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Factors Affecting Verbal Agitation in Dementia Patients Living in Nursing Homes, South Korea

DOI: 10.4236/ojn.2018.86028, PP. 339-354

Keywords: Dementia, Nursing Home, Psychomotor Agitation

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The purpose of this study using secondary data analysis was to identify factors affecting verbal agitation in patients with dementia staying at nursing home. This study is a secondary analysis of an existing original quantitative data set (n = 193). A total of 166 subjects’ data were included in this current study after 27 subjects’ data were excluded from the original data because they did not appear verbal agitation. Multiple regression analyses identified hallucination (β = 0.27), total number of physiologic discomforts (β = 0.19) and pain (β = 0.17) as significant predictors of verbal agitation and these factors explained 27.8% of the variance in the model. The findings of this study showed that hallucination, total number of physiologic discomforts and pain with dementia need to be considered when intervention programs to control verbal agitation in patients with dementia were developed.


[1]  Statistics Korea (2016) 2015 Elderly People Statistics.
[2]  John, A.F., Korten, A.E. and Henderson, A.S. (1987) The Prevalence of Dementia: A Quantitative Integration of the Literature. Acta Psychiatrica Scandinavica, 76, 465-479.
[3]  National Institution of Health (2003) Progress Report on Alzheimer’s Disease, USA.
[4]  Ministry of Health & Welfare (2012) National Dementia Strategy 2013-2015.
[5]  Kong, E.H., Evans, L.K. and Guevara, J.P. (2009) Nonpharmacological Intervention for Agitation in Dementia: A Systematic Review and Meta-Analysis. Aging & Mental health, 13, 512-520.
[6]  Kong, E.H. and Park, M. (2015) Effects of Music Therapy on Agitation in Dementia: Systematic Review and Meta-Analysis. Korean Journal of Adult Nursing, 27, 106-116.
[7]  Cohen-Mansfield, J. and Billig, N. (1986) Agitated Behaviors in the Elderly: I. A Conceptual Review. Journal of the American Geriatrics Society, 34, 711-721.
[8]  Cohen-Mansfield, J. (2008) Agitated Behavior in Persons with Dementia: The Relationship between Type of Behavior, its Frequency, and Its Disruptiveness. Journal of Psychiatric Research, 43, 64-69.
[9]  Schreiner, A.S. (2001) Aggressive Behaviors among Demented Nursing Home Residents in Japan. International Journal of Geriatric Psychiatry, 16, 209-215.<209::AID-GPS314>3.0.CO;2-9
[10]  Gang, M., Park, H. and Park, H. (2016) Factors Affecting Agitation in Nursing Home Patients with Dementia. Journal of Korean Gerontological Nursing, 18, 41-52.
[11]  Kim, K.A. (2003) Development of an Assessment Tool of Problematic Behaviors for Institutionalized Old People with Dementia. Unpublished Doctor’s Thesis, Seoul University, Seoul.
[12]  Kong, E.H. (2005) Agitation in Dementia: Concept Clarification. Journal of Advanced Nursing, 52, 526-536.
[13]  Cohen-Mansfield, J., Marx, M.S. and Werner, P. (1992) Agitation in Elderly Persons: An Integrative Report of Findings in a Nursing Home. International Psychogeriatrics, 4, 221-240.
[14]  Cohen-Mansfield, J. and Marx, M.S. (1992) The Social Network of the Agitated Nursing Home Resident. Research on Aging, 14, 110-123.
[15]  Cohen-Mansfield, J. and Libin, A. (2005) Verbal and Physical Non-Aggressive Agitated Behaviors in Elderly Persons with Dementia: Robustness of Syndromes. Journal of Psychiatric Research, 39, 325-332.
[16]  Pelletier, I.C. and Landreville, P. (2007) Discomfort and Agitation in Older Adults with Dementia. BMC Geriatrics, 7, 27.
[17]  Zuidema, S.U., de Jonghe, J.F., Verhey, F.R. and Koopmans, R.T. (2009) Predictors of Neuropsychiatric Symptoms in Nursing Home Patients: Influence of Gender and Dementia Severity. International Journal of Geriatric Psychiatry, 24, 1079-1086.
[18]  Kang, Y.S. (2000) A Study on Disturbing Behaviors of Demented Elderly Staying at Home. Journal of Korean Community Nursing, 11, 453-469.
[19]  Algase, D.L., Beck, C., Kolanowski, A., Whall, A., Berent, S., Richards, K. and Beattie, E. (1996) Need-Driven Dementia-Compromised Behavior: An Alternative View of Disruptive Behavior. American Journal of Alzheimer’s Disease, 11, 10-19.
[20]  Suh, G.H. (2004) Agitated Behaviours among the Institutionalized Elderly with Dementia: Validation of the Korean Version of the Cohen-Mansfield Agitation Inventory. International Journal of Geriatric Psychiatry, 19, 378-385.
