Psychological Symptoms Of Dementia Research Articles

Effect of virtual-reality-based education program for managing behavioral and psychological symptoms of dementia: A randomized controlled trial

This study aims to evaluate the effect of the virtual-reality-based education program (VR-EduBPSD) for managing behavioral and psychological symptoms of dementia (BPSD). Sixty-six family caregivers of people with dementia were randomly assigned to either the experimental or control group following a 1:1 ratio. The experimental group received VR-EduBPSD while the control group received analogous paper-based educational materials. The outcome measures were competence in managing BPSD, dyadic relationship, caring self-efficacy, attitudes toward dementia, and behavior management skill. Only the ‘awareness of symptoms’ sub-scale score for competence in managing BPSD showed a significant group-by-time interaction. Significant time effects were also observed on the total and sub-scale scores for competence in managing BPSD, as well as on the dyadic relationship. This program, which utilizes high-immersion VR technology, offers a valuable learning experience for those new to the care of people with dementia. This study was registered at cris.nih.go.kr with number of KCT0006788.

Perceived health and working life in caregivers from nursing homes that used or did not use nighttime personalized non-pharmacological therapies to address residents’ behavioral and psychological symptoms of dementia

Dementia is frequent in nursing home (NH), affecting between 40 and 50 % of the residents and is associated in 90 % of the cases with behavioral and psychological symptoms (BPSD) which are detrimental to caregivers’ working life and perceived health. We compared perceived health and working life between NHs that used or did not use nighttime personalized non-pharmacological therapies (PNPT) to address BPSD. This anonymous survey included 96 caregivers from 25 NHs which used (n = 69) or not (n = 27) nighttime PNPT. Perceived health, nursing and medical care, quality of care and internal motivation were significantly higher, stress symptoms and workload were significantly lower and there was a tendency to enhanced satisfaction with work in caregivers from NHs which used nighttime PNPT. Our present data open a new window on the benefits of PNPT.

HCA PIECESTM Care Coach Program: Peer to peer approach to promote person-centred care in long-term care

In Long-Term Care (LTC) settings, the potentially inappropriate use of antipsychotics for behavioural and psychological symptoms of dementia is a persistent issue, with high rates despite limited benefit and serious risk. Best practice is a non-pharmacological, person-centred approach to care, though this can be challenging in LTC settings. To help address this gap, we developed the PIECESTM HCA Care Coach Program and described its implementation and outcomes observed at 13 LTC homes. This program empowers Health Care aides with training, tools, and processes to practice the principles of person-centred care and provide peer mentorship to the care team. After 1 year, we found declining antipsychotics use (by 4.4%) and positive indicators of improved staff experience and improved resident quality of life. The Care Coach Program can be adapted and spread to a variety of LTC settings to help reduce potentially inappropriate antipsychotic use and better support people living with dementia.

Discontinuation of Alzheimer Disease Medications in Patients Receiving Home Care Medicine.

There is no consensus on how long antidementia medications should be administered to patients with Alzheimer disease (AD). To clarify this issue, we investigated the discontinuation of antidementia medications in Japanese home care settings, including community-dwelling and institutionalized patients. Using medical records from April 2017 to March 2022 at 3 clinics in Tokyo and Chiba prefectures, we selected patients with AD who started receiving home care medicine. Forty-nine patients discontinued antidementia medications during the observation period, there was no apparent deterioration in cognitive function or new occurrence of behavioral and psychological symptoms of dementia caused by the discontinuation of medications. More aggressive discontinuation of AD medications probably is recommended for patients with activities of daily living dysfunction, such as those receiving home care medicine.

Knowledge, Attitude, and Practice of Care Providers Toward Non-Pharmacological Intervention for Managing Behavioural and Psychological Symptoms in Australian Aged Care Residents with Dementia: A Cross-Sectional Survey

ABSTRACT Objectives This study aimed to assess the knowledge, attitude, and practice of the healthcare professionals and paid caregivers toward non-pharmacological interventions (NPIs) for managing behavioural and psychological symptoms of dementia (BPSD) in Australian residential aged care homes (RACHs). Methods A cross-sectional, online survey was completed by RACH staff and physicians over the period 6 March-31 August 2023. Descriptive statistics were used to present the results. Results Ninety-six respondents participated (41.7% aged 35–54 years, 80.2% female, 38.5% nurses). While 50–65% of the respondents were extremely familiar with 15 of NPIs, only 22% believed there was a sufficient funding for their implementation, and 6% felt there were sufficient human resources. Although 66% of the respondents viewed NPIs as more useful than medications, only 46% expected consistent positive outcomes from NPIs. The most used NPIs were redirection, behaviour management, and validation therapy. Conclusions The study highlights that barrier such as inadequate funding, limited human resources, skepticism about NPIs’ effectiveness, unfamiliarity with certain NPIs, and unfavourable attitude toward NPIs are likely to slow NPI adoption for BPSD management. Clinical implication To improve practice, it is essential to address these barriers through targeted education, and training, increased funding, and enhancement of the workforce.

The Impact of Behavioral and Psychological Symptoms of Dementia on Individual's Autonomy: a Scoping Review.

The purpose of this study was to identify, map, summarize, and clarify the existing literature on the effects of behavioral and psychological symptoms of dementia (BPSD) an individual's autonomy across all types of dementia diagnoses. The study aimed to determine whether there is a correlation between BPSD and a decrease in a person's autonomy, as this relationship is important for improving dementia care through effective interventions. To achieve this goal, a scoping review was conducted using the Joanna Briggs Institute's methodology for scoping reviews and the PRISMA extension for scoping reviews checklist. The inclusion criteria were: (i) population: participants with a clinical diagnosis of any type of dementia; (ii) concept: examining the relationship between one or more neuropsychiatric symptoms or BPSD and the individual's autonomy; (iii) context: the progress of any type and any stage of dementia. The database search yielded 74 records, of which 41 fully met the pre-established eligibility criteria. Most studies in this review focused on participants with Alzheimer's disease and analysed their functional abilities. Most studies in this review showed significant outcomes regarding the impact of BPSD on a person's autonomy. The main BPSD investigated in the studies were depression, apathy, irritability, agitation, aggression, disinhibition, and lability. Apathy had a recurrent association with reduced autonomy in persons with dementia, while depression and psychosis were also found to have an impact on individuals' autonomy.

Racial differences in the quality of care interactions among nursing home residents with dementia

ABSTRACT Objective The resident population in nursing homes is increasingly racially diverse. The purpose of this study was to assess racial differences in the quality of care interactions among nursing home residents with dementia. Design The study utilized baseline data from the Testing the Evidence Integration Triangle for Behavioral and Psychological Symptoms of Dementia (EIT-4-BPSD), a randomized controlled pragmatic trial. The Quality of Interaction Scale (QuIS) was used to measure quality of staff-resident care interactions. The sample included 531 residents. An analysis of covariance was conducted to address the aim. Results The majority of interactions were positive social (42%) or positive care (37%). Black residents living with dementia had higher QuIS scores (M = 5.98, SD = 1.66) than White residents with dementia (M = 5.40, SD = 1.75), whereas higher QuIS scores indicating more positive interactions. However, the results of the analysis of covariance indicated that there was not a significant difference in QuIS scores between Black versus White residents living with dementia (p =.203). Conclusion The findings suggest that care interactions in nursing homes are consistent between Black residents and White residents. Future research should evaluate the impact of staff race on the quality of care interaction among nursing home residents.

