motor patterns, we found out that: 1) social disinhibition would be less present during activity (eg, reading), 2) there would be less compulsivity when patients are dealing with the questionnaire, and 3) impulsivity would increase during exploration of the room (eg, books).ConclusionThis study relying on a semi‐ecological setting highlights interesting areas for non‐pharmacological treatments of behavioural disturbances in bvFTD, consistent with previous studies encouraging concentration on a given task, hobbies or a tidy environment to reduce undesired behavioural symptoms in dementia.

Caring for behavioral symptoms of dementia (CBD): A new investigation into cannabidiol for the treatment of anxiety and agitation in Alzheimer’s dementia

AbstractBackgroundAnxiety and agitation symptoms affect 25‐70% of the dementia population, though there are no FDA‐approved medications that treat the behavioral symptoms of AD. Thus, the need for developing safe and efficacious treatments for anxiety and agitation in AD is dire. One potential treatment is cannabidiol (CBD), the major non‐intoxicating constituent of cannabis sativa, a variety of the cannabis plant that contains &lt;0.3% delta9‐tetrahydrocannabinol (THC), the main intoxicating constituent in cannabis, by weight. The present open‐label clinical trial seeks to address this gap in knowledge by assessing the efficacy and tolerability of a high‐CBD/low‐THC sublingual solution as a treatment for anxiety and agitation in older adults with Alzheimer’s disease.MethodAn 8‐week open‐label clinical trial of an industrial hemp‐derived high‐CBD/low‐THC sublingual solution. This includes 12 research participants with AD and symptoms of anxiety with or without agitation. Our primary efficacy outcome measures include the anxiety domain of the Neuropsychiatric Inventory‐Clinician Version (NPI‐C) and the Generalized Anxiety Disorder‐7 Item Scale (GAD‐7). Our secondary safety outcome measures include monitoring for serious adverse events and medication side effects, cognitive decline estimates from the Mini Mental Status Exam (MMSE), and the emergence of possible delirium from the Confusion Assessment Method (CAM). Scores on the NPI‐C, the Cohen‐Mansfield Agitation Inventory (CMAI), and caregiver burden estimates from the Zarit Caregiver Burden Interview will be included as additional exploratory measures.ResultsWe hypothesize that twice daily treatment with a high‐CBD/low‐THC solution in older adults with AD for 8 weeks will be associated with a statistically significant reduction in anxiety and agitation symptoms compared to baseline, as measured by our efficacy outcome measurements. We predict that the solution will be well‐tolerated by the study population, as measured by our safety outcome measurements.ConclusionWith no current FDA‐approved treatments for these behavioral symptoms, patients with AD risk ineffective therapies or mortality‐associated antipsychotic treatments to address their NPS. Treating anxiety and agitation in these patients not only alleviates their symptoms but could also reduce caregiver burden and lengthen the time to institutionalization. CBD is a promising anxiolytic treatment that could advance our available treatment options for anxiety and agitation in AD.

Using Sensor Technology to Detect and Monitor Behavioral Symptoms of Dementia

Using Sensor Technology to Detect and Monitor Behavioral Symptoms of Dementia

No impact of COVID-19 lockdown on clinical status of elderly with cognitive impairment or dementia using a structured phone-based assessment

Aim of the study was to investigate by a standardized telemedicine protocol the impact of prolonged lockdown on cognitive and behavioral symptoms of dementia (BPSD) in a consecutive series of patients with cognitive decline.

The functional role of cerebellum in visual hallucinations

The role of the cerebellum in behavioral symptoms of dementia is still largely unknown. We explore cerebellar structural and metabolic correlates of visual hallucination in dementia-with-Lewy bodies(DLB)-related VH.