[21]  Kang, Y.W., Na, D.L. and Hahn, S.H. (1997) A Validity Study on the Korean Mini-Mental State Examination (K-MMSE) in Dementia Patients. Journal of the Korean Neurological Association, 15, 300-308.
[22]  Folstein, M.F., Folstein, S.E. and McHugh, P.R. (1975) Mini-Mental State: A Practical Method for Grading the Cognitive State of Patients for the Clinician. Journal Psychiatry Research, 12, 189-198.
[23]  Holden, U.P. and Sinebruchow, A. (1978) Reality Orientation Therapy: A Study Investigating the Value of this Therapy in the Rehabilitation of Elderly People. Age and Ageing, 7, 83-90.
[24]  Gang, M.H. (2005) Effects of Horticultural Intervention Program on Cognition, Emotion, Communication and Problematic Behavior in Older Adults with Alzheimer. Unpublished Doctor’s Thesis, Chungnam National University, Daejeon.
[25]  Won, C.W., Yang, K.Y., Rho, Y.G., Kim, S.Y., Lee, E.J., Yoon, J.L., et al. (2002) The Development of Korean Activities of Daily Living (K-ADL) and Korean Instrumental Activities of Daily Living (K-IADL) Scale. Journal of the Korean Geriatrics Society, 6, 107-120.
[26]  Hurley, A.C., Volicer, B.J., Hanrahan, P.A., Houde, S. and Volicer, L. (1992) Assessment of Discomfort in Advanced Alzheimer Patients. Research in Nursing & Health, 15, 369-377.
[27]  Kim, S.J. (2006) A Study on Pain-Causing Factors for the Dementia Suffering with Aged Women. Unpublished Master’s Thesis, Chung-Ang University, Seoul.
[28]  Alexopoulos, G.S., Abrams, R.C., Young, R.C. and Shamoian, C.A. (1988) Cornell Scale for Depression in Dementia. Biological Psychiatry, 23, 271-284.
[29]  Kim, K.U. (2005) Dementia Care Assessment Packet. The Korean Association for Dementia, Seoul.
[30]  Cummings, J.L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D.A. and Gornbein, J. (1994) The Neuropsychiatric Inventory Comprehensive Assessment of Psychopathology in Dementia. Neurology, 44, 2308-2308.
[31]  Choi, S.H., Na, D.L., Kwon, H.M., Yoon, S.J., Jeong, J.H. and Ha, C.K. (2000) The Korean Version of the Neuropsychiatric Inventory: A Scoring Tool for Neuropsychiatric Disturbance in Dementia Patients. Journal of Korean Medical Science, 15, 609-615.
[32]  Buffum, M.D., Miaskowski, C., Sands, L. and Brod, M. (2001) A Pilot Study of the Relationship between Discomfort and Agitation in Patients with Dementia. Geriatric Nursing, 22, 80-85.
[33]  Talerico, K.A., Evans, L.K. and Strumpf, N.E. (2002) Mental Health Correlates of Aggression in Nursing Home Residents with Dementia. The Gerontologist, 42, 169-177.
[34]  Cohen-Mansfield, J., Werner, P., Watson, V. and Pasis, S. (1995) Agitation among Elderly Persons at Adult Day-Care Centers: The Experiences of Relatives and Staff Members. International Psychogeriatrics, 7, 447-458.
[35]  Leonard, R., Tinetti, M.E., Allore, H.G. and Drickamer, M.A. (2006) Potentially Modifiable Resident Characteristics That Are Associated with Physical or Verbal Aggression among Nursing Home Residents with Dementia. Archives of Internal Medicine, 166, 1295-1300.
[36]  Volicer, L., Frijters, D.H. and Van der Steen, J.T. (2012) Relationship between Symptoms of Depression and Agitation in Nursing Home Residents with Dementia. International Journal of Geriatric Psychiatry, 27, 749-754.
[37]  Hahn, S.J. and Paik, N.J. (2015) Pharmacological Treatment of Dementia. Brain & Neurorehabilitation, 8, 19-23.
[38]  Kunik, M.E., Snow, A.L., Davila, J.A., Steele, A.B., Balasubramanyam, V., Doody, R.S., et al. (2010) Causes of Aggressive Behavior in Patients with Dementia. The Journal of Clinical Psychiatry, 71, 1145-1152.
[39]  Chang, S.O. (2007) Development and Effect of Pain Management Protocol for Nursing Home Patients with Dementia. Journal of Korean Academy of Fundamentals of Nursing, 14, 29-43.
[40]  Kim, S.J., Ryoo, E.N. and Park, K.S. (2007) A Study on Pain, Physical Function, Cognitive Function, Depression and Agitation in Elderly Women with Dementia. Journal of Korean Academy of Adult Nursing, 19, 401-412.
[41]  Cohen-Mansfield, J. and Creedon, M. (2002) Nursing Staff Members’ Perceptions of Pain Indicators in Persons with Severe Dementia. The Clinical Journal of Pain, 18, 64-73.
[42]  Kim, E.J. (2006) Nurses’ Attitudes and Perceptions of Pain in Patients with Severe Dementia. Clinical Nursing Research, 12, 159-167.
[43]  Menon, A.S., Gruber-Baldini, A.L., Hebel, J.R., Kaup, B., Loreck, D., Itkin Zimmerman, S., et al. (2001) Relationship between Aggressive Behaviors and Depression among Nursing Home Residents with Dementia. International Journal of Geriatric Psychiatry, 16, 139-146.<139::AID-GPS284>3.0.CO;2-5


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