The development of an intradisciplinary staff training intervention on the optimal management of behavioural and psychological symptoms of dementia: A qualitative study

Introduction: Behavioural and psychological symptoms of dementia (BPSDs) are a group of highly prevalent symptoms in residents with a neurocognitive disorder (NCD), including agitation and depressive symptoms. Caregiving staff often mention knowledge and skills deficits regarding optimal BPSD management. While several staff trainings on BPSDs management exist internationally, their transferability to other clinical contexts is limited, owing to methodological challenges. Therefore, to address this implementation gap, there is a strong need for trainings based on high-quality research to strengthen existing evidence, ensure feasibility and reproducibility. Methods: This qualitative study, part of a larger research project, occurred in 2022 on a long-term care (LTC) center unit and an alternate level of care (ALT) hospital unit located in the Province of Quebec, Canada. This study aimed to: 1) evaluate the needs and perceptions of staff caregivers regarding BPSD management, 2) identify the training content and modalities to prioritize according to experts, 3) develop an intradisciplinary training on BPSD management, and 4) pretest the preliminarily version of the training. Objectives one and two were evaluated using focus groups and objective four using individual cognitive interviews. Qualitative interview data was audio-recorded with participants’ consent, transcribed verbatim, and thematically content analyzed using an established method. Results: Overall, thirteen caregivers participated in objective one (8 from the LTC unit, and 6 from the ALT unit). The main staff training need identified on each site was the management of resident’s aggressive behaviours. Staff verbalized a preference for a virtual training. Objective 2 involved a panel of eight experts. Experts recommended the use of an online training platform, and certain training models and indicators. Based on caregivers and experts’ input, five interactive online staff training capsules lasting from 20-25 minutes each and an algorithm guiding the evaluation and management of BPSDs were created. The training capsules and the algorithm were iteratively improved following cognitive interviews with 4 caregivers from the participating sites. Conclusion: An interactive virtual staff training on BPSD management was created based on staff and expert consultation. The next step in investigation will be to evaluate the feasibility and acceptability of the training.

Subsyndromes and symptom clusters: Multilevel factor analysis of behavioral and psychological symptoms of dementia with intensive longitudinal data.

Behavioral and psychological symptoms in dementia (BPSD) are dynamic phenomena with a high amount of intraindividual variability. We applied a multilevel framework to identify subsyndromes (between-person factors) that represent clinically relevant profiles of BPSD and identify symptom clusters (within-person factors) that represent contextually driven daily symptom experiences. This study used an intensive longitudinal design in which 68 co-residing family caregivers to persons living with dementia were recruited to proxy report on their care recipient's daily symptom experiences of 23 different BPSD for eight consecutive days (n=443 diaries). A multilevel exploratory/confirmatory factor analysis was used to account for nested data and separate within-person variances from between-level factor estimates. Exploratory factor analysis identified a 4-between 3-within factor structure based on fit statistics and clinical interpretability. This study offers major methodological and conceptual advancements for management of BPSD within Alzheimer's disease and related dementias by introducing two related but distinct concepts of subsyndromes and symptom clusters. Because behavioral and psychological symptoms of dementia (BPSD) are dynamic temporal phenomenon, this introduces measurement error into aggregate group-level estimates when trying to create subsyndromes. We propose a multilevel analysis to provide a more valid and reliable estimation by separating out variance due to within-person daily fluctuations. Using a multilevel exploratory factor analysis with intensive longitudinal data, we identified distinct and meaningful groups of BPSD. The four factors at the between-person level represented subsyndromes that are based on how BPSD co-occurred among persons with Alzheimer's disease (AD). These subsyndromes are clinically relevant because they share features of established clinical phenomena and may have similar neurobiological etiologies. We also found three within-person factors representing distinct symptom clusters. They are based on how BPSD clustered together on a given day for an individual with AD and related dementias. These clusters may have shared environmental triggers.

Therapeutic Doll Interventions for People Living with Dementia in Care Homes: A Scoping Review.

Doll therapy is a psychosocial intervention that has been commonly used within dementia care for many decades. The practice of doll therapy involves supporting people with dementia to engage with a therapeutic doll and this has been associated with positive changes in a person's wellbeing and behavior. While there have been several systematic reviews that have focused on behavioral outcomes, limited reviews have explored the broader psychosocial outcomes associated with doll therapy in care home settings. A scoping review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). Four electronic databases were searched systematically (CINAHL Plus, Medline, PsycINFO, and PubMed). Twelve primary research studies from the past ten years (2013-2023) were included in this review. Primary data were synthesized using a narrative synthesis methodology. The three main themes from this review relate to a reduction in levels of behavioral and psychological symptoms of dementia (BPSD), increased communication skills, and a reduction in caregiver distress. Doll therapy has the potential to be an effective person-centered intervention that can enhance quality of life for people living with dementia in care home settings.

