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An analysis of the relationships among engagement, agitated behavior, and affect in nursing home residents with dementia

Published online by Cambridge University Press:  06 January 2012

Jiska Cohen-Mansfield ,
Maha Dakheel-Ali ,
Barbara Jensen ,
Marcia S. Marx  and
Khin Thein
Jiska Cohen-Mansfield*
Affiliation:
Innovative Aging Research, Silver Spring, MD, USA George Washington University Medical Center, Washington, DC, USA Tel-Aviv University's, Herczeg Institute on Aging and Sackler Faculty of Medicine, Tel-Aviv, Israel
Maha Dakheel-Ali
Affiliation:
Innovative Aging Research, Silver Spring, MD, USA
Barbara Jensen
Affiliation:
Innovative Aging Research, Silver Spring, MD, USA
Marcia S. Marx
Affiliation:
Innovative Aging Research, Silver Spring, MD, USA
Khin Thein
Affiliation:
Innovative Aging Research, Silver Spring, MD, USA
*
Correspondence should be addressed to: Jiska Cohen-Mansfield, Innovative Aging Research, 807 Horton Drive, Silver Spring, MD 20902, USA. Phone: +301-649-3416; Fax: +301-649-4957. Email: InnovAgingRes@gmail.com.
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Abstract

Background: Affect, behavior, and cognition can be considered as basic constructs that dictate human functioning, with intricate and bi-directional relationships among them. Prior to the present study, relationships among these constructs have not been systematically examined within the context of dementia.

Methods: Sample 1 contained 185 nursing home residents with a diagnosis of dementia. Sample 2 contained 117 residents with dementia, all of whom manifested agitated behaviors. Outcome measures included stimulus engagement (assessed via the Observational Measure of Engagement), affect (measured using Lawton's Modified Behavior Stream), and agitation/problem behavior (recorded via the Agitated Behaviors Mapping Instrument). Real time direct observations were collected during both stimulus presentation and control conditions.

Results: The relationship of engagement with positive affect, represented by the variables of interest and pleasure, were high and positive. No relationship emerged for engagement with negative affect or agitated behavior. A consistent positive relationship was found between agitated behavior and negative affect, and in Sample 2, a negative relationship between agitated behavior and both pleasure and interest.

Conclusion: This is the first study to examine relationships among variables that are typically examined individually and, in doing so, has clarified the nomenclature used to describe the constructs of affect, engagement, and agitated behaviors in persons with dementia. The finding that the constructs of engagement, agitated behavior, and affect are multidimensional and that relationships among these constructs occur for some of the dimensions is important for the development of interventions and for clear communication in practice and research.

Keywords

dementianursing homesanxietyapathylong-term care
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 5 , May 2012 , pp. 742 - 752
Copyright
Copyright © International Psychogeriatric Association 2012

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