Clinical and Market Analysis of NanoBEO: A Public-Worth, Innovative Therapy for Behavioral and Psychological Symptoms of Dementia (BPSD)-Emerging Evidence and Its Implications for a Health Technology Assessment (HTA) and Decision-Making in National Health Systems.

According to scientific literature, some 99% of patients affected by Alzheimer's disease (AD) suffer from behavioral and psychological symptoms of dementia (BPSD), also known as neuropsychiatric symptoms (NPSs). In particular, agitation is one of the most difficult disorders to treat. States of agitation represent a very serious problem as they make these subjects dangerous for themselves and others and worsen as the disease advances. To date, there are no specific solutions for treating agitation. The only authorized drug is risperidone (as well as brexpiprazole, approved by the FDA on 11 May 2023), which can be used for no longer than 6-12 weeks because it increases the risk of death-owing to cardiocerebrovascular accidents-by 1.6-1.7 times. In order to address the latter noteworthy unmet medical need, NanoBEO was produced. The aim of the present work is to generate the health technology assessment (HTA) of this nanotechnological device. The latter consists of a controlled release system, based on solid lipid nanoparticles loaded with bergamot essential oil (BEO). The results of the present research assessed the current evidence in the field of non-pharmacological treatments for this condition, including relevant primary preclinical and clinical data studies supporting the use of this device and the production of the operative plan for its launch on the market. The findings offer recommendations for decision-making on its implementation in dementia. NanoBEO represents a public-worth innovation in this neglected area, marking a significant advancement in the history of dementia, moving from academic research to product development.

Understanding Family Caregivers' Needs in Coping with the Behavioral and Psychological Symptoms of People with Dementia: A Hermeneutic-Phenomenological Study.

Alzheimer's disease and related dementias (ADRD) are progressive conditions. Family caregivers of patients, especially those caring for patients with ADRD exhibiting behavioral and psychological symptoms of dementia (BPSD), undergo significant physical and mental changes during long-term care. While most researchers have focused on the specific needs of family caregivers, the comprehensive understanding of these needs is limited. In this study, Alderfer's existence, relatedness, and growth theory was used to develop an interview framework to systematically and comprehensively understand the needs of family caregivers of individuals with ADRD. The objective of this study was to understand family caregivers' needs in coping with BPSD in individuals with ADRD, aiming to alleviate caregivers' stress and promote their overall well-being. This study used a hermeneutic-phenomenological interview research design. Data were collected via remote conferences involving interviews with 17 participants selected via maximum variation sampling. The Colaizzi seven-step method was utilized, and the interview contents were analyzed using NVivo 12.0 software. The needs of family caregivers in coping with the BPSD of individuals with ADRD could be summarized into three themes, namely existence needs, relatedness needs, and growth needs, and 10 sub-themes. The study findings provide new insights into the needs of family caregivers in coping with patients exhibiting BPSD. Family caregivers experience significant negative emotions, poor caregiving experiences, heavy caregiving burdens, and a desire for professional assistance and policy support.

Workload-Related Issues among Nurses Caring for Patients with Behavioral and Psychological Symptoms of Dementia: A Scoping Review.

As the elderly population grows, the prevalence of dementia is rising, with 70-95% of patients in hospital settings exhibiting problematic behaviors such as aggression. These behaviors significantly contribute to increased nursing workloads, affecting nurses' well-being and patient care quality. This study aims to review workload-related issues among nurses caring for dementia patients, highlighting the need for targeted interventions to mitigate stress and improve care quality. A scoping review was conducted using the five-stage framework of Arksey and O'Malley. The literature search covered studies published between 2013 and 2023, focusing on quantitative research about nurses' workload-related stress when managing patients with dementia and problematic behaviors. Databases such as PubMed and PsycINFO were searched, and 13 studies were selected based on predefined inclusion and exclusion criteria. The review revealed that problematic behaviors, particularly aggression, significantly increase nurses' stress and workload. This stress has negative consequences on nurses' physical and mental health, often leading to burnout, decreased job satisfaction, and a decline in care quality. Inadequate staffing and support systems exacerbate these issues. Targeted education, sufficient staffing, and support are essential to reduce the workload and stress experienced by nurses caring for dementia patients. Implementing these strategies can enhance the quality of care provided and improve the well-being of healthcare professionals.

Prescribing Trends and Associated Outcomes of Antiepileptic Drugs and Other Psychotropic Medications in US Nursing Homes: Proposal for a Mixed Methods Investigation.

Pilot data suggest that off-label, unmonitored antiepileptic drug prescribing for behavioral and psychological symptoms of dementia is increasing, replacing other psychotropic medications targeted by purposeful reduction efforts. This trend accelerated during the COVID-19 pandemic. Although adverse outcomes related to this trend remain unknown, preliminary results hint that harms may be increasing and concentrated in vulnerable populations. Using a mixed methods approach including both a retrospective secondary data analysis and a national clinician survey, this study aims to describe appropriate and potentially inappropriate antiepileptic and other psychoactive drug prescribing in US nursing homes (NHs), characteristics and patient-oriented outcomes associated with this prescribing, and how these phenomena may be changing under the combined stressors of the COVID-19 pandemic and the pressure of reduction initiatives. To accomplish the objective, resident-level, mixed-effects regression models and interrupted time-series analyses will draw on cohort elements linked at an individual level from the Centers for Medicare and Medicaid Services' (CMS) Minimum Data Set, Medicare Part D, Medicare Provider Analysis and Review, and Outpatient and Public Use Files. Quarterly cohorts of NH residents (2009-2021) will incorporate individual-level data, including demographics; health status; disease variables; psychotropic medication claims; comprehensive NH health outcomes; hospital and emergency department adverse events; and NH details, including staffing resources and COVID-19 statistics. To help explain and validate findings, we will conduct a national qualitative survey of NH prescribers regarding their knowledge and beliefs surrounding changing approaches to dementia care and associated outcomes. Funding was obtained in September 2022. Institutional review board exemption approval was obtained in January 2023. The CMS Data Use Agreement was submitted in May 2023 and signed in March 2024. Data access was obtained in June 2024. Cohort creation is anticipated by January 2025, with crosswalks finalized by July 2025. The first survey was fielded in October 2023 and published in July 2024. The second survey was fielded in March 2024. The results are in review as of July 2024. Iterative survey cycles will continue biannually until December 2026. Multidisciplinary dissemination of survey analysis results began in July 2023, and dissemination of secondary data findings is anticipated to begin January 2025. These processes are ongoing, with investigation to wrap up by June 2027. This study will detail appropriate and inappropriate antiepileptic drug use and related outcomes in NHs and describe disparities in long-stay subpopulations treated or not treated with psychotropics. It will delineate the impact of the pandemic in combination with national policies on dementia management and outcomes. We believe this mixed methods approach, including processes that link multiple CMS data sets at an individual level and survey-relevant stakeholders, can be replicated and applied to evaluate a variety of patient-oriented questions in diverse clinical populations. DERR1-10.2196/64446.

Effectiveness of a mobile app-based individualized non-pharmacological intervention on behavioral and psychological symptoms of dementia in community-dwelling older adults: Study protocol for a randomized control trial

Effectiveness of a mobile app-based individualized non-pharmacological intervention on behavioral and psychological symptoms of dementia in community-dwelling older adults: Study protocol for a randomized control trial

A multimodal non-pharmacological intervention for persons with dementia in nursing homes: a multicentre randomised controlled trial.

Persons with dementia in nursing homes often experience cognitive decline (e.g., memory and visuospatial/construction problems), behavioural and psychological symptoms of dementia (BPSD), and impaired activities of daily living. Therefore, comprehensive interventions for this population are needed. We assessed whether a multimodal non-pharmacological intervention improved cognitive functions, BPSD, and activities of daily living in persons with dementia in nursing homes. This was a multicentre randomised controlled trial. Participants were 40 persons with dementia (38 women) living in four nursing homes (intervention group = 21; control group = 19). The intervention was conducted for 8 weeks, followed by an 8-week follow-up. Outcome measures were scores on the Japanese version of the Neurobehavioral Cognitive Status Examination Five and the ABC Dementia Scale. In the analysis, parameters were estimated using Bayesian statistics and a mixed-effects linear regression model for the change in each outcome measure. There were significant between-group differences in changes in ABC Dementia Scale BPSD scores (8-week: posteriori median = 1.66, 95% Bayesian confidence interval 0.36-3.01; 16-week: median = 2.37, 95% Bayesian confidence interval 0.05-4.65). There was also a significant between-group difference in changes in Neurobehavioral Cognitive Status Examination Five constructional ability scores (16-week: median = 0.93, 95% Bayesian confidence interval 0.35-1.50). This intervention may have a maintenance and improvement effect on BPSD in persons with dementia in nursing homes, and a sustained effect on constructional ability post-intervention. The intervention may be useful and easy to apply in practice.

Group Reminiscence Therapy for Dementia to Improve Well-Being and Reduce Behavioral Symptoms.

The global increase in dementia cases highlights the urgent need for effective treatment and care strategies. The aim of this study was to evaluate the effects of group reminiscence therapy on cognitive function, subjective well-being, and behavioral and psychological symptoms of dementia (BPSD) in older adults with moderate to severe dementia. A pre-post comparative design was used, with 49 participants receiving eight group reminiscence therapy sessions over 4 weeks. Baseline, one-week, and one-month postintervention assessments were conducted using the Hasegawa Dementia Scale-Revised (HDS-R), the Neuropsychiatric Inventory-Nursing Home Version (NPI-NH), and the Philadelphia Geriatric Center Morale Scale (PGC Morale Scale). The results showed no significant improvement in HDS-R scores, but significant improvements in PGC Morale Scale (p = 0.0417) and NPI-NH scores (p = 0.00226), indicating improved well-being and reduced BPSD. These findings suggest that group reminiscence therapy is effective in improving BPSD. Future research should focus on extending the duration of the intervention, including different populations, and combining group reminiscence therapy with other therapeutic approaches to fully determine its long-term benefits and mechanisms. Research on its cost-effectiveness and cultural applicability could further validate and improve the use of group reminiscence therapy in diverse care settings.

Shoulder Joint Range of Motion Related to Dementia

Introduction: Dementia is caused by various diseases, including Alzheimer’s disease dementia (ADD) and dementia with Lewy bodies (DLB). We often encounter patients with dementia who have limited shoulder joint range of motion (ROM), especially those with behavioral and psychological symptoms of dementia (BPSD). But the relationship between the diseases of dementia and restricted shoulder joint ROM is currently unclear. Methods: We examined cognitive function and shoulder joint ROM in 234 new outpatients at 7 memory clinics in Japan. We assessed cognitive function using the Mini-Mental State Examination (MMSE) and Revised Hasegawa Dementia Scale (HDS-R) and BPSD using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Patients were categorized by dementia diagnosis (ADD, DLB, other dementia, and control). Right, left, and total shoulder joint ROM was assessed using validated the Japanese Orthopaedic Association (JOA) score. Results: We found significant associations of lower right, left, and total shoulder joint ROM scores with male sex, advanced age, higher NPI-Q score, lower HDS-R, and MMSE scores. Little difference was found between right and left shoulder joint ROM scores. Restricted shoulder joint ROM was related to serial 7, verbal frequency domain scores on the HDS-R and repeat score on the MMSE. It was also related to the hallucinations, irritability/lability and nighttime disturbances scores on the NPI-Q. Furthermore, the dementia groups, especially the DLB group, showed worse shoulder joint ROM than the control group. Conclusions: Dementia was significantly related to restricted shoulder joint ROM. Maintaining communication and social interaction may help maintain shoulder joint ROM.

Oral health knowledge, attitudes, and practices of people living with mental illness: a mixed-methods systematic review

People living with mental illness experience poorer oral health outcomes compared to the general population, yet little is known about their oral health knowledge, attitudes, and practices. The aim of this mixed-methods systematic review was to synthesise evidence regarding oral health knowledge, attitudes, and practices of people living with mental illness to inform preventative strategies and interventions. Database searches were conducted in PubMed, MEDLINE, PsycINFO, CINAHL, ProQuest, and Scopus with no limitations placed on the year of study. All studies available in the English language, that explored the oral health knowledge, attitudes, and/or practices of people with a mental illness were included. Articles were excluded if they primarily pertained to intellectual disability, behavioural and psychological symptoms of dementia, drug and alcohol or substance use, or eating disorders. A thematic synthesis was undertaken of 36 studies (26 high-moderate quality), resulting in 3 themes and 9 sub-themes. Study participants ranged from n = 7 to n = 1095 and aged between 15–83 years with most having a diagnosis of schizophrenia, schizoaffective, or bipolar affective disorder. People diagnosed with a mental illness were found to have limited oral health knowledge, particularly regarding the effects of psychotropic medication. Various barriers to oral health care were identified, including high dental costs, the negative impact of mental illness, dental fears, lack of priority, and poor communication with dental and health care providers. Study participants often displayed a reduced frequency of tooth brushing and dental visits. The findings highlight the potential for mental health care providers, oral health and dental professionals, mental health consumers, and carers to work together more closely to improve oral health outcomes for people with mental illness. The systematic review protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO), (registration ID CRD42022352122).

Designing an mHealth application for informal carers concerning the management of behavioural and psychological symptoms of dementia: a need analysis survey

BackgroundInformal carers face difficulties and challenges when dealing with the behavioural and psychological symptoms of dementia (BPSD) of their family members or friends residing at home. Mobile health (mHealth) applications are promising for educating and supporting carers. However, needs analysis studies have not been conducted in Sri Lanka to develop mHealth applications for informal carers of people with dementia.AimsTo explore the needs to design an mHealth application for informal carers of people with dementia concerning the management of BPSD.MethodAn exploratory cross-sectional survey was conducted among a convenience sample (N = 203) of informal carers as a part of developing an mHealth application. Family members, relatives, or friends who lived with people with dementia and provided care on an unpaid basis for more than three months were included. The questionnaire included sociodemographic data, carer-rated prevalence and severity of BPSD, and informal carers’ knowledge of dementia, carer burden, information-seeking sources, availability of smartphones, mHealth information seeking and perception of mHealth information seeking related to managing BPSD. Descriptive analysis and inferential tests were performed.ResultsInformal carers of people with dementia were predominantly female (70.4%), and 64% showed low knowledge of dementia. Of the participants, 35% reported a high carer burden, 53.7% reported a low burden, and only 11.3% reported no carer burden. Most of their care recipients (97%) had at least one BPSD. The prevalence and severity of BPSD were significantly and positively correlated with the carer burden. The participants’ main source of information was health professionals. Most of them owned smartphones (63.5%), but none used mHealth applications for dementia-related information seeking. Approximately half of the respondents were ready to spend time (52.7%) and money (46.8%) on mHealth information seeking. Perceived mHealth usefulness was significantly associated with dementia knowledge, smartphone ownership, and readiness to spend time and money on mHealth information seeking.ConclusionInformal carers of people with dementia were affected by BPSD in their care recipients. This study explored carers’ educational needs concerning dementia, BPSD, and carer burden. Informal carers could adapt mHealth for dementia-related information seeking. Their unmet needs in managing BPSD should be